Saturday 26 April 2014

No 'top-down reorganisation' of the NHS at No. 10

"Boy, Oh boy!" Arturo said, "you know something, mi old pal - we're living with Humpty-Dumpty. Remember what he said, do you?
“When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.’
And that's just what 'Boy David' Cameron has been doing with words on the NHS!"

So - I looked up to find out just what Cameron had said about the NHS - when he hoped to catch people's votes.
Mr Cameron called the NHS one of the 20th Century's greatest achievements.

"Tony Blair explained his priorities in three words: education, education, education," he told Tory activists in Bournemouth.

"I can do it in three letters: NHS."

These sentiments were quoted by the BBC in 2006 - before Cameron attained power. In the same speech, the BBC reported
He promised "no more pointless and disruptive reorganisations". Instead, change would be "driven by the wishes and needs of NHS professionals and patients".

This was part of a speech in which:
The Tory leader also hit out at those accusing him of peddling spin rather than substance.
In an attempt to refute these accusations:
He said: "I want to deal with this issue about substance. Substance is not about a 10-point plan, it is about deeper things than that. It is about knowing what you believe, it is about sticking to your guns.

"It is about taking time to think things through, not trotting out the easy answers that people want to hear.

"It is about character, and judgement, and consistency. It is about policy, yes. But it is about developing policy for the long-term."
http://news.bbc.co.uk/1/hi/uk_politics/5403798.stm

So - the NHS is 'one of this country's greatest achievements', is it? It WAS! But - 'Baby, look at it now!'

So - 'substance' is about 'knowing what you believe, it is about sticking to your guns' Well - let's look at the evidence.

Some guns!! Cameron with the help of the LibDems have done a demolition job on the NHS - couldn't do that with just a Colt 45, could he?

What else did this man of substance do about the NHS? He embarked on a radical plan of re-organisation almost as soon as he became Prime Minister. The reorganisation was under the guidance of Hatchet-man Lansley. The King's Fund had this to say:
The Health and Social Care Bill represented the biggest shake-up of the NHS since its inception...
http://www.kingsfund.org.uk/topics/nhs-reform/health-and-social-care-bill

Protests were rife - this was not what Cameron had pledged. Not at all. So - ever the PR man, he set to work to keep the masses happy. He didn't quite ask them to 'eat cake' - but almost! He told them he would have further consultations and would listen! I bet, he did!

After that, Emily Fox in 2011 wrote in The Express
David Cameron admitted ministers had “learnt a lot” in recent weeks and insisted that many people had changed their minds about the proposals.

In a speech to NHS staff in London, the Prime Minister admitted there were areas of the reforms that needed to change.

He said: "Hospital doctors and nurses - not just GPs - would now be involved in commissioning, clinical senates would bring together healthcare professionals to oversee the integration of care over wide areas and the health regulator Monitor would have a duty to promote integration."

Acknowledging widespread concerns about the Health and Social Care Bill, Mr Cameron promised there would be no “selling off” of the NHS, that waiting times would be kept under control and that competition would only be used as a means to improving services.

The Prime Minister said there had been an “important debate” over the past two months which had led to “a whole range of people” changing their views.
http://www.express.co.uk/news/uk/251349/Cameron-NHS-is-safe-in-our-hands

Nothing daunted and with the LibDems' sycophantic help, the Health and Social Care Act was passed. Last year, Cameron was still uttering his mealy-mouthed words. ITV reported:
David Cameron said the NHS was "completely safe" in the Government's hands after 11 failing hospitals were placed under "special measures" management.

Speaking after Sir Bruce Keogh's damning review of hospitals, the Prime Minister said: "I think everyone can have confidence in the NHS and everyone can have confidence that their local hospital either is a good hospital or is being turned around and being made into a good hospital.

The man obviously thinks he is in 'Alice in Wonderland'! ITV went on to report Cameron's musings:
"There is much to celebrate in our NHS and I love our NHS, and I never want to do it any harm, but we don't serve our NHS by covering up problems and difficulties and clearly there are some hospitals with too-high mortality rates."
http://www.itv.com/news/update/2013-07-16/cameron-nhs-completely-safe-in-coalition-hands/

Sadly, we are not in the fantasy world of 'Wonderland'; we are in the here and now. So, let's see what the present situation really is.

According to the headline written by Mark Gould in The Guardian:
GPs braced for shutdown after 'toxic mix' of loss of funds and high demand: At one of 98 GP surgeries in England under threat of closure there is despair that NHS reforms could kill off good care

The article continues.
"Give it a year and I think we will have to close," says Naomi Beer, a frustrated and angry GP who works in a surgery (Jubilee Road) which has been providing care to a largely poor and deprived area since the start of the NHS in 1948. In February, NHS England admitted that 98 surgeries could be under threat of closure as a result of what doctors' leaders have described as a "toxic mix" of a flawed funding system and seemingly uncheckable demand for medical care. ...

But, due to changes in the labyrinthine system of funding general practice, Jubilee Street faces the loss of many hundreds of thousands of pounds, which Beer and the equally angry practice manager, Virginia Patania, say will soon make it financially unsustainable.

"We are now eating into practice savings to continue providing a quality service. But we are planning for a 'red button day' when we will have to dissolve the practice," says Patania, who gives a detailed breakdown of their financial crisis. "I have been raising our concerns with NHS England since Christmas and I get no satisfactory answer. I want to know sooner rather than later because I'd rather dissolve at six months than wait 12 and face even higher losses."

The article continued:
The practice hits all the government's quality targets, has a 94% patient satisfaction rate, and has introduced internet-based consultations, appointments, repeat prescriptions, and while-you-wait phlebotomy. And it is the only surgery in Tower Hamlets that has received the Royal College of General Practitioners (RCGP) Quality Practice Award – for excellence in training and for the quality of its care.

Mark Gould gives details of the consequences of this catastrophic situation for the NHS. It is not just this practice, as he makes clear:
Dr Richard Vautrey, the deputy chair of the British Medical Association's GP committee, fears the Jubilee Street situation could be repeated in several hundred practices, not just the 98 identified by NHS England as at severe risk. "This is the tip of the iceberg," he says. "Practices are struggling with workload and funding and many GPs, although they love general practice, are seriously considering retiring early. The knock-on effect of losing high-quality general practice and cutting its funding will be more pressure on hospitals. We need concrete action from NHS England and that requires more financial resources."
http://www.theguardian.com/society/2014/apr/16/gps-surgeries-shutdown-loss-funds-high-demand-nhs

Of course, this is only one small bit of the story! We don't know the full picture of what's happening in our hospitals - apart from the fact that many are closing! Also - there's the little matter of privatisation! But - we can only whisper about that! Otherwise Cameron might have apoplexy - then where would he go to be treated!

So, after all the Cameron rhetoric, this is the state of the NHS in 2014. Just read what he pledged in a speech at the Royal College of Pathologists on 2 November 2009:
"With the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS."
http://www.newstatesman.com/politics/2013/11/pre-election-pledges-tories-are-trying-wipe-internet

The present parlous state of the NHS throughout the country is really bad timing for our 'Safe in Our Hands' Coalition of Tories and LibDems - the European Election is looming and there's to be a General Election next year! Let's hope that like elephants, the voting people of the UK have long memories!

Arturo said, after a little while, "Of course, mi old pal, you have to recall the whole of the Humpty-Dumpty quotation to get the full picture. Let's see, if I remember it correctly, it is:
"When I use a word," Humpty Dumpty said, in a rather scornful tone, "it means just what I choose it to mean -- neither more nor less."

"The question is," said Alice, "whether you can make words mean so many different things."

"The question is," said Humpty Dumpty, "which is to be master -- that's all."
http://iheartquotes.com/tags/lewis_carrol

"That, of course is the problem here in Downing Street," Arturo hissed, "Humpty-Dumpty rules OK. He's certainly the 'master' of verbiage in these corridors!"

Arturo and I felt more than a little queasy after all this malarkey - so it's just a little dim sum for us tonight!

Bye

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