What do health reforms mean to YOU ?

[Doc Alan]

Health Secretary Andrew Lansley’s controversial Bill applies only to England.
Everyone probably knows if it goes ahead it will abolish Primary Care Trusts while handing over most of the NHS budget to “ commissioning “ groups of GPs, and promote competition in provision of services.
In Scotland Health Boards run the NHS, and there are no plans for “ reforms “ or a competitive market because there is insufficient evidence it delivers better healthcare.
Similarly in Wales there are a small number of Health Boards and no plans for a competitive market.
In Northern Ireland there is a Health and Social Care Board and Public Health Agency and no plans to give GPs more commissioning power.
In the Philippines there is a wide range of health care, dominated by private health providers, and a need for reform with the goal of universal health care in the future.
There’s opposition to England’s Health Bill from many quarters, not least doctors and nurses.
It would take an even longer thread to list the arguments for and against the Bill. All members probably want to know is “ What does it mean for me ? “ If it goes ahead, patients will walk into GP surgeries in 2015 and have greater choice of treatments, still free at the point of delivery. More of these would take place in surgeries – or at home – not hospitals. But even the “ experts “ are actually not sure ! The service may become more variable, some practices will become over-commercialised ( profit before patient ) . In others there would be no obvious change. If you do need hospital treatment, no one’s sure how much would be provided privately.
Wherever you live and whatever your health, changes are needed in its provision. It will be based less in hospitals, more in the community. With more elderly patients health and social care need to be integrated. Screening for and prevention of illness – including individuals better managing their own lifestyle – should become more important.
Who provides healthcare is less important than the quality of what is provided. Competing private providers need monitoring if we’re to avoid the breast implant scenario where profit came before safety.
Healthcare needs to improve and remain affordable, whether in the Philippines ( least spent ), UK, France, Germany and the USA ( most spent ). England doesn’t need this Bill to achieve that goal, in my opinion.

[Steve.r]

A really difficult one to answer Alan. I think it will suit some more than others. Thinking of maybe the elderly, local tratment will be better for them, as long as the quality provided is to the same standards as before (maybe better??)
It could be that the treatment lottery system be made less prevalent so we can all beneift from specialist care, where ever we live.. as long as we are prepared to travel.

I think the general concensus will be one of 'if we can get the same standard of treatment or better' everyone will be happy. The proof I think will be in the pudding as they say

[Arthur Little]

I'm not sure if the average lay person is really aware of the extent to which Andrew Lansley's reforms will affect him/her. And as you point out, Alan, the NHS in Scotland where I live is run by Health Boards ... for whom I have nothing but praise for the ongoing care I have received since my operation 3 months ago.

I've said this before, on several occasions - and I'll say it again - all I know is, WE, the members of this marvellous forum, are extremely grateful to have among us, a man of your calibre. Hopefully, EVERYONE here, will focus their attention on your latest thread and carefully.

[imagine]

if it isnt broke why fix it,,, seems to me the health board do a fine job

[raynaputi]

Now I understand what this NHS reform that has been discussed in the news! hehehe Thanks Doc Alan for explaining..

[stevewool]

sorry Alan i cannot add anything to this, i hae not seen or read anything about this and who is this bloke, just goes to show how i am intrested in this goverment, just my thought dont mean to offend anyone

[joebloggs]

from what i've seen BMA are against it, 3/4 of nurses are against it, most medical professional bodies are against it.

NHS productivity has risen in 10 years, undermining Lansley's case, says study
Paper published in Lancet says taxpayers have got more for their money out of the NHS, undermining government claims

http://www.guardian.co.uk/society/20...-lansley-study

[Doc Alan]

sorry Alan i cannot add anything to this, i hae not seen or read anything about this and who is this bloke, just goes to show how i am intrested in this goverment, just my thought dont mean to offend anyone

You don't offend Steve I guess there are many intelligent people like you, who either don't know about - or don't understand - these proposals. The best answer to my own question is " We actually don't yet know what they would mean to individuals when they go to their doctor ! " All most of us do know is that they seem expensive and unnecessary ! For Joebloggs, here's the original Lancet article : http://www.thelancet.com/journals/la...782-0/fulltext .
Thanks Steve.r, Rayna, Arthur, and Imagine for your posts and kind comments .

[Rosie1958]

I am lucky enough to be a member of a private heath care scheme which is organised by my employer. It’s not entirely free as I pay tax on the benefit of receiving this perk. It’s interesting to note that even private healthcare is changing too as it was recently announced by the scheme that initial appointments with Hospital Consultants will now be available over the phone rather than having to actually attend hospital.

I am keeping an open mind about this at the moment but due to the level of referral (by an existing medical professional), I do wonder whether perhaps video conferencing (maybe over the internet) might in some circumstances be more appropriate rather than just a chat on the phone, particularly for certain visible conditions and illnesses. Some 55% of communication is via body language which can’t be seen on the phone and surely this important part of communication should not be disregarded.

I know that I would certainly welcome the ability to book a routine medical appointment over the internet with my local GP rather than ringing a constantly engaged telephone no. and a telephone consultation would be acceptable in some instances which would save time all around . This surely should be the way to go for ordering repeat prescriptions too and no doubt it is already being practised by some surgeries.

I have to admit to feeling rather sceptical about the prospect of having any minor surgery at a GPs surgery because of a previous experience. I would expect there to be very stringent rules and governance in place regarding the competency of those carrying out any such practise and the appropriate risk assessments in place.

[mickcant]

I am another who does not understand much of the system now let alone changes

I can well remember when we had local "Cottage Hospitals" that did treat patients in their commuinity and they were much better places to have treatment in that the large hospital that replaced them
Mick.

[lastlid]

Yes. Difficult to predict how it will all pan out.

Like Rosie, I was a member of a private healthcare scheme, for many years, until the end of 2010 so I know that private healthcare can and does work and seemingly efficiently, but of course at a price....

[joebloggs]

Like Rosie, I was a member of a private healthcare scheme, for many years, until the end of 2010 so I know that private healthcare can and does work and seemingly efficiently, but of course at a price....

and when private healthcare doesn't work they can always dump you back on the NHS to sort you out

this could be the one thing that will wipe out the tories at the next election.

[Terpe]

There's been plenty of media attention on the NHS reforms, but despite all that I remain, like most people, uninformed on exactly what's wrong with the NHS and what the options are to put it right.

It's hardly surprising that support for the reforms are dwindling, when we don't fully understand what's wrong with it.

Every government over the years has promised a better and more patient-centric health service. All have failed overall.

Most people need the NHS to provide good patient care.
To utilise the training of staff, and to apply medical and nursing knowledge and skill with understanding, kindness and dignity to those of us who get ill.

I'm just an ordinary bloke and I have no way of knowing if the nurses and staff looking after me are adequately trained or not.
I do know that most Senior Nurses or Staff Nurses spend a lot of their time on the ward desk, either in front of the computer screen or answering the telephone enquiries of relatives or completing mountains of assesment paperwork, or organising various patient movements and tests.
Through no fault of their own they're not actually doing the job they joined the NHS for, or were trained for, and the job that patients need them to do.

What do these reforms mean to me? Well I don't know anything about the capabilities of Andrew Lansley, but frankly I do question any logic that results in spending so much time developing a plan that requires even more boxes to tick, even more audit paper trails, even more pressure from management to achieve targets, even more data to collect and optimise and ever more cuts to prioritise.

My untrained mind says that just leads to even less basic patient care, less qualified nurses, less time at my bedside and less time making me better.

I'm not so naive to think that improving management and administrative performance isn't also an important activity, but surely Andrew Lansey's improvement plan means that nursing and medical resources are once again being diverted for solely political reasons.

Some things about the NHS are just too complex to precisely measure objectively to the nth degree. Time to trust the professionals.
Hire professional administration/data analysis to inform an much slimed down and flattened management structure.
Let the front line medical staff do their job.

Just my opinion

[lastlid]

I'm just an ordinary bloke and I have no way of knowing if the nurses and staff looking after me are adequately trained or not.

One way of gaining an insight into this is to spend sometime in hospital. I was in an NHS hospital in 2005 for about 8 days and I learned there about understaffing and insufficient training and how it can affect ones treatment etc. I also learned that the food was poor, not so much in terms of my personal likes and dislikes but in terms of nutrition quality, we are what we eat and all that....

Interestingly, because I didn't transfer to a private hospital for treatment I earned a cheque for £1100 from the said private health organisation for not using their hospital.

When I finally had an op, later that year, I went private. There is a difference, but like I say, it has to be paid for somehow.

At that point in time I felt that there was room for improvement with the NHS.

[Doc Alan]

Some interesting responses .
Rosie – agreed, it’s vital to see the patient, if not for “ real “ then by video ( Skype, for example ), and expert opinions are available by teleradiology ( sending X Rays etc over the internet ). Expect more “ minor “ GP surgery in the future, or join a long waiting list at the hospital.
Joebloggs – too right, complications CAN arise from private healthcare ( in UK or as a “ health tourist “ ), especially for “ major “ procedures, when the NHS bails out patients if clinically indicated.
Lastlid – spending time in hospital DOES give insight ; poor food is partly – but not entirely - because of limited budget.
Mickcant and Terpe – you’re not alone in misunderstanding the Health Bill, its many amendments, or even how the health service can be improved. But if it’s not needed for the rest of the UK, it should be scrapped for England.
Life expectancy is greater in UK than Philippines, and by other criteria standards of healthcare are better here. Indeed the Philippines aspire to the core principles of the NHS ( meeting the needs of everyone, free at point of delivery, based on clinical need ). But improvements are needed – less spending on hospital care, more on the community. Health inequalities around the UK are large, but not as huge as in the Philippines. Two general examples from the UK – 1. cancer treatment is less good than other European countries ( Sweden, Norway ), Canada or Australia ; 2. hospital care is less good at weekends. If you’re not happy with treatment, the Government has just avoided defeat on an amendment that would have made it a duty for NHS organisations to admit mistakes to patients .
Despite this, survival rates for common killers like heart disease and cancer HAVE improved, there is no need for such massive reform, and many GPs neither have the management skills nor actually want to take on “ commissioning “ of health services. If they were put in charge of the budget, they would still need managers while they got on with looking after patients.