Mary Seacole | 22.05.2011 00:19
NHS Modernisation Listening Exercise
London SW1A 2NS
The public can also submit responses to a series of biased and leading questions which fall under 4 categories, 1; Choice and Competition, 2; Accountability and Patients, 3; Advice and Leadership, 4; Education and Training, online here -
Here are some sample responses (take a look at the website to see the original questions) -
1; Choice and Competition
The question about which are the types of services where choice of provider is most likely to improve quality is a dishonestly leading question, because the question itself tries to trick people into thinking that "choice" of provider is itself "likely to improve quality" - it isn't. The "any willing provider" aspects of Andrew Lansley's White Paper will actively undermine treatment quality, because willing providers are not necessarily the best qualified, and because the Bill's provisions will compel providers to under-cut each other and compel GPs to award contracts to the cheapest providers.
The question about how to ensure a level playing field between different kinds of provider is also a dishonestly leading question. The question NHS patients want answered is how to ensure quality of service, especially considering that the NHS is, considered in market terms, a health insurance scheme our families have been paying into for generations. The numerous forms of tax UK citizens pay have helped build-up the NHS over many decades, and this is a historic investment that we are entitled to draw upon when we are sick or injured. No-one wants "Free" healthcare. We want the health services we've already paid for.
The question about making patient choice a reality is yet another dishonestly leading question. When patients visit their GP they prize an optimum quality service more than they prize the hassle of having to choose a rival service if the first is poor. The "choice" the "any willing provider" and lowest-price competition aspects of the NHS reforms are designed to encourage is the government's hope that more patients will "choose" to pay extra (in addition to the tax they've already paid) and go private, because, as a direct result of their White Paper, NHS services will for many patients have become intolerably poor.
2; Accountability and Patients
The question about how we can ensure commissioning decisions are made transparent, and that commissioning consortia engage fully with patients etc, is a dishonestly leading question, because the question presumes patients actually want commissioning consortia in the first place, which they don't. Commissioning consortia are being planned as a means to pay GPs to take purchasing power away from hospitals, with the effect that purchasing bureaucracies and red-tape will be needlessly duplicated across thousands of new consortia, that hospitals will lose much of their power to benefit from making cheaper bulk purchases, and that hospitals will lose the power to subsidise loss-making aspects of their provision from the profitable services, which (if these reforms are implemented) will have been taken away and given to private companies.
The question about how we can best ensure the NHS commissioning budget is allocated transparently and used with proper accountability at local level, is also a dishonestly leading question, because it presumes that patients actually want processes of accountability to be enacted at a "local" level. The way to ensure financial best-practice is to compare the performance of different regions nationally, and when patients are sick or injured, they're much more concerned about quality of treatment than they are about issues to do with accountancy. I have never met anyone who has shown the slightest interest in scrutinising the accounts of their local hospital or GP practice, but I've met hundreds of people who are deeply worried about the quality of public healthcare.
As for the question about whether we are doing enough to make sure the NHS at local level has the freedom it needs to take locally-based decisions, the answer is "no", but Anrew Lansley's White Paper commits to government to forcing GPs to commission the cheapest possible services, therefore totally destroying the NHS's ability to exercise "freedom" when it comes to making decisions locally.
3; Advice and Leadership
Since Cameron and Lansley's plans for GP commissioning havn't been passed into UK law, and aren't therefore supposed to have been implement yet, the question about what "early" action is being taken to "improve" quality of services through clinically-led commissioning, shows the government has no intention of actually LISTENING to anyone before pressing GPs to progress the White Paper's plans for clinically-led commissioning! The government puts forward this "listening" exercise as an exercise in democratic consultation, but this question strongly suggests the White Paper's provisions are already being implemented before the consultation process is even finished and despite overwhelming public opposition.
To reiterate, commissioning consortia are being planned as a means to pay GPs to take purchasing power away from hospitals, with the effect that red-tape will be needlessly duplicated across thousands of new consortia, hospitals will lose much of their power to benefit from bulk purchasing, and hospitals will lose the ability to subsidise loss-making aspects of their provision from profitable services. In any true democracy NONE of these plans should be ever implemented "early".
As for what more could be done to ensure that commissioners collaborate to join up services to fit around the lives of patients and carers, the answer is that the government could halt their plans to set-up GP consortia as agencies that take (so-to-speak) "business" AWAY from NHS hospitals, as doing so increases competition (at the expensive of patients) while reducing collaboration.
4; Education and Training
Without specifying what the "aims of the modernisation process" are presumed to be, the question of how proposed changes to the education and training system will support those aims is a bizarre question. However the way health professionals can take greater ownership of education and training is definitely NOT to use GP commissioning to re-direct State healthcare funding towards private providers who have no obligation whatsoever to invest in the training of NHS staff.
The same response also answers the questions about how we can ensure the values of the NHS are placed at the heart of our education arrangements, and how we can BEST combine local and national knowledge to improve staff training - in neither case can these objectives be served by siphoning tax-payers' money towards buying services from private healthcare providers who have no obligation to invest in training NHS staff.