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Public Services for All > Published by Trevor Cheeseman, January 31st 2011 at 10:25 am

NHS case for change “oversold”, as medics’ concerns grow

The basis for the government’s NHS reforms have been challenged by the UK’s leading health policy institute, the Kings Fund, as more doctors’ groups voice their concerns.

Operating-theatre David Cameron said that patients should not have to settle for “second rate” healthcare, while health secretary Andrew Lansley told the BBC:

“We don’t get the results we should compared with other European countries; if we did we would save thousands of lives.”

Yet in a report from the King’s Fund Institute (President: the Prince of Wales and by reputation scrupulously non-political) has openly questioned the rhetoric that poor NHS clinical outcomes should be better, saying the case for change has been “over-sold”.

The report, by King’s Fund chief economist Professor John Appleby, says figures relating to cancer and heart attack deaths are “not straightforward” to interpret, and “depend where you look”.

The report highlights that:

“The trajectory for many causes of death swoops up and down over decades – often linked to changes in lifestyle behaviours rather than spending on healthcare…

“These are confirmed by the Office for National Statistics, which last year reported improvements in five year survival rates between 2001-6 and 2003-7 for nearly all cancers. But Eurocare [the cancer study cited by Lansley] is problematic; the latest study includes diagnoses only up to 2002.”

The context here is that UK health spending as a proportion of GDP declined under John Major’s government, and only started to increase from 2000/1.

Interviewed by the BBC, Appleby commented:

“These trends must challenge one of the government’s key justifications for reforming the NHS.”

The message that NHS outcomes have been improving and do not need the shock therapy of full market forces to continue this trend is reinforced by report in The Daily Telegraph on briefings for MPs, prepared for this week’s discussion of the Health Bill.

The Royal College of Surgeons briefing says:

“GP commissioners are likely to avoid buying expensive, but necessary, operations such as hip replacements and hernia surgery in order to save money… Short-term apparent economies are likely to cost the public purse more in the long term.”

It also said that “standards of patient care may be compromised” unless it is made clear that “the lowest price” should not drive decisions.

The Royal College of Physicians says it is “anxious” that the new system should not lead to the fragmentation of services, which will worsen a nationwide “postcode lottery”. It remains significant as well that the group of doctors who lead on clinical change for the Department of Health have kept a low profile on the reforms, apparently resisting being drawn into Lansley’s attempts at clinical justification for rolling out a market in healthcare.

The respected medical journal The Lancet is blunter still, the latest editorial saying:

“As it stands, the UK Government’s new Bill spells the end of the NHS.”

Drawing comparison with healthcare before the foundation of the NHS in 1948, they comment:

“Now, GPs will return to the market place and will decide what care they can afford to provide for their patients, and who will be the provider. The emphasis will move from clinical need (GPs’ forte) back to cost (not what GPs were trained to evaluate).

“The ethos will become that of the individual providers, and will differ accordingly throughout England, replacing the philosophy of a genuinely national health service.”

So, in the words of Philip Stephens in the FT:

“Mr Cameron has yet to come up with a plausible explanation of the problem he is trying to solve… All the evidence – in terms of clinical outcomes and patient satisfaction – suggests the NHS is travelling in the right direction.”

http://twitter.com/rattlecans/status/32021767002259456 Ma

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
http://twitter.com/suey2y/status/32021797188665344 Sue Marsh

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
http://twitter.com/jacquipybus/status/32022008816467968 Jacqui Pybus

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
http://twitter.com/wmjlee/status/32026423933804544 William

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
http://twitter.com/jordanbhall/status/32026589218734080 Jordan Hall

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
http://twitter.com/edwardclarke/status/32027005478248448 Edward Clarke

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
http://twitter.com/banerji1/status/32027413248475136 ria banerji

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
http://www.bigtony.co.uk/blog/2011/01/31/nhs-reforms-are-this-governments-poll-tax-the-guardian-6/ NHS reforms are this government’s poll tax – The Guardian « Google News « Big Tony's Big Network

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http://www.bigtony.co.uk/blog/2011/01/31/nhs-reforms-are-this-governments-poll-tax-the-guardian-9/ NHS reforms are this government’s poll tax – The Guardian « Google News « Big Tony's Big Network

[...] Press AssociationWar of words as Health Bill gets debatedOnMedicaPolitics.co.uk -U.TV -Left Foot Forwardall 765 news articles » Bookmark on Delicious Digg this post Recommend on Facebook [...]
http://twitter.com/bethwatbrad/status/32031167066673152 Bethany W-Bradley

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
http://twitter.com/westernshores/status/32033001747521536 Pen

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
http://www.bigtony.co.uk/blog/2011/01/31/pms-relative-questioned-nhs-reform-the-press-association/ PM’s relative questioned NHS reform – The Press Association « Google News « Big Tony's Big Network

[...] Without OverhaulSky NewsWar of words as Health Bill gets debatedOnMedicaPolitics.co.uk -Left Foot Forward -HealthInvestorall 777 news articles » Bookmark on Delicious Digg this post [...]
http://twitter.com/healthfreaks/status/32036971492679680 sge

NHS case for change “oversold”, as medics' concerns grow: The context here is that UK health spending as a propo… http://bit.ly/icbnnk
scouser

something must be done to stop the drain on the money the tax payer puts into the nhs, the nhs is bloated with people doing non jobs plus many of todays nurses are very poorly trained and their bed side manners are not as they should be money is being wasted by beaurocarcy and over staffing, my wife had an appointment at our local hospital to see a specialist, when we arived at the area in the hospital where the doctor was holding his surgery, we where met by two young girls seated at a desk where they signed my wife in, we where told to go to a waiting room and after a 45 minute wait a nurse took her another room and weighed her, then she was told to go back and wait for her name to be called, after a 30 minute wait her name was called and a different nurse took us from that waiting room to another waiting room, we waited 10 minutes then a fourth nurse then lead us to a room where the specialists was situated, he looked over my wifes records and asked her some questions regarding her health and how she was feeling and told her an appointment would be sent to see him again in 6 months time, in the doctors office sitting alongside the doctot was yet another nurse who showed us to the exit and said goodbye, in all we had seen 2 clerical staff and 5 nurses surely the hospital cannot afford to pay for that many people just to get every patient safely to the doctors office
http://twitter.com/andy_s_64/status/32041935631818752 Andy S

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
http://twitter.com/lesa50/status/32044482580975617 lesa

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
Paul B

The people you saw were probably health care assistants, not nurses. And they were not “getting you to the doctors door”, they were weighing your wife (the patient) and recording the details so that the doctor’s time could be spending doing what doctors are paid to do – make clinical decision. Nurses training is the highest it has ever been (a degree is now required).
http://twitter.com/wdjstraw/status/32047684164521986 Will Straw

As Cameron agains talks down the NHS, health experts question Government rhetoric as “oversold” http://bit.ly/gin8Mg
http://twitter.com/therightarticle/status/32047967925964800 Michael

RT @wdjstraw: As Cameron agains talks down the NHS, health experts question Government rhetoric as “oversold” http://bit.ly/gin8Mg
http://twitter.com/pmreid86/status/32048263649562624 Paula Reid

RT @wdjstraw: As Cameron agains talks down the NHS, health experts question Government rhetoric as “oversold” http://bit.ly/gin8Mg
http://twitter.com/benleto/status/32048968145829888 Ben Leto

RT @wdjstraw: As Cameron agains talks down the NHS, health experts question Government rhetoric as “oversold” http://bit.ly/gin8Mg
http://twitter.com/bernardandpaul/status/32049692598607872 Bernard and Paul

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow http://bit.ly/fRoGxs
http://victorialabour.wordpress.com/2011/01/31/lancet-the-government%e2%80%99s-new-bill-spells-the-end-of-the-nhs/ Lancet:- the Government’s new Bill spells the end of the NHS. | Victoria Ward Crosby labour

[...] from Trevor Cheeseman in Left Foot Forward The respected medical journal The Lancet is blunter still, the latest editorial [...]
http://twitter.com/mellandells/status/32060624313782272 Mel Landells

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow: http://bit.ly/gin8Mg
http://twitter.com/biggervoice/status/32073218835615745 Jan Bennett

RT @wdjstraw: As Cameron agains talks down the NHS, health experts question Government rhetoric as “oversold” http://bit.ly/gin8Mg
Peter

The problem that we (The “Left”) has is that instead of engaging ideology with ideology, we play THEIR (the Tories’) game of ‘managerialism’. Arguing the toss over the statistics is not invalid, but largely unproductive. Nobody, least of all Joe Public believes any of it anyway!

We need to put our case in simple terms: we believe in Universal Free at the point of delivery Health Care. We believe that we should tax people to acheive it. We believe it should be the best. We believe that it is best provided via a Government funded and run scheme.

I could go on.

Frankly, if it comes to smarmy over-educated middle class men in suits, then superficially at least ours and theirs are essentially the same. Ed needs to whip-up a bit of Class Consciousness and make some unashamedly “Socialist” statements.

Marx may be dead, but Marxism isn’t. I was about to write that we are drifting into a new Feudalism, but we’re not drifting, we’re steaming at full speed. The new (note no capital) Labour project should be to reintroduce some politics into the debate.
max

The problem is that people believe that they have a God given right to free health care, if they actually knew the money that is spent for every appointment they would be greatful for the NHS.
http://twitter.com/cllrkrichards/status/32198411990077440 Kevin Richards

RT @leftfootfwd: NHS case for change “oversold”, as medics’ concerns grow http://bit.ly/fRoGxs
Mr. Sensible

The public don’t want these reforms, the medical professions don’t want these reforms, and even the Spectator is unsure.

The government need to go back to the drawing board and start again.