How will NHS reforms affect role of private sector?

Join us for our daily live blog debating the government’s controversial restructuring of the health service 12.03pm: At 1pm today there we will be holding a live Q&A session on Spire Healthcare’s new survey , which shows waiting times creeping upwards for a number of procedures. Online debating the pros and cons of turning to private providers for the answer will be: • Dr Jean-Jacques de Gorter , clinical director, Spire. • Jacky Davis , NHS consultant radiologist. We want the questions to come from you in the comments below, but here are a few suggestions: • Can private providers help reduce waiting times? • Do private providers save money? There’s evidence they cost more. • What are the risks of using private providers? • Do we have any examples of private providers working well and working badly? Why? • If we do use taxpayers’ money to fund private contracts, how can we get the most out of them? • Can GPs find themselves commissioning healthcare for patients from providers they might have an interest in? If so what can be done to prevent this conflict of interest? • If private providers take all of the work out of hospitals, what will this mean for the training of junior doctors? 11.51am: My colleague Hélène Mulholland has filed a story on David Cameron’s comments that “changes need to be made” to the NHS reforms ( see 10.03am ). Here are the key quotes from the prime minister (left): Yes, I think they do need to change. We need to get this right. But I don’t think it was wrong to get started rapidly on a process of change. While it’s an option to stick with the status quo, I don’t think it’s a sensible option. So I think it was right to get moving. But we have a moment now where the legislation is almost finished in the Commons, where I think it is right to stop and to pause, to rethink and improve because I think we can make further improvements to our policy. I think that is a different thing for the government to do. Normally governments just plough ahead regardless, but I think it’s important to see if we can further improve those policies and, at the same time, make sure we have more full-throated support from people working in the NHS, most of whom know change is necessary. I want to get them on board for the changes we are considering and see if they have ideas for further improvement. 11.33am: Sunny Hundal (left) at the left-liberal blog Liberal Conspiracy has just written this post criticising the NHS reforms . He says the government is confused and points to a recent YouGov poll for the Sunday Times showing that the public remains unconvinced. Response? Total support 27%, Total oppose: 52%, Don’t know: 21%. That’s a big thumbs-up from the public then. 11.23am: Peter Ward Booth, who describes himself as a partially retired NHS consultant and who followed the blog yesterday, sent this email to Rowenna this morning saying that practitioners and patients need more information about the reasons about the government’s reforms. Ward Booth tackles the important point about whether GPs are really in a position to cut the cash flowing into highly specialised hospital specialities. Of course we all know it’s about saving money – specifically targeting secondary specialist or hospital care – however you want to describe it. Yes, it is expensive, because it is super-specialised, with beds and highly trained healthcare workers. Yes, if GPs hold the funds, they will restrict referrals to save money, just as PCTs restrict referrals by declaring certain procedures “low priority” – euphemism for not treating a condition. Either way the quality of care will go down, unless you can afford private care. In the past governments tried to reduce the cost of secondary care by trying to have managers micromanage the running of the hospitals; the price was we have statistically a manager for every hospital bed. Managers are, however bright or motivated, driven by their political masters, not by patient or doctor needs. They are also very expensive. So let’s be honest and recognise we need secondary/specialist care, but address the costs issue separately. Let’s give the power to the consultants to run their own departments and have “costs” league tables as well as “outcome” league tables. Have teams of peers to review the failing units with the power to hire and fire. Above all the “reforms” should not be allowed to reduce specialist care to only those who can afford it. Yes, GPs are specialists, but not in surgery (or) cardiology. 10.37am: The health secretary got a boost today with a sympathetic and pithy portrait from the Independent’s health editor Jeremy Laurance . Laurance gets the health secretary’s deadpan humour to a tee, recalling his funniest personal anecdote about suffering a stroke while playing cricket. “People imagine politicians are a bit brain dead,” [Lansley] would say. “Well I am – and I have the MRI scan to prove it.” On a less humorous note, in the Guardian former Labour chair of the health select committee David Hinchliffe attacks the government for its pro-market tilt. The same market philosophy which impacted upon my constituents 20 years ago is at the heart of the health and social care bill. Its proposals are driven by an ideology totally alien to a health service whose success has been rooted in co-operation and collectivism. In the FT there’s more bad news for the government as one of four NHS trusts chosen to be early adopters of the electronic patient records pulled out – plunging the health service’s £12.7bn programme to create a vast patient database into “yet another crisis”. Also in an ominous sign of things to come, news that Trafford General Hospital is in a financial mess. It’s an iconic place in NHS history – treating the first ever state-funded patient when the health service was inaugurated in 1948. The Manchester Evening News says “the hospital where the NHS was founded could find itself £75m in debt by 2015″. And trust the Daily Mail to come up with a holiday story in health. The tabloid claims that a hospital is considering flying foreign patients overseas rather than fund their long-term care. One way to beat the Easter traffic. 10.32am: Rowenna points out a political spat in Scotland where Labour claimed that knife injuries cost the NHS in Scotland £500m a year – almost 5% of Scotland’s £11bn NHS budget. Nigel Hawkes on Straight Statistics has an interesting take on how politicians are using stats on the health costs of knife crime to score political points. He says the Scottish Labour party has promised a mandatory prison sentence for anyone found in possession of a knife outside their home. To justify the policy, they say knife injuries cost Scotland’s NHS £500m a year, or 4.5% of the health budget. But after some digging, Nigel says that even with the “best will in the world” it’s hard to see the total cost of knife crime exceeding £10m a year – or 50 times less than the Scottish Labour party is claiming. Scottish Labour’s policy doesn’t make much sense, Nigel argues, given that they are setting aside an extra £20m to provide the extra prison places that will be needed if more people are sent to jail as a result of their policy.” (Disclaimer: Rowenna is standing as a candidate in local elections next month in England for the Labour party.) 10.03am: Hello. I am Randeep Ramesh, the Guardian’s social affairs editor, and my colleague Rowenna Davis and I will be liveblogging the government’s radical NHS reforms all day. Today there will be a question and answer session on Spire Healthcare’s new survey , which sees waiting times creeping upwards in a number of procedures. No surprise perhaps that families are not getting fertility treatments at a time of cuts, but worryingly patients are facing long waits for hip replacements and hernia repairs. Online debating the issues will be Spire’s clinical director, Dr Jean-Jacques de Gorter, and NHS consultant radiologist Jacky Davis. Also Rowenna will be at a conference on looking how to close hospitals painlessly. Earlier this month welfare secretary Iain Duncan Smith marched to save his local hospital ; while his cabinet colleague Andrew Lansley has to marshal insufficient resources to meet rising demand, this is one of the most vexing political issues of the day. For those who missed it Andrew Sparrow has already caught up with David Cameron’s interview on the Today programme. The main take away is that there will be changes to the NHS reforms. Interestingly Cameron made a point of saying hospital doctors would have a say in how GPs commission services for their patients. The prime minister’s brother in law, Carl Brookes, works as a cardiologist in Basingstoke for the North Hampshire NHS trust and memorably told him he was concerned that family doctors would become too powerful under Andrew Lansley’s plans. You can email me at randeep.ramesh@guardian.co.uk or tweet at tianran . Rowenna’s email is rowenna.davis@guardian.co.uk and her Twitter name is rowenna_davis . NHS Health Public services policy Public sector cuts Andrew Lansley Randeep Ramesh Rowenna Davis guardian.co.uk

Posted by on April 19, 2011. Filed under News, Politics, World News. You can follow any responses to this entry through the RSS 2.0. You can skip to the end and leave a response. Pinging is currently not allowed.