A new philosophy for health services?

Martin Barkley said ” The purpose of these changes is to deliver better outcomes than in the past.” What does that mean?
Following the 2010 election which returned a Coalition Government of Conservatives and Liberal Democrats, the Department of Health was too busy with the torturous passage through the House of Commons and Lords of the Health and Social Care Bill, which became the Health and Social Care Act 2012, and took their eye off the ball, neglecting to commission training places in Universities for Doctors, nurses physiotherapists and other valuable and essential health professionals. This resulted in a national shortage which we are seeing today, in A&E surgeons, paediatricians, nurses and other staff.  The outcome may have been intentional. Michael Portillo speaking on the BBC Parliament channel following the election, said that the Conservatives kept quiet about their intentions for the health service because they knew that if their plans became known, they would not be elected. The intended change was to the fundamental foundation of what used to be the National Health Service, the Secretary of State’s duty to provide, which was removed and a system of contracting services out to tender to enable more profit making companies to siphon off the NHS revenue put in place with competition law operational.
Martin Barkley says that the Care Closer to Home model of service provision will be sustainable. This is government propaganda. What does sustainable mean?  The funding for the health service is a matter of choice. Government chooses to fund it or not. This government and the Coalition, chose not to.  Even when ‘Care Closer to Home’ is put in  place and Dewsbury Hospital downgraded, completely as planned for spring 2017, the government could choose to reduce funding still further. This is exactly what is happening with the mandatory and secretive Slash Trash and Plunder (STP) agenda, being worked up by the Councils, CCGs and Trusts, in West Yorkshire footprint number 5. The West Yorkshire STP has to save money as part of West Yorkshire’s share of the £22billion ‘efficiency savings.’
There is NO EVIDENCE to show that the cuts to hospital provision and services at home, are less expensive than inpatient stays. The pilots in Torbay were inconclusive.  In fact they may prove to be more expensive. The expenditure of the National Health Service model as it had been and the treatment it carried out, was consistently found  by OECD studies to be the most cost effective in the developed world, treating everyone according to need. This was the case even including the increased costs and associated difficulties caused by the marketised Foundation Trust system.
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Dr Kelly begins to outline what he describes as a “whole system change” in the NHS. What he describes, is chopping the services into tiny bits and letting private profit making companies provide the cheaper, less complex services,  such as the dermatology he mentioned http://www.priderm.co.uk and the opticians on the high street. This denies revenue to the Hospital Trust, destabilising it. A new contract announced after the public meeting for Musculo- Skeletal services has gone toprivate company  ConnectHealth, http://www.connecthealth.co.uk   redirecting even more revenue away from the Trust https://www.northkirkleesccg.nhs.uk/news/patients-shape-musculoskeletal-service./.  The ‘Right Care ‘ initiative mentioned is an import from the US. What does ‘redesigning therapies’ mean? The Right Care programme, is looking at money. Is this the first step to withdrawing what was once available?  The Royal College of Surgeons has criticised the policy of withdrawing treatments now evaluated as procedures of limited clinical effectiveness (PoLCE) or procedures of limited clinical value (PoLCV). There is no national list of these, as CCGs are free to choose which ones to fund and which to not. The Royal College of Surgeons states that the growing list is “extremely detrimental to patients across the NHS, removing equality of access to treatment, creating postcode lotteries, lowering the standard of care provided in the NHS and potentially reducing the quality of life for some patients.”*
Following the fragmentation described here, the architects of the STPlans want an Accountable Care Organisation (ACO) to put it back together, with the private sector cocooned and shareholding, in the provider structure.
Dr Kelly speaks of the Hospital Avoidance Team, going into hospitals to facilitate early discharge. What we have learned since the public meeting is that there is a postcode lottery with regard to what is on offer following a hospital stay and hospital nurses and other staff have to know where you live, because North Kirklees patients can not have what Wakefield patients get.
 

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