As the Guardian reports this morning:
The NHS's 111 non-emergency telephone helpline was in crisis after one of the major providers announced it was pulling out for financial reasons, leading to warnings from medical groups of chaos and patients being put at risk.
Astonishingly, NHS Direct, which is the organisation that has pulled out, is itself an NHS Trust. As the Guardian notes:
The public organisation said it was likely to earn only half the projected £43m a year for running 111 services as it announced its departure only four months after the new structure had been set up. It has already withdrawn from providing services in two of the 11 areas, north Essex and Cornwall.
Three obvious observations follow. The first is that if a call to NHS 111 is only worth £8 then you can be pretty sure that the advice provided has about the same value. In that case, worry.
Second, it's notable that despite this private sector providers are carrying on with the service. In which case, worry even more.
Third, note that the introduction of NHS 111 - which has to be one of the simplest medical services that can be provided since it is entirely protocol driven with the automatic option that in the event of uncertainty being encountered a back up service can be called upon and no other decision needs to be taken - has been described as an 'abject failure'. However, it's now the case that situations where massive uncertainty is faced - such as mental health care and end of life care - are to be privatised. There is no option in these cases of avoiding the issue, or saying there is a fixed price unit cost unless disastrous health outcomes are to be guaranteed. In which case worry even more.
And worry in all these cases for good reason, which is that the logic of all such privatisations is fundamentally flawed. The logic of privatisation is that health care is bounded and exists within silos of activity, so that for example 111 exists independent of A&E or out of hours and can be costed independently of them, even though failure in 111 does, of course, automatically impose cost on these other services. And, in the case of mental health it will be assumed that this exists independently of other services when in fact there are very frequently co-morbidities involved, which the pricing of the new contracts will no doubt ignore.
To put it another way, these contracts assume health care is a discrete activity involving separate and unrelated episodes of care when nothing could be further from the truth. Health care has to be about integrated care and markets work on separation. That is why 111 if failing. That is why the further £5 billion of privatised health care the FT is talking about today will fail. And that is why the neoliberal approach to healthcare is bound to be a disaster.
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This would be why A&E is coming under increasing pressure.
The “flying doctor” service operating around here is such an abject failure that calling them almost always results in being told to go to the hospital, where a “grounded-flying-doctor” will arrive in due course.
That would be the same hospital where the paediatric A&E has been closed due to the removal of all doctors-in-training, which was by the training institution due to no consulktants being available !
http://www.bedfordshire-news.co.uk/News/LIVE-Protestors-demonstrate-outside-Bedford-Hospital-over-childrens-ward-closure-20130726130000.htm
Bet you never thought you’d see something like that. The betting is on the entire hopitals A&E being closed in a year….many of the hospitals functions are now done elsewhere….Cambridge mainly.
And under legislation currently being considered, that demonstration would be banned.
I watched the Dispatches program last night about worrying failings in the new NHS 111 call system.
“Dispatches’ reporters were told of ambulances dispatched when one patient rang in with a cold and another with a hangover. While working in the Bristol call centre, one of the undercover reporters was told that an ambulance had been sent for someone with ‘a cat scratch’.”
http://www.channel4.com/programmes/dispatches/4od#3556557
This morning I read a private hospital, run by a group which has just won a renewed £200 million contract, asks the government for a loan of £3.5 million.
http://skwalker1964.wordpress.com/2013/07/29/private-hospital-asks-govt-for-3-5m-loan-while-renewing-200m-contract/
Of course none of this will get airtime at the BBC, or Sky News, they are busy gearing up for the next onslaught on the NHS with the first ‘friends and family’ ratings to be published, Sky already leading with they are “Expected” to show shocking new revelations of poor level of care .. we can already see the neoliberal approach to healthcare is a disaster.
A privately-run hospital has been taken over by the NHS amid patient safety fears following the deaths of three people after routine surgery, confidence in it was so low that GPs were refusing to refer patients.
“At least three people died, 8,500 patient records were lost and a whole host of serious failings led to the Care Quality Commission beginning proceedings to suspend Clinicenta-Carillion’s licence to operate at the Surgicentre because of serious concerns for patients’ safety,”
http://www.independent.co.uk/life-style/health-and-families/health-news/privatelyrun-hospital-taken-over-by-nhs-after-patient-deaths-following-routine-surgery-8742745.html
It has been bought by the Government from Clinicenta Ltd, part of British construction multinational Carillion, for a sum in excess of £54m.
From The DT… “But yesterday, NHS Direct disclosed that when the service was tested, and found to be safe – though it did not reduce demand on A&E – centres were spending £13 on each call, much of it to cover staff costs (Which staff? Management? Shareholders wanting no cut of this £13 of course…).
When the system was then rolled out across the rest of the country, “extremely challenging” cuts were demanded, with NHS commissioners only agreeing to pay between £7 and £9 a call, its annual report said.” NHS Direct now seemingly blaming commissioners faced with budget cuts for their NHS111 disaster. The market’s culture of buck passing rolls on and on…
http://www.telegraph.co.uk/health/healthnews/10209863/NHS-111-helpline-is-on-brink-of-collapse-after-contracts-abandoned.html
111 worked for me before Easter but that was because it was in Durham where it had trialled for 2 years before I needed it for myself. Otherwise I would be dead.
However, it did not work when needed for my husband 18 months ago.
What is wrong with 111 is that the whole of the rest of the country is being changed together, along with all the other changes in the NHS. At Easter, very few of the hospital staff I talked to knew that there were going to be big changes.
The govt. has done it this way in order to have scapegoats when things collapse, although we cannot blame David Nicholson for any of this chaos, according to them. We can just ask private healthcare companies to rescue us!