I thought I was beyond anger but that was before going on holiday which gave me the time to read the latest Andrew Lansley thriller: Equity and excellence: liberating the NHS.
Ok, I read the summary - the whole thing is over 600 riveting pages, specifically designed to minimise the chances of anyone actually reading it. I don’t want to be overly dramatic here, but my conclusion is that if these plans come to fruition, the NHS will be reduced to a brand name, under cover of which taxpayers’ money will be handed over to “any willing provider”, provided they are the cheapest.
The trust which the NHS name has earned will be exploited by any private company we’ve never heard of and know nothing about. So it’s goodbye to population-based assessment of healthcare needs, goodbye to national terms and conditions, and goodbye to anyone with an interest in improving public health by health promotion - after all more illness equals more business.
I also have a sneaking suspicion that we are being set up to fail. Uncomfortable funding decisions will be blamed on GPs and doctors, and when GP consortia go bankrupt, as seems likely given their lack of experience and the complexity of the task, private companies will be brought in to “rescue” the situation.
If you don’t believe me, or even if you do, read the BMA’s white paper summary yourself.
The white paper has yet to be debated in parliament, so now is our chance to voice concerns. At the very least you have to question the sanity of anyone you wants to destabilise a £100bn organisation without even a feeble attempt at a pilot - what private company would do that? And then there’s the value for money of the estimated (presumably on the back of the usual envelope) £1.7bn cost of the changes, at a time when we’re told we can’t even pay for collapsing school roofs.
Talking of recessions, we had a family gathering this week at which I realised that of the six adults of working age, only I had relatively secure employment. Two are facing redundancy from teaching jobs, my brother’s timber merchant firm laid him off last year, and the other two are PCT employees in public health.
This is the brave new world. I can think of only one solution - use my husband’s redundancy money to buy shares in the likes of United Healthcare UK - they’re certain winners!
Tags: Health policy
But If privatisation is the only way which can improve the situation for the doctors in training ,( like in the USA , where you have a rigorous training period , after which you can earn top income . ) I am up for it.
As for the managers and everyone else giving hard time to the clinical staff this should be bad news.
And also the public , who would have to pay more than what they are now.
But why treating everyone same when people are not equal , so not all deserve same type of care.
Some Deserve better.
Like Hard Working Doctors.
Like everquest I think the training issue is important, unlike everquest I have read the White paper and I think it will be disastrous. Also, everquest seems to think that US doctors are all millionaires, they are not. In fact, if you talk to GPs in the US you’ll get the impression that for many the job is thankless and (compared to here) underpaid.
The White paper is remarkably coy about training. It says that “all providers of healthcare will pay to meet the costs of education and training” and that there will be “a level playing field between providers”. ALL NHS hospitals will become non-publicly owned (ie private) not-for-profit companies (so called “social enterprises” - SEs). The “level playing field” is between (former NHS) SEs and private hospitals. This is spelt out in detail in the Conservative draft NHS bill from 2008.
What worries me is that currently SHAs provides some of the salaries of doctors in training (this is quoted as being between £10k and £100k pa per doctor, but the last government wanted a fixed payment of £40k pa per doctor). So where will this money come from when the SHAs are abolished? The White paper does not say, it just says that there will be a consultation document “in due course”.
I think that we will move to the US system, and junior doctors will have to take out seven figure loans to pay for ALL of their training costs. And then to progress further to consultant the doctor will have to take out another seven figure loan to pay for that training. This will drive salaries up, but since SEs will be extremely short of funding, the number of posts will be drastically cut.
So everquest, be very careful what you wish for.