Health and Social Care Bill - a danger?

[Chippy Minton]

Not good for the government and Lansley on this today.

Firstly, both the Community Practitioners? and Health Visitors? Association and the Faculty of Public Health have become the latest professional bodies to come out against the Bill.

Then tonight, it loses the vote in the Lords regarding the priority given to mental health.

[Marmora Man]

Chippy,

Reportage, such your last post, doesn't quality as debate, argument or discussion. I can read the news expressed with more rational and objective comment and analysis in the broadsheets.

[Undisputedtruth]

And likewise with your posts, Marmora Man.

[david_carnell]

Mamora Man - perhaps you could offer insight into the pro-business FT writing a leader today that also proposes that the govt should drop this "mess" of a bill?

[????]

Interesting that now a number of Tories saying drop the Bill as they believe it will get the blame for the inevitable crisis looming in the the NHS - right wing free market critics are almpost saying leave it alone and let it collapse under its own contradicitions

We have

- ever increasing cost of treatment;

- the baby boom generation hitting 65 and fairly soon 75 - the ages when need grow enormously

- an infrastructure built largely for 1940s medical practice

My personal 'prejudices' are that additionally

- some internal culture which sees the NHS as a provider of employment rather than a service for the public

- deep internal 'conservatism' a general widespread internal culture of antagonism to reform, which New Labour found everywhere too

I'm not saying the current reforms are right, I've given up on this debate but am deeply suspicious of those who advocate the Status Quo and cry "Wolf" ("or literralyy 'they want to deystroy the NHS') at any attemp at reform.

[david_carnell]

Whilst I can see the arguments for reform, as indeed can many of the Royal Colleges who are opposing the Bill, I am also left wondering whether after 13 years of Labour reforms and now more promised by the coalition, the NHS is in a constant state of flux.

We bemoan that increased bureaucracy stops clinical staff treating patients but instead ties them to a desk filling out forms and yet with every new reform or reorganisation we are making that situation worse.

A moratorium on reform may be more beneficial in the short term. Lansley apparently spent six years in opposition coming up with these proposals and yet he may have done better jotting them down on the back of an envelope.

[????]

Personally I think what we need to do is really comprehensive review of what a health service free at delivery should look like in the 21st Century...but that is largely impossible because of the politics, especially the small C conservatine intrasigence from the Health Prefession in general and the Unions, means that no government (but especially a Tory one) can say they are looking and root and branch reform, so intstead we get tinkering, change of direction etc. Long term it is unsustaanable in terms of its current delivery and funding given what I said earlier (demographics and medical advancement). We need radical reform but that as good as politically impossibl - and that appears to me to be becuase of blatant self interest packaged as emotive 'protecting the NHS from those that want to destroy it' and the inevitable weight of massive, self fuffilling, self preserving bureacracy.

[El Pibe]

Orrrrr maybe its because everyone in the country wants free health care and is prepared to pay for it, and anything other than tinkering at the edges in a bid to drive down costs is political suicide at the ballot box.

Tend to agree that organisations can only take so much radical reform without the glue beginning to give, and I'm pretty sure that's where we're at right now.

There is no doubt that things can be done better but we'd probably be better off getting disinterested experts to give the recommendations rather than politicians, and it'd be great if they could be incorporated over a period of time irrespective of the colour of ties of the government.

For starters we could look at taking advantage of the economies of scale in purchasing the NHS could leverage, where currently things are so bad that there isn't even a strategy within an average PCT.

I did a project for NPEP (NHS Purchasing Electronic Psomething) that was looking at increasing pan institutional communication with a bid to doing this sort of thing and it was blocked at every turn before being dismantled as a 'costly' quango by the tories.

A conservative estimate at cost savings would be about 15 billion a year. Amazing that noone is doing anything about it.

[Brendan]

Why can't the NHS be run as a corporation independent from political/government intervention? With a strict charter and legal obligations obviously. Like the BBC.

To my mind the 2 things that redeem the entire British nation are the existence of the NHS and the BBC. The one works very well because it is able to keep at arms length (to a degree) the tide of sub-human slime that are the political classes while the other seems constantly fraught with peril because it can?t.

[????]

I think you're just confusing where we are are now with what the very near future will look like in terms of resource requirements (see also pensions)...soooooooooo maybe that's just because people aren't really aware about what oongoing commitments with a rapidly ageing population means (without some radical overhaul) in terms of the future tax burden.

Try and getting a vote for the basic tax rate to go back to 30% to pay for maintaing current standards in the NHS as a vote winner say?

"A conservative estimate at cost savings would be about 15 billion a year. Amazing that noone is doing anything about it." that's classic unweldy bureacracy for you

Everyone wants first class public services paid for by someone else

[Chippy Minton]

The sheer number of changes being proposed in the Bill mean that despite the admin savings from abolishing PCTs and SHAs there is a real risk that additional bureaucracy will be created.

Also, the NHS has made significant progress since 1997. It currently costs circa ?100bn per year to run. Raising basic rate tax by just 1% would raise circa ?4.75bn per year. Even with an ageing population and even if no reforms were introduced, I don't think it's necessary to increase its budget by circa 50% just to maintain current standards.