The government has no "credible plan" to make NHS savings of £20bn by 2014 aa committee of MPs warns today.
The figure would represent "unprecedented" efficiency gains if the quality of care is to be maintained, say the MPs.
Stephen Dorrell, the former Conservative health secretary who chairs the select committee, said the NHS chief executive, Sir David Nicholson, had warned that the 4% productivity improvements required by the £20bn cut had "never been achieved in the history of the NHS or any healthcare system in the world".
Let’s put it another way: the government is tasking NHS GPs, who are wholly unskilled to do the job, with the task of producing the greatest increase in efficiency in the history of world health care.
They’ll fail, as the government intends they should.
Then they’ll try privatisation on very long contracts that they hope no future government will dare reverse. That will fail too — but it won’t matter by then, they think — billions of public money will have been captured for private gain in perpetuity, which is what they want.
And in that way in full privatisation of the NHS will happen.
Except it won’t. Rioting —or violence will have stopped it well before then. When the President of the Royal College of GPs is already warning its members to expect to face anger and threats from their patients at their role in seeking to impose these impossible cuts the situation is going to implode long before we reach this situation.
But people will die on the way.
And that’s unnecessary.
And a ConDem choice.
The words “callous” and “bastards” come to mind. Nothing else does. They know what they’re doing.
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You are absolutely right. Of course the government now trades on lies, and this is another example of Newspeak. Nobody can believe for a moment that enormous savings can be made – by not cutting patient services. We know that we will all suffer, apart from the rich, of course.
From what I’ve seen on Lansley’s approach to NHS “reform”, Pickles on local government funding, Micky Gove on schools and ‘Slasher’ Osborne, the ConDems are either incredibly clever (in that they have a cunning plan to win the next election which we don’t know about), or incredibly stupid. For me, it looks like the latter.
Given that the govt has no coherent plan about how to improve any of these services – just to destroy them by upheaval and starving many of them of cash – I can’t see how they’re going to avoid huge declines in service quality, and becoming the most unpopular govt of all time. If I was a Tory or Lib Dem activist I’d actually be pretty annoyed about all this stuff – just from a narrow party political perspective – as it seems to me that these guys are throwing the next election away. Am I missing something?
They’re also getting rid of the independent living fund, a very small fund that helps those with severe disabilities to live at home, rather than in long term care. That’s the kind of “cut” that can only cost more to the NHS, and it’s impossible to imagine the ConDems don’t understand this. Which means it’s deliberate. A deliberate hit to some of the poorest, most vulnerable in society, which will have a direct cost to the NHS and social services.
You’re right – don’t ever get ill. Or old.
We are undoubtedly in Act 5 of Thatcherism. It will take the form of three scenes of uncertain length. First, the government proposes ‘less is more’ efficiency savings. Second, most of the general public comes slowly to the realisation that ‘less is less’. Third, it all ends nicely with some sort of ‘if less is more then just think how much more more is’ Keynesian stimulus. Hopefully.
Of course the ConDems know what they are doing. Apparently Lansley is in thrall to GPs, goodness knows why. Some GPs cannot run their own practices efficiently let alone be trusted with commissioning services for a wider population. Additionally, GPs are technically self employed not NHS employees although I believe they enjoy some of the perks of being NHS employees. If people care to remember, the Coalition Agreement stated there was to be no topdown reorganisation of the NHS yet this is precisely what is happening without any electoral mandate. The Coalition has more or less perpetrated a political coup on the British people.
Demographics.
Spending on healthcare is laregly a transfer of wealth, not from the wealthy to the poor, but from the young to the old. Just as the current baby boomers had free university education that they now want to deny to the following generations, so they are now fighting for free healthcare in their old age, in the knowledge that those who fund it for them will never have it for themselves.
I’m not sure I agree with the above, by the way. But it is entirely inaccurate?
“They’ll fail, as the government intends they should.”
Yes, I agree. This is being imposed knowing that it will fail, thus creating the conditions for phase II of health reform to be implemented.
For all the mistakes which Labour made in 13 years (don’t mention the wars), when you look at all the good socialist policies they put in place which are about to be trashed, I do wonder whether the electorate will appreciate what they lost when they booted out Gordon Brown. Benefits for young families, pensioners, the disabled were massively improved. Just one thing, the free nursery care for 3-5 year olds comes especially to mind. I remember well the time when only the comfortably off could afford to send their young children to nurseries. The Tories introduced vouchers which only the latter could then afford to top up. It seems that young parents in particular never gave a thought to the origin of this largesse and never thought to connect it with the polling booth. I wonder if they will when they’re all gone.
Its amazing how everyone is suddenly an expert in health economics. The reality is that the NHS, DH and all the health professionals know that there is a fantastic amount of waste and the required savings (£5bn a year) are quite achievable through efficiencuy savings.
A report from McKinsey in 2009 demonstrated that bringing the least efficient acute services up to the productivity levels of the *average* acute unit in the NHS would save £2.4 billion a year.
If you ask the workforce planners in DH and the NHS (and I know them both very well) they will tell you that the biggest block to reforms and improvements are often the senior medical staff – suregeons who insist on a full operating surgery rather than learning more efficient keyhole surgery techniques, empire builders and senior consultants doing work that could be taken on by less junior doctors.
There are so many ways that the NHS could be made more efficient that the biggest problem is knowing where to start. It is easy to say that this leel of saving has never been achieved before. The explanation is that we have had 13 years of massively increased spending when the ministers in charge didn’t bother to get value for money and saw spending as a desirable objective irrespective of value. After 13 years of poor management, saving 4% will not be difficult.
Many of Lansley’s advisors are from private health companies. Eg. John Cash of Care UK who donated 21K to Lansley in Jan.2010.
My guess is that many ex-employees , clutching their redundancy packets, from the disbanded PCTs, will be re-employed by the same private companies who will offer a commissioning service to the GP consortia. The commissioning companies will then negotiate packages with the NHS and the private hospitals. All the simple, profitable procedures will be hived off into the private hospitals leaving the NHS will the ‘difficult’ bits. Staff training will be impaired by the distortion of cases in the NHS, and the best staff will be leached away into the private sector. As the NHS becomes worse and worse, more and more people will take out health insurance until we have a mirror image of the US system, with the NHS offering a scratch service to the poor.
I believe that senior members of the Royal College are describing this as a complete car crash! As you say Richard, the tragedy is that patients will die who should be alive.