NHS reforms live blog

It’s a big day for the NHS. The prime minister is answering mounting questions on the health bill this morning, and Steve Field GP will be with us in the afternoon. We’ll be live blogging all the news right here. 11.34am: The prime minister is moving on to the second half of his speech: we need NHS reform to make sure we deal with the extra demand from an ageing population and the cost of new technology. 11.33am: “We’re approaching the European average spending on health. I just think it’s time we had the confidence to say we should have some of the best health outcomes in Europe too. Saying this doesn’t make you anti-NHS……it makes you pro-NHS – because you want to make things better for everyone.” 11.32am: The prime minister acknowledges that “we are getting better, and we are closing the gap with our European neighbours” in terms of outcomes from the NHS, but we still have some way to go. 11.30am: Cameron has sat in on Prof Steve Field’s surgery. “sat in a surgery in Birmingham last week, listening to the doctor explain that he has world-class physiotherapists in the same building…but he can’t refer his patients to them because the current system stopped it. This is frustrating enough, but add to it to the lack of co-ordination and integration. Modern healthcare needs to be joined up. 11.29am: Cameron takes a pop at vested interests. ” “Last year, the Health Select Committee said “Primary Care Trust commissioning is widely regarded as the weakest link in the English NHS”, citing their “lack of clinical knowledge” in particular. This is what top-down control is doing to our NHS – and I believe it should change. Then there’s the inflexibility of the NHS – and this is what frustrates so many patients, and indeed nurses and doctors.” 11.27am: David Cameron is saying that it’s “because I love the NHS that we need to change it” and denies that he’s talking down the NHS. It’s a classic Whiggish “reform in order to preserve” line. 11.25am: David Cameron is preparing to rally support for his government’s NHS reforms to health professionals in Ealing hospital West London. The speech has been widely trailed in the media, and we’ll be live blogging it here. 11.00am: A spirited exchange between Roy Lilley and Labour’s health policy wonk Joe Farrington Douglas gets to the point: AbetterNHS’s call for the NHS reforms to answer the challenge posed by Non-Communicable Diseases gets immediate backing from the global health community In an email we receive entitled Health Professions Unite to Issue Warning on Global Epidemic of Non-Communicable Diseases we read that Global leaders of nurses, pharmacists, physical therapists, dentists and physicians, said what is needed is a single strategy to prevent and manage non-communicable diseases. NCDs – including cardiovascular disease, some cancers, chronic respiratory diseases, diabetes, mental disorders and oral disease – accounted for more than 60 percent of global deaths, killing 36 million people in 2008, many prematurely. 10.10am: The blogosphere has cranked up the pressure on the government: Paul Corrigan , the widely-respected health analyst who was in a previous life Blair’s health guru, writes a perceptive piece unpacking the propaganda in the NHS debate. He pointed out that a few weeks ago Stephen Dorrell MP, said that the Government had lost control of its health policy. But what if the only alternative you have to losing control is to plough on with a disastrous policy? Isn’t it really rather neat under those circumstances to completely lose control? Just allow a cacophony of dissent to build and then, after a little while, come in and say, “This all sounds pretty bad, and riven by disagreement – let’s start all over again.” That way people see not a Government carrying out a U turn, but one moving forward from arguments between different people with different opinions and coming out with a few very small changes to the existing status quo. So perhaps I have been wrong all along and losing control of a policy is a lot better than being in control of a disaster? The Jobbing Doctor, a GP outside London, blogs that “change is needed, to be sure. But not the grandiose and fundamental change proposed by the Government.” He says the answer is: • Firstly, abandon the vastly expensive and futile project that is “Connecting for Health”. This has cost billions, so far, and is pretty useless to most clinicians. • Redesign the process of “Choose and book” – an appointments booking system, so that it is fit for purpose. • Abandon the internal market in health care where every admission and procedure is costed by the providers (the hospitals) and paid for by the purchaser (the Primary Care Trusts – soon to be commissioning consortia). This only makes sense if the final outcome is complete marketisation of the NHS. • Reduce the level of bureaucracy at all levels of the service Witchdoctor combs through the conference programme at which Mark Britnell, Cameron’s advsior and KPMG’s head of global health, to find this ge: Ruben Toral CEO, Medinet asks: Medical tourism is like buying a holiday on Expedia and the options are no longer local, they are global. Is healthcare inherently different to buying a car or vacation online? Witchdoctor sums it up: “So, it seems we are consumers, not patients, and global companies are poised to opportunistically take their place in the global health marketplace.” A forenzic look by a AbetterNHS at one of the big drivers of future cost in the NHS at non-communicable diseases concludes, rather depressingly, “Patients will have to start paying for their care”. As recommended by the World Health Organisation and highlighted in the BMJ this week, the most cost-effective way to prevent many NCDs is to act ‘upstream’ on the social determinants of health rather than downstream at the level of individuals. This will involve serious and concerted efforts to tackle the effects of food markets globally, and the food and alcohol industry nationally. Sadly our government have shown no interest at all, instead opting for meaningless partnerships with industry and emphaising individual responsibility. 9.35am: Here is a round up of news on the health reforms over the weekend: David Cameron’s spin machine has been whirring away over the weekend – trailing his speech today in which the PM comes out for his cabinet minister, Andrew Lansley. We know this because it’s in all the papers. The FT has Cameron arguing that without reform the NHS will be left with a £20bn hole. Intriguingly it outs Andrew Cooper, Cameron’s new head of political strategy, as a Lansley-sceptic. A “listening phase” was initiated to see how the reforms could be improved, but some advisers – including Andrew Cooper, the new Downing Street director of political strategy – are thought to have advised the whole bill be dropped. The Lib Dem peer Lady Williams is calling on Cameron to dismiss his senior adviser Mark Britnell after he told a conference that the NHS could be improved by charging patients and could be transformed into a “state insurance provider, not a state deliverer” of care. You can read how we liveblogged the Britnell comments here , here , here and here . The BBC’s Today programme had the British Medical Association’s Hamish Meldrum and Jennifer Dixon of the Nuffield Trust. The tone’s pretty sceptical of the bill. Our colleague Denis Campbell led the front page of Saturday’s paper with news that the head of the government’s listening exercise Steve Field GP – who incidentally will be appearing in our offices later today for a live Q&A – said that the government’s health reforms were potentially “destabilising”. On Sunday Andrew Lansley popped up in the Sunday Times where he spent an hour with features writer Margaret Driscoll in pleasant conversation – only to leave without saying goodbye. The blog would say that among the shortcomings of the health secretary brusqueness in departure is not one of them. Driscoll did unearth two important points 1) Lansley knows it’s the speed and size of his bill that worries people. What’s intimidating about it is we’re trying to fulfil all the reform needs in one go. 2) The health secretary’s being backed by David (Cameron): David and I go back 20 years and every step of the way we’ve worked together on this. I’ve seen nothing in the past few weeks that’s undermined my confidence that we have collectively engaged in reforming the NHS in a way that is evolutionary, not revolutionary. Most of the problems and things I have to put up with — saving your Grace’s presence — is to do with media and comment. Over at the Spectator they ask pertinently: The real question, though, is whether this defiance is merely a front, or whether Lansley’s NHS reforms will actually be spared from the “substantive changes” that Nick Clegg has in mind. The Chair of the Liberal Democrat Parliamentary Policy Committee for Health and Social Care John Pugh picked up on Denis Cambell’s story on Saturday saying that his government’s health reforms should be abandoned. Pugh has had the thankless task of collecting Lib Dem opposition to the proposed bill, and this is what he has concluded: He (Lansley) needs to stop tinkering with the existing Bill and start again. Some would say it would be a humiliation. I wouldn’t. I’d say it was the act of a wise man. Listening but is anyone being consulted? Two thirds of people demand that David Cameron rethink the NHS reforms, according to a poll published by the Sunday Mirror. The COMRES poll surveyed 2,004 US adults online this month, emphasing particularly strong opposition to GP control. The BBC reports that private providers are unlikely to swamp the NHS in the wake of the reforms , reporting comments from the NHS Partners Network, which represents health firms, who point out that the 3.5% of NHS operations that are currently conducted by private firms was unlikely to even double over the next decade. 9.00am: With the NHS speeding to the top of the political agenda, we’ve got quite a line up today: 11:30am: David Cameron answers questions on the health service – we’ll be live blogging the whole event 1pm – 3pm: Steve Field GP, head of the government’s listening exercise, will be in the Guardian offices to hear your thoughts. See how he responds to questions from our audience.  If you have any questions for us or Steve Field, please do post them in the sections below, email randeep.ramesh@guardian.co.uk or rowenna.davis@guardian.co.uk or contact us on twitter @tianran or @rowenna_davis. And if that wasn’t enough multimedia options for you, you can also post your thoughts in our flickr account . Cool. NHS Health David Cameron Andrew Lansley Health policy Steve Field Rowenna Davis Randeep Ramesh guardian.co.uk

Posted by on May 16, 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.