Pretty well hidden in the Guardian web site this morning is an article about comments made by retiring NHS chief executive Sir David Nicholson. It is reported that he said:
The NHS in England faces a number of patient safety scandals unless there is a significant shakeup in the service that has seen unused hospital wards close, hi-tech surgery centralised and GPs banded together into bigger practices.
Warning that the NHS would face an ageing population, more people suffering from long-term conditions and a stagnant budget, the service's outgoing boss Sir David Nicholson said it would need to make £30bn in savings over the next eight years. He said cuts alone were not an option: "There is a limit to how much more can be achieved without damaging quality or safety." He gave the example of paying below-inflation rates of pay, which could save £8bn but would demoralise staff.
Nicholson said the result of such a scorched-earth policy, which has been implemented in Ireland, would mean paring back the NHS to dangerous levels. "If we allowed things to go on, we would squeeze hospitals more and more," he said. "As 75% of spending is on staff we would be looking at reducing staff on wards. That would have a really bad effect on patient safety."
Now, his direction of argument was that the savings required should be planned, not muddled as this was the only way he thought that 5% a year could be saved. And he warned charging was not possible. But as he has then noted, that must mean more centralisation of service, or, as the article notes:
Officials said the public will have to shoulder greater responsibility for their wellbeing — citing those with long-term conditions such as diabetes, depression, dementia and high blood pressure.
I have to admit I am bemused by the comments on depression and dementia, in particular.
The possibility that would solve this problem and meet demand - which is funding a better NHS - seems the one that is ruled out. But why? It is the one I think people would vote for. And yes, they do want local hospitals, and they do want local GPs. And that's why they'll pay for them.
Where is the party that will say so, please?
At which point I realise I have just invited Clive Peedell (a man I much admire) and the National Health Action Party to comment.
Thanks for reading this post.
You can share this post on social media of your choice by clicking these icons:
You can subscribe to this blog's daily email here.
And if you would like to support this blog you can, here:
Having watched Liam Byrne’s excrutiatingly awful display on Channel 4 News, yesterday evening (calling for the spare bedroom tax to be dropped but refusing to say if Labour would abolish it), it certainly won’t be Labour, Richard.
But anyway, on topic: last week I was talking to a colleague whose been involved in NHS research (on innovation) for the last four or five years. He was telling me that he recently attended on NHS workshop in Oxford, at which he was shocked to see the sheer number of private sector people clearly there to start raping (sorry, taking over) the NHS. His opinion, which I respect as he’s not prone to exageration, is that the NHS as we’ve known it for decades is already finished. Incidentaly, he also mentioned the growing number of incidences of conflict of interest that he’s observed over the last year.
As we continued talking about what he’d observed the only bright spot we could come up with was that this disintegration and the resulting chaos and cost (human, organisational, etc) will all be VERY evident within the next year. Consequently the Tories and Lib dems will have to account for it at the 2015 election.
Ivan, I too watched Liam Byrne’s display on C4 news, frankly I believe he is nothing more than a cyrpto Tory who should be sacked by Miliband.
The NHS is obviously intended to be a ‘gift’ to Tory donors and because much of the public swallowed the Coaltion mantra that the previous government caused the economic mess because it ‘overspent’, this privatisation has progressed without much challenge. I doubt whether the Coaltion will be very bothered that it will have to account for this at the 2015 election, because the underlying strategy (yes I do think it is a strategy rather than misguided incompetence) coupled with its appalling economic policy is the ‘shock doctrine’ policy designed to shrink the state and therefore fundamentally alter the relationship between the state and its citizens. Unfortunately many people are totally unaware or are resigned to this. Certainly Labour seems to have no alternative policy narrative and by 2015 much damage will already have been done.
Wasn’t Byrne also responsible for the ‘all the money is gone’ (or something similar) note, that subsequently became so poisonous for Labour, Teresa? He was also a management consultant for one of the big firms before entering parliament – which about sums him up.
But anyway, I agree with you that there is a strategy to this, and it is a Tory version of the schock doctrine. And sadly I have to agree also that many people – the majority, in fact – are unaware or resigned to what’s being done. But on the NHS specifically, come this winter and into next year, I think the realisation and anger will build, with some damaging outcomes for the Tories. Anyway, time will tell.
Very well put on various points. I’ve wondered, for some time, why Labour hasn’t stood up for itself with regard to the overspending slur. I’m fairly sure that alternative views have not found a platform with the BBC and most newspapers, but feel there is more to it than that. As X-Files as it may seem Labour look to have been happy to go along with the overspending mantra thus neatly allowing them to continue with austerity and state sell-offs next time round. That really does sound crackers though. Nearly as crackers as Arsenal signing Suarez.
“this privatisation has progressed without much challenge”
My guess is because it went unnoticed by most of the general public, because it was simply not reported or investigated by the vast majority of the MSM, thus the majority of the public have no clue about it. Jeremy Hunt in 2009 called for the NHS to be dismantled. Hes now setting about that, first he has to erode the public’s trust and faith in it, and that’s what he is currently doing, paving the way for the privatization cavalry to ride in and “save the day” without complaint from the public.
http://www.youtube.com/watch?v=4i-yFfLgzSc
We are in the middle of a Lib Dem enabled Tory fire sale … they after all have a lot of “donors” to thank before 2015, just in case they don’t get back in.
Some people make what I believe to be a mistake by viewing healthcare as a cost rather than an investment .
I looked at John Redwood’s blog the other day and on many subjects , particularly housing , the majority of readers comments made sense but on public services and the NHS there seemed to be a collective blind spot .
Someone was claiming they hadn’t used healthcare services much and was advocating this as a reason for moving away from a national insurance funded model to a pay-as-you-use model .
Presumably on the basis that he/she had not been seriously ill up to that point , the conclusion was drawn that it would never happen to them ….
I don’t think care for old people who are not ill , just aged should be the responsibility of the NHS but suspect people end up being admitted to hospital (dumped) by default because there is nowhere else for them to go .
Coming to think of it there more irony in the persons backward rationale for moving away from an insurance model .
Exactly the same argument is used to support the case for using insurance to deal with the financial consequences of an event which is possible but far from inevitable .
i.e. the financial losses of the few being absorbed across the many .
Surely the fact that, with competitive tendering, up to 25% of NHS budgets goes on tendering and subsequent monitoring processes, is a clue to how budgets can be redirected to cover the shortfall.
Agreed
I took this from another forum post.
“This one won’t go away for Cameron.
PM pressed on election guru Lynton Crosby tobacco links
http://www.bbc.co.uk/news/uk-23301478#
On Any Questions Grant Shapps, Tory chairman, said that neither Cameron or he had spoken to Crosby. In which case why are they employing him.
This contradicts what Shapps said. Crosby was with the Tories last week.
http://blogs.spectator.co.uk/coffeehouse/2013/07/exclusive-how-the-tories-plan-to-attack-ukip/
Crosby runs his lobbying agency for commercial clients alongside his advisory work for Cameron. It all sounds rather murky and will blow up in Cameron’s face like the Coulson tie up.”
http://www.guardian.co.uk/politics/2013/jun/08/lynton-crosby-tory-strategy-lobbying-firm
Is the obvious fact under discussion the 1000s upon 1000s upon 1000s of patients simply left to die by NHS?
http://www.telegraph.co.uk/health/heal-our-hospitals/10178296/13000-died-needlessly-at-14-worst-NHS-trusts.html
Ahhhh….now I see:
http://tinypic.com/r/2sbapa8/5
“unless there is a significant shakeup in the service that has seen unused hospital wards close, hi-tech surgery centralised and GPs banded together into bigger practices.”
And so far every time this has been tried, the public then shout, “Nahh….not my hospital…it’s got to provide every single service ever…..” even though the quality might be dubious and death rates horrific.
After all, nothing was done after the Bristol Heart Scandal back in the ’90s by any colour of govt. and when recently the Leeds unit was judged to be possibly a bit dubious, there was hell on from locals demanding their unit shouldn’t close but that someone else’s should of course.
The fact is that even if HMG spent 15-19% of GDP on health (US levels in other words instead of the 9-11% we pay now) the NHS would still demand more and more and more.
Perhaps its about time to say ‘Yes, we can have an NHS but we bloody well should state what it should provide…..if you want more it’s gotta be paid for by the person.’
After all, the retirement age is going ever upwards so by the time the 30-something’s come to retire, you can bet there will be f**k all in the pot to pay them any sort of pension after being forced to pay into the system for upwards of 50 years.
People want health
And they’re willing to pay for it
So how much of the nations GDP should we spend then Mr. M? Perhaps 15%, 20%, 25% or even more? How much would be enough?
What services should the NHS provide?
As to ‘willing to pay for it’ – if that’s the case why is it that the take-up of private healthcare in the UK is so low? Do people really want to pay? Or are the booze, fags and Sky subscription more important.
Simply the wrong question
Spending on health generates wealth
Now tell me why you want people to suffer – and what from?
Mr. M.,
I asked how much do you think we should spend on health. For whatever reason you declined to give an answer and then asked the question:
“Now tell me why you want people to suffer — and what from?”
I didn’t mention suffering or withdrawing treatment, just that I wanted to ask you how much spending on health would be enough – we have rationing now. We just don’t call it rationing. I’m asking you as a man keen on state solutions, how much of the funds provided by the taxpayer to HMG should be spent on health.
Every other European (or even the Australian and US systems) has some form of rationing of healthcare in order to cap costs.
Perhaps this might provoke a thought or two when it comes to health spending:
“At some point, you can spend more money and not get the same rate of return. At some point, you exhaust your resources and you’re wasting money. It is not inconceivable that most systems find an equilibrium. That is likely along the line.”
http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-introduction/
I’ll ask again, how much should taxpayers be spending on health to achieve the outcomes you want.
It is very clear that unless we increase health spending by about 3% a year we cannot meet demand
So I suggest we do that, at least