Sunday, August 04, 2013

Who Killed the NHS?

Or is it just a victim of its own success? Since it was created in 1948 by Saint Bevan it has grown into a colossus doing things that seemed unimaginable back then. Some of you will remember those days when we had things called clinics and Matrons. I recall me and my mates carrying another mate round to the local clinic with a 6 inch nail sticking through his foot. They patched him up, put a load of that yellow stuff on it and some bandage and we were all back playing on the bombsite in no time at all. Can you imagine that nowadays? Mummy would have a fit and be onto the lawyers in a flash.

So, is it just the amazing things that the medical profession can do these days that has caused the current problems? Or is there something else apart from ideological political interference? Well, there is that thing called the PFI – Private Finance Initiative – otherwise known as off-sheet accounting. It seems to me that all the current problems stem from lack on wonga, money. There is no shortage of expertise, equipment or people available to do the job. It’s a lack of money, and the money is being drained away from the front end by PFI payments to private sector speculators and the highly paid but necessary administrators employed to “manage” this part of the operation [sic!].

I can understand why we have centralised hospitals for Major Trauma, Chest complaints and Strokes. But why does Maternity need to be centralised and why are local Accident & Emergency centres under threat all over London? And why are we being treated like idiots? The plan to close King George A&E at night time has been denied by the local Trust, but the evidence says otherwise.

Here’s Alfred on the subject:

"The faceless idiots who are trying to close the A&E department at King George Hospital (and who doubtless will ultimately succeed) have apparently developed, to use the words of Blackadder’s Baldrick, ‘a cunning plan!’. This information comes directly from the horse’s mouth, or rather, from a conversation with a local ambulance driver. It appears that when patients in Redbridge call out the local ambulance service, they or their relatives are normally offered a limited choice of hospitals to which they could be taken. Queens is OK, Whipps Cross is OK, but – guess what? – King George is a no-no. Ambulance drivers have apparently recently been told not to offer this one. Is this because K.G. services are inadequate? Is this because the place is too far away? Is it because it’s closed for lunch? Well, actually it’s none of these. The closure advocates have realised that the fewer emergency patients received by King George’s, the more credible will be their claim that the A&E department there is under-used, adding strength to the argument that it must be closed. We all know this is a travesty of the truth but equally we all know what can be achieved by fiddling the figures. What a world!"

So, will future generations look back and answer the question by pointing the finger at another Labour, yes a Labour, Politician – the man who introduced the blood sucking virus (PFI) that killed the NHS? I give you Gordon Brown and an old saying - “beware of those with good intentions”.

"The National Health service and the Welfare State have come to be used as interchangeable terms, and in the mouths of some people as terms of reproach. Why this is so it is not difficult to understand, if you view everything from the angle of a strictly individualistic competitive society. A free health service is pure Socialism and as such it is opposed to the hedonism of capitalist society."
—Aneurin Bevan, In Place of Fear, p106

26 comments:

  1. "who killed the NHS" Tony don't care blair did.

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  2. Actually PFI was invented by Norman Lamont, not Gordon Brown, let's get our facts straight

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    1. I didn't say he invented it, I said he introduced it into the NHS. Let's get our facts straight eh!

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  3. Actually PFI was invented by Norman Lamont not Gordon Brown and as for Tony Blair killing the NHS what!! Before Labour came to office the NHS was in a right state.

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    1. dear mr lewis,tony blair and the effects of every thing he did has killed the country,and anyone who voted for him is in complete denial.he was lying to us for years about the financial state of the country,you only had to work in the banking industry to know this,he gave out bigger benefit amounts in order for people to spend money and keep businesses going,those on the lowest incomes have the most disposable incomes,then to top it all off him and his band of men then allowed more people in which means more money paid out in benefits,education,housing and council tax benefits and oh yes the burden and cost to the NHS.........cause and effect be it a few years later but that's how polotics work.

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    2. I would not trust Bliar to care for next door's cat - but then come to it I wouldn't trust Clamerclown, Cleggover, or Moribund either.

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  4. The NHS is not safe in the hands of any government - and here in Redbridge it is at risk of collapse in the hands of the local "Trust". Indeed use of the word trust when applied to that lot is an abuse of language and a gross deception; they are not to be trusted with the NHS at all.

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  5. I think one of the reasons the NHS is in trouble is that, because it is free at the point of delivery, people think it is actually free and don't treat it in the same way that they certainly treat anything they have to pay for. The NHS is only free if you have never paid tax in the UK. I didn't say 'haven't paid NI contributions' as they, like the road fund licence fees, are not kept in a separate pot to fund a specific function of government but are thrown in with general taxation and used by whichever government for whichever purpose they choose. If the government ringfenced NI contributions and used them as they were originally intended, we would soon see how little health care, pensions and benefits could actually be bought and would have to make the decision to pay more if we wanted more, or use what we had more frugally.

    I await the obvious comments about how many people have never paid UK tax but statistically it is a very small number, they just get a lot of publicity. If we denied all but emergency treatment to visitors, illegal immigrants and people who have never paid UK tax it would not save the NHS enough money to make a difference. It makes me cross that my neighbour's mother visits from India and while she is here she has open heart surgery, but I would probably do the same if I lived in India and had a daughter living in the UK so let he who is without sin cast the first stone. It makes me cross but it is probably a drop in the ocean as far as the NHS budget is concerned.

    The problem of unlimited access is compounded by the litigation culture. Ambulance crews hardly dare to tell somebody that his condition is not serious enough to merit a trip to hospital in case that person is the one in however many thousand who turns out not to have earache but to have ear cancer and sues the NHS for failing to act. I have telephoned NHS Direct only once, the morning after I burnt my hand and was appalled by the size and colour of the blister. I merely wanted to know whether I should keep a dressing on it or not. I was told to go and see my doctor. If that is what these services always tell you to do, what is the point of having them? If nobody dares to say 'go away, you've got a cold/a little cut on your finger/a mosquito bite on your leg but you'll be fine' in case they are sued, then people are going to continue to call 999 or present at A&E with the most trivial symptoms and clog up the whole system.

    I do, however, have a suggestion. Would it be a good idea to have a doctor's surgery attached to every A&E, staffed 24/7 by GP's? People often turn up at A&E because they are worried about something and know they may have to wait days for an appointment with their GP. Anybody who needed immediate treatment could then be transerred to the hospital. If there were a minor injuries clinic, also open 24/7, alongside the surgery, then A&E could get on with treating the really serious cases. It would only need a re-allocation of space within the hospital and some recruitment, which shouldn't be difficult as half the population seems to be studying medicine these days. (The other half, of course, is studying law, which may offer a clue to the vast increase in litigation.)

    If you think this is a sensible idea, then we can all be quite sure that it will never be given serious consideration.

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    1. Admirably stated Patsy - but you forgot the half who are "studying" sociology......

      Nobody waited for long to see a GP when you paid 1s.6d to see them at the surgery, or 2s.6d for a home visit. Then much later some clown decided to pay them in excess of £100,000 a year with no requirement to provide out of hours service as part of their contract.

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  6. Every single government (of any colour) since the inception of the NHS, has nibbled or taken great bites from the only good idea that any political party has had since the second world war, (I might stretch that to the First World War,)therefore, ergo, every administration,has contributed to the state that it now finds itself.Both Parties should feel ashamed, and apologise to the whole country, for their lack of concern for their constituents, instead of their greed for power.

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  7. She's done it again. Patsy puts the situation in a nutshell (albeit a coconut shell).

    There is one point she makes which in fact was an actuality.
    There WAS a GP service which ran alongside the A&E services at K.G. It was called the 'GP after hours clinic' and it was run by local GPs after the surgeries were closed, approximately between 8pm and 7am on weekdays and suitable hours at the weekends. Service was instant and efficient with very little waiting around and if you were fortunate you might even have found your own GP sitting there. It was replaced I think by the completely useless and lunatic 111 system. Talk about 'if it ain't broke, don't fix it'!

    Incidentally, while everyone seems to be blaming Brown or Blair for everything including the Wall Street Crash, the sinking of the Titanic, the catastrophic failure of the US banking system and the death of Queen Victoria, readers might like to be reminded that it was Conservative Virginia Bottomley, when she was the Health Minister, who insisted on putting hundreds of mentally unbalanced patients on the streets by emptying mental health wards. I know personally of one instance where an acquaintance of mine was actually killed by such a patient who would otherwise have been firmly under lock and key.

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    1. As I've indicated, I trust none of them with the NHS - including the unelected, unaccountable and deaf mafia at Becketts House.

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    2. sorry to hear about your friend,but would that be one of the hospitals that were converted into great big expensive (don't know why)housing estates that mr blair and I am sure so called "socialist" mp's probably own houses on/in.

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  8. This is the letter Averil Jobsworth sent out


    18 July 2013
    To:
    Healthwatch Members
    Members of Parliament
    Overview and Scrutiny Committee members
    Health and Wellbeing Board members
    CCG leads

    Dear Colleagues
    Re: Measures to improve emergency care for our community
    Further to my letter of 9th July, you will be aware that the Care Quality Commission has said
    the Trust needs “radical thinking” to address the problems with the Queen’s Emergency
    department, including excessive demand, shortage of permanent medical staff and delays for
    patients.
    I am writing today to give you an update on our plans, following media reports regarding a
    date set for the closure of King George Hospital’s (KGH) Emergency department to blue light
    ambulances and a proposal to close the A&E to blue light ambulances at night in the coming
    months.
    As you will be aware, the North East London reconfiguration plans have been in place for
    some time, and were ratified by the Secretary of State in October 2011. We have been
    working with commissioners on implementation plans, which will ensure a safe and seamless
    transfer of services. A provisional date has been set of 2015 to enable this detailed planning
    work to continue. This will allow time for building work to expand the capacity of the Queen’s
    Emergency department, and other necessary changes. These include measures to ward
    configurations and patient pathways to improve patient flow and continuity of care,
    shortening length of stay and ensuring our medical staff are based around the needs of
    patients.
    I would like to stress that no final decision on this date has been made and I will keep you
    fully informed about our implementation plans. The decision on whether to implement the
    plan will be made in the light of our current readiness, and all available evidence about the
    impact on patients and the public. You will recall that our commissioners undertook a
    ‘gateway review process’ for the closure of KGH to maternity deliveries earlier this year, only
    making the final decision following engagement with stakeholders and review of the current
    readiness of the healthcare system as a whole.
    2
    However, it is no longer an option to maintain the status quo until Queen’s is ready to absorb
    the additional demand from the sector and King George, which is likely to take between one
    and two years. The CQC has made it clear that urgent action is necessary, certainly before
    the busier autumn and winter period. Patients are waiting too long in the Queen’s Emergency
    department. We do not have enough permanent medical staff in the Emergency department
    to provide the care that our patients deserve. Queen’s is already the busiest hospital in
    London for ambulance attendances, with 110 a day, often with over 20 ambulances arriving
    an hour in peak times. We also experienced the biggest increase in ambulance attendances
    of anywhere in London over the last year. We cannot simply carry on as we are.
    This is why we are thinking radically about whether any immediate changes can be made to
    the way we use our staff across the two hospital sites to provide the best care to emergency
    departments. Very few patients come to King George in a blue light ambulance at night and
    require a full medical team. This is in contrast to Queen’s, which experiences high demand at
    night. By closing KGH to blue light ambulances at night, we may be able to better meet the
    community’s needs. A full 24/7 urgent care centre for walk-in patients who do not require a
    full medical team would be maintained.
    Our thinking is at an early stage and no decision has been made or timeframe set. We would
    obviously need to work through all the knock-on implications for other services and consider
    in detail how any such decision could be implemented. However, we do know that we will
    need to take urgent action before the autumn, and report to the CQC with an updated plan by
    August. I can assure you that we will work with our partners to plan this through and keep
    you fully informed.
    .
    Yours sincerely,
    Averil Dongworth
    Chief Executive

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    1. I see that Mrs Jobsworth's solution to the Trust's financial crisis is to raise parking charges for the lowest paid staff by more than 42%, but "only" 33% for those on higher salaries. Clearly been keeping a watch on Dedbrisge Council.

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    2. Is this the same Trust who told the Health Scrutiny Committee some 2 years ago that there were 'lessons to be learnt' by closing The Drive surgery with barely a week's notice?
      Is this the same Trust who sat before the Health Scrutiny Committee and the public and said the final decision on Maternity at KGH was not finalised and the following week the local paper had decision on it's front page?
      Is this the same Trust, who clearly have very short memories on communication and lessons learnt that closed the Spearpoint Surgery with just a week's notice?

      The Director of Adult Social Services was 'informed' - please note not consulted but informed 29 minutes before Ward Councillors were and this is the same Trust who are suppose to be in 'partnership' with us as a Council and as a community?

      I agree with the vast majority of the content of Patsy's contribution - however one small point, wasn't it Dear Gordon who increased NI contributions by 1% and that would be 'ring-fenced' to go to the NHS?

      When will the noddies who run the Trust locally and those at a higher level admit, if they do NOT want A&E's cluttered up, they need to provide more GP's so that people do NOT have to be told come back in 2 weeks+/you can only discuss 1 health issue at a time/if you are ill on a Weds/Thurs afternoon (let alone the weekend),forget it.

      Oh and when the trust has been offered areas in new developments such as those built in the centre of Ilford, to set up a GP surgery the offer was declined!

      Vanessa Cole

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  9. 1. Averil Ding-Dong's sublimely obtuse reasoning might have come straight out of a Lewis Carrol handbook. 'Very few patients come to King George in a blue light ambulance at night and require a full medical team...' she says. Of course they b-well don't!!! THEY'VE BEEN TOLD NOT TO GO THERE. So the solution to the now admitted shortage of A&E services (who could have foreseen that?)is to close down an ideal perfectly sited working unit on which incidentally, an enormous amount of money has quite recently been spent and whose closure has been protested against by every right-thinking person of every political colour and every civil and medical organisation in the area and beyond.

    Who's objecting? Well let's wait a little while and close it down when nobody's looking.

    2. Gordon Brown DID ring-fence that 1% increase. It was David Cameron's dear late unlamented friend Andrew Lansley who gave the keys of the house to the burglars.

    3.I wish I could sometimes understand what jkm was talking about. What has releasing mental patients into the community got to do with housing estates?

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    1. I took it that jkm was referring to the closure of Claybury Hospital and its sale for housing development - now known as Repton Park

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    2. i was dear morris,but there are several more around Essex and beyond,did you also know that the developers were also trying at the time to get the whole place a Chigwell postcode and not a woodford one.

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    3. I didn't know that - but surely IG8 is one up on IG7?

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  10. What baffles me is that when I put down a motion at full council for quarterley reporting on Redbridge i of KGH and Queens Key Performance Indicators such as bed and staffing numbers along with mortality rates no other cllr would second the motion.

    Quarterley reports would be a lever to keep open KGH A&E and so stop the planned cut in medical staff in BHRUT of 25% by 2015.

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    1. A good idea in principle - but I would not trust the statistics to be accurate: "lies, damned lies, and BHRUHT statistics".

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  11. I have recently come across the idea of "community health workers" who work in many countries across the planet. Google "BRAC" for example.

    I wonder sometimes if we are fiddling around rearranging stuff without thinking through what it is we want to achieve and what is needed to do that.

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  12. http://clivedurdle.wordpress.com/2013/02/01/primary-health-care-what-is-it/

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  13. THE NEW Chief Inspector of Hospitals has called on people to tell him about the care provided by Barking, Havering and Redbridge University Hospitals NHS Trust.
    Professor Sir Mike Richards said feedback was crucial to helping a team of inspectors decide what to look at when they inspect Queen’s Hospital, in Romford, and King George Hospital, in Ilford, later this month.
    Officials confirmed the trust has been chosen after being identified as being 'potentially high risk'.
    They will hold a 'listening event' on Tuesday October 15 in Redbridge Town Hall, High Road, Ilford, at 6.30pm, before checks are carried out. Anyone who is unable to attend the listening event but wishes to give their views to the inspection team can do this by email to cqclisteningevents@live
    group.co.uk
    Sir Mike said: “It is vital that we hear the views of the people who have had care at either of the hospitals run by the trust, or anyone who wants to share information with us. This will help us plan our inspection, and so help us focus on the things that really matter to people who depend on this service.
    “This is your opportunity to tell me and my team what you think, and make a difference to the NHS services in the local area.”
    Sir Mike said the new inspections were designed to provide people with a clear picture of the quality of the services in their local hospital, exposing poor or mediocre care as well as highlighting the many hospitals providing good and excellent care.
    He added: "We know there is too much variation in quality.”
    The trust is in the first wave of 18 hospital trusts to be inspected under radical changes being introduced by the Care Quality Commission.
    The formal inspection at Barking, Havering and Redbridge University Hospitals NHS Trust will start on Tuesday October 15.
    Sir Mike will lead 'large' inspection teams, headed up by clinical experts including trained members of the public.
    They will investigate A&E, medical care (including frail elderly), surgery, intensive/critical care, maternity, paediatrics/children’s care, end of life care, and outpatients.
    A full report of the inspectors’ findings will be published by the Care Quality Commission later in the year.

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