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Laura

Brown To Unveil Radical Nhs Rethink.

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Gordon Brown is to unveil next week a significant expansion of private sector involvement in health provision.

The move is likely to be portrayed as a climbdown by opposition parties because the Prime Minister previously fought against less drastic Blairite reforms to public services.

The idea bears similarities to the "Patient's Passport" policy dropped by the Tories after the last general election.

Mr Brown will publish his "Building Britain's Future" document on Monday as he seeks to regain the initiative following dire polls and leadership speculation. He will promise to strip away top-down targets in favour of "entitlements" for people using services.

For the first time, if a primary care trust (PCT) cannot give cancer patients a specialist appointment within two weeks of referral from a GP, it will have to provide equivalent funding for a private consultation.

In practice the measure is only expected to affect a few hundred patients, as nearly all NHS trusts in England meet the deadline.

However, the principle of involving the private sector in acute treatment is regarded as a major change of approach.

Currently only elective surgery such as hip replacements and cataract surgery is provided through private treatment.

The two-week target was first introduced for suspected breast cancer cases in 1999, and extended to all cancers in 2000. However, while prospects have improved, research has indicated that five-year survival rates in the UK are still below the European average.

EDIT:- Oops, forgot da LINK

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All healthcare is set to be privatised by whatever party comes to power.

Payment by results ( google it) will be one of the main things and pfi is up to its neck in it all.

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To think, this man was a dead man walking just a few weeks ago

Through his own stubborness and intimidation of others, he's suddenly surrounded by sycophantic parasites and it's all been forgotten. The dear leader continues to reign

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Radical NHS rethink.

Wonder if it will be as radical as his radical rethink of the financial regulation system: "Carry on the pretty much the same, lads."

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Guest DissipatedYouthIsValuable

1. Create arbitrary target.

2. Appoint auditing teams and punitive financial and legal incentive target for clinicians.

3. Announce big new thing to public.

4. Consider asking if target is realistic, human resources and funding are available.

5. -> 1.

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1. Create arbitrary target.

2. Appoint auditing teams and punitive financial and legal incentive target for clinicians.

3. Announce big new thing to public.

4. Consider asking if target is realistic, human resources and funding are available.

5. -> 1.

And it gets reported as "news".

Goldfish.

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I can not believe how stupid this govt is. Have they not learnt anything from the new contracts for doctors they introduced a few years back.

So all these NHS cancer consultants that also work for the private sector as well as the NHS will say that they are too busy to see people on the NHS so they can then put there private hat on and say I will see you tommorrow and stuff the taxp payer for the bill. So their NHS salary will not be reduced they just get a massive increase in private fees by operating a go slow in thier NHS work.

FFS Brown is just a moron.

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Gordon Brown is to unveil next week a significant expansion of private sector involvement in health provision.

The move is likely to be portrayed as a climbdown by opposition parties because the Prime Minister previously fought against less drastic Blairite reforms to public services.

The idea bears similarities to the "Patient's Passport" policy dropped by the Tories after the last general election.

Mr Brown will publish his "Building Britain's Future" document on Monday as he seeks to regain the initiative following dire polls and leadership speculation. He will promise to strip away top-down targets in favour of "entitlements" for people using services.

For the first time, if a primary care trust (PCT) cannot give cancer patients a specialist appointment within two weeks of referral from a GP, it will have to provide equivalent funding for a private consultation.

In practice the measure is only expected to affect a few hundred patients, as nearly all NHS trusts in England meet the deadline.

However, the principle of involving the private sector in acute treatment is regarded as a major change of approach.

Currently only elective surgery such as hip replacements and cataract surgery is provided through private treatment.

The two-week target was first introduced for suspected breast cancer cases in 1999, and extended to all cancers in 2000. However, while prospects have improved, research has indicated that five-year survival rates in the UK are still below the European average.

EDIT:- Oops, forgot da LINK

great more spending and rtransfer of resources to PFI type institutions - when can we get rid of this imbecile?

please before he destroys us all

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I can not believe how stupid this govt is. Have they not learnt anything from the new contracts for doctors they introduced a few years back.

So all these NHS cancer consultants that also work for the private sector as well as the NHS will say that they are too busy to see people on the NHS so they can then put there private hat on and say I will see you tommorrow and stuff the taxp payer for the bill. So their NHS salary will not be reduced they just get a massive increase in private fees by operating a go slow in thier NHS work.

FFS Brown is just a moron.

:lol: - it's funny because it's true.

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The intention has been for some years to privatize all public services.

Health , education, welfare etc

Once this is complete then the government will gradually get people to pay for the services themselves

so we will be back to position where only the rich can afford health and education.

I firmly believe the massive boom and bust was deliberate and would give the excuse for all this privatisation

of public services and cutting of wages and conditions and making people work till they drop because they have

reneged on providing pensions.

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I can not believe how stupid this govt is. Have they not learnt anything from the new contracts for doctors they introduced a few years back.

So all these NHS cancer consultants that also work for the private sector as well as the NHS will say that they are too busy to see people on the NHS so they can then put there private hat on and say I will see you tommorrow and stuff the taxp payer for the bill. So their NHS salary will not be reduced they just get a massive increase in private fees by operating a go slow in thier NHS work.

FFS Brown is just a moron.

Hello. My first post, but had to respond to this.

So, so true.

I'm a junior doctor, but am spending a few years as a service manager and in re-design in the NHS (Darzi wants more doctors to be amangers too).

I spent 6 months last year on a project to decrease waiting times for hand surgery at a major teaching hospital in england. The main constraint was that the surgeons were doing approx. 2 or 3 operations for a common condition, carpel tunnel syndrome, in a 4 hour theatre session. We reckoned they should be able to do six. They were extremely reluctant - bearing in mind they were sending themselves and the theatre staff home early on an afternoon!

It turned out that the same surgeons were being paid to pick up the slack on the waiting lists on a saturday morning at BUPA down the road - here they were paid per patient and had re-designed the theatre and staff processes to get maximal efficiency: 8 patients per session.

Robbing bastards. And no one excpet me thought this was surprising, unusual, fraudulent or a significant conflict of interest!

I have no problem with bringing in patient choice or multiple providers into the NHS, even private providers, so long as the bill is picked up by the NHS.....I am a service mabnger at the monent, and I'm kept on my toes by the fact that there's another provider of the same service down the road.....but surely some performance management has to be part of it where people are allowed to work for both providers at once.

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It turned out that the same surgeons were being paid to pick up the slack on the waiting lists on a saturday morning at BUPA down the road - here they were paid per patient and had re-designed the theatre and staff processes to get maximal efficiency: 8 patients per session.

Robbing bastards. And no one excpet me thought this was surprising, unusual, fraudulent or a significant conflict of interest!

Perhaps they should become MPs.

Was the NHS getting charged more for doing it this way?

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477px-Kim-jong-il_portrait.jpg

mrblobbylb1.jpg

Spot the difference.

The bottom one was elected. Actually no he wasn't, its not that then. Forget I spoke!

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Perhaps they should become MPs.

Was the NHS getting charged more for doing it this way?

Yes, indeed.

As I say, I have no problem with a lot of New Labour's policies in principle, it's just that they tend to put things into place without being properly thought through.

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Hello. My first post, but had to respond to this.

So, so true.

I'm a junior doctor, but am spending a few years as a service manager and in re-design in the NHS (Darzi wants more doctors to be amangers too).

I spent 6 months last year on a project to decrease waiting times for hand surgery at a major teaching hospital in england. The main constraint was that the surgeons were doing approx. 2 or 3 operations for a common condition, carpel tunnel syndrome, in a 4 hour theatre session. We reckoned they should be able to do six. They were extremely reluctant - bearing in mind they were sending themselves and the theatre staff home early on an afternoon!

It turned out that the same surgeons were being paid to pick up the slack on the waiting lists on a saturday morning at BUPA down the road - here they were paid per patient and had re-designed the theatre and staff processes to get maximal efficiency: 8 patients per session.

Robbing bastards. And no one excpet me thought this was surprising, unusual, fraudulent or a significant conflict of interest!

We need more guys like you in executive positions where you can kick these criminals up the ****!

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477px-Kim-jong-il_portrait.jpg

mrblobbylb1.jpg

Spot the difference.

One is the repressive unelected leader of a quasi socialist nuclear weapon armed rogue state who rules with an iron fist by decree and ruthless intimidation over a population whose standard of living has continuously dropped since the fifty's, and the other is Kim Jong-Il?

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One is the repressive unelectred leader of a quasi socialist nuclear weapon armed rogue state who rules with an iron fist by decree and ruthless intimidation over a population whose standard of living has continuously dropped since the fifty's, and the other is Kim Jong-Il?

One is reported to have told the Queen on a visit 'I'm fuc KING IT'! Where as the other told the Queen on a visit 'I am fuc KING IT'! Spot the difference?

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One is reported to have told the Queen on a visit 'I'm fuc KING IT'! Where as the other told the Queen on a visit 'I am fuc KING IT'! Spot the difference?

What, one is Lore and the other is Data?

[/scifi geek mode off]

;)

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Hello. My first post, but had to respond to this.

So, so true.

I'm a junior doctor, but am spending a few years as a service manager and in re-design in the NHS (Darzi wants more doctors to be amangers too).

Anecdotal balls

The New Consultant Contract was negotiated in the belief NHS consultants were doing exactly what you describe, with the practice being widespread.

The evidence in survey after survey was that NHS consultants worked significantly above their contracted hours for the NHS (20-30% more) on average

This evidence was pointed out during negotiations by the BMA with the warning that if a switch was made to a time-sensitive contract, this extra unpaid work would have to be paid for.

This evidence was wilfully ignored by the DoH and Health ministers. They went ahead anyway.

The result - big payrises for consultants on the new contract, just as predicted, just as was an obvious outcome from the evidence, and just as was ignored by the DoH. They squandered goodwill and the bill ran into the billions, all because they assumed that on average consultants were as corrupt as they were when they weren't.

A small example of the managerialisation of medicine destroying quality of care

- when I worked A&E 15 years ago, major cases such as "acute abdomens" (eg pancreatitis, appendicitis) were triaged by a nurse and seen by the A&E doctor quickly. Pain relief, investigations and treatment were decided by the A&E doctor having seen the patient. The cost of this approach was that patients with minor ailments had to wait several hours

- now (speaking from personal experience and challenging the senior A&E nurse to explain the triage system) the "acute abdomens", if their BP is OK, are given IV opiates, blood tests and a drip before being seen by any doctor. They are then seen by the doctor within 4 hours (in this particular case, the time given was 3 hours and only got shorter after the patient's BP dropped)

To allow 3-4 hours to pass before letting a doctor assess a patient with severe abdo pain is bordering on negligence. To prescribe and administer opiates without a medical assessment is terrible care. But this ghastly system has taken root because it is 'efficient', allowing patients to haemorrhage/ go into shock quietly, in a cubicle strung out on opiates, while the docs tick the boxes treating the 'minors'.

Darzi will kill many more than he cures. He is a serial failure in medical management, a Brown stool.

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Anecdotal balls

The New Consultant Contract was negotiated in the belief NHS consultants were doing exactly what you describe, with the practice being widespread.

The evidence in survey after survey was that NHS consultants worked significantly above their contracted hours for the NHS (20-30% more) on average

This evidence was pointed out during negotiations by the BMA with the warning that if a switch was made to a time-sensitive contract, this extra unpaid work would have to be paid for.

This evidence was wilfully ignored by the DoH and Health ministers. They went ahead anyway.

The result - big payrises for consultants on the new contract, just as predicted, just as was an obvious outcome from the evidence, and just as was ignored by the DoH. They squandered goodwill and the bill ran into the billions, all because they assumed that on average consultants were as corrupt as they were when they weren't.

A small example of the managerialisation of medicine destroying quality of care

- when I worked A&E 15 years ago, major cases such as "acute abdomens" (eg pancreatitis, appendicitis) were triaged by a nurse and seen by the A&E doctor quickly. Pain relief, investigations and treatment were decided by the A&E doctor having seen the patient. The cost of this approach was that patients with minor ailments had to wait several hours

- now (speaking from personal experience and challenging the senior A&E nurse to explain the triage system) the "acute abdomens", if their BP is OK, are given IV opiates, blood tests and a drip before being seen by any doctor. They are then seen by the doctor within 4 hours (in this particular case, the time given was 3 hours and only got shorter after the patient's BP dropped)

To allow 3-4 hours to pass before letting a doctor assess a patient with severe abdo pain is bordering on negligence. To prescribe and administer opiates without a medical assessment is terrible care. But this ghastly system has taken root because it is 'efficient', allowing patients to haemorrhage/ go into shock quietly, in a cubicle strung out on opiates, while the docs tick the boxes treating the 'minors'.

Darzi will kill many more than he cures. He is a serial failure in medical management, a Brown stool.

Not in any A&E I've worked in, (post 4 hour rule)! Mind you, I've worked in a few. The one I spent 2 x 6 months in was a large one and they took the 4 hour target as a reason to re-design the department and the service was vastly improved. Triage was done by a doctor almost literally on the door, who could do far more than a nurse in the first few minutes.

I've worked in another hospital, though not in the A&E there, where they simply shuffled patients aropund to avoid the 4 hour thing. They have, to this day, 'assessment areas' coming out of every orifice, any bit oif space that can be classified as 'not A&E' is where patients get dumped.

So, it depends how a department responds to the targets as to whether they improve or worsen patient care - it's not the targets themselves.

With regard to consultant contracts, you are of course correct on the whole. Most consultants do work above and beyond the call of duty.....my story is, as you say, an anecdote, and not necessarily representative. But these two surgeons really were something else. But the financial incentive to be awkward bastards was there. And believe me, these two really were the epitome of the 'spend half the time on the golf course' stereotype. And stereotypes have to come from somewhere, remember.

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