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Foundation Hospitals

Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
http://news.bbc.co.uk/1/hi/health/3134421.stm

What are your views on the proposals to create these privately-run treatment clinics?

I'm not sure. I like the idea of cutting waiting lists (who doesn't?). And I'm not so much worried that they might be the start of a slope towards privatisation. I'm more worried about whether they'll actually be a help or a hinderance to the NHS. Will it mean funding diverted away from NHS hospitals? What will happen to the people who decide to stay on NHS waiting lists?

Comments

  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Every single public service the private sector touches turns into shit.

    Don't expect this to be much better...
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    wheres MOK when you need him?
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Originally posted by morrocan roll


    nice new sig Mr Roll


    :)
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Here's a radical thought:

    You have these big "treatment centre" buildings and they treat everything, cataracts, hip replacements, pregnant women, stroke victims the lot. Then you have a "walk in centre" where the public can come in and get treated for any accidents that befall them. We could also have "community service vehicles" which pick up the injured quickly and take them to the "treatment centres" and you'd call for these "community service vehicles" on a memorable number like "NHS Direct". You could have these services run by a "compulsory universal insurance contribution" taken from peoples wages and it could be run by one company which would have "community involvement" as the public would elect "managers" to a London headquarters who would steer these centres in a stated direction.

    Sound familiar? ;)

    Fact is this is New Labour management-speak bollocks. The way to improve the NHS is actually very simple, you don't need public private partnerships or private finance initiatives or even contributions from the voluntary sector. You.... <shock horror> raise taxes, you tell people if they want a decent health service they need to pay for it and if they don't like it they can vote Tory and get a £5,000 bill for a hip replacement when the time comes. Then you spend the money on actually hiring people, building new hospitals and providing more treatments. No contractors, no profit motives, no fuss - the only motive is to provide the best possible service to the patient. Hmmmm, funny idea, wonder if it'll ever catch on? :chin:

    Edited to add that you don't need private contractors to build new "treatment centres" you just give existing NHS hospitals the money to add some new wards, buy new equipment and hire more staff. But then again that wouldn't involve the private sector....

    New Labour is a lot like Animal Farm "private good, public baaaaad" said the New Labour backbenchers. :rolleyes:
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Originally posted by morrocan roll
    wheres MOK when you need him?

    Enjoying my weekend, away from the NHS!

    Still I’m glad someone else has posted about this. I was going to but wasn’t sure that others would be interested. Relieved to see that they are…

    When I talk about “capacity” I am referring to beds, theatres, nurses, doctors etc. Each of these (plus numerous other people) are needed to allow operations to happen. A full team and equipment together means that we have space resources available to operate – we refer to this as capacity.

    Sorry if that sounds condescending but I have to make sure that people understand what I am talking about. Too often we use terms that the public doesn’t understand and it gets us into trouble…
    Originally posted by KoolCat
    What are your views on the proposals to create these privately-run treatment clinics?

    First off I need to explain that you are talking about two different things. The title of this thread is “Foundation Hospitals” but this isn’t what the release was about on Friday.

    What the Govt are proposing – well, what is actually going to happen – is that a number of separate clinics/hospitals/treatment centres (call them what you want) will be set up, with the funding for the new buildings required paid for by private companies. This release says that 7 companies will get the first contracts to run these centres. Five are foreign.

    Foundation Hospitals are existing Trusts which will be given new “rights”, but are not connected to this at all.
    I'm not sure. I like the idea of cutting waiting lists (who doesn't?). And I'm not so much worried that they might be the start of a slope towards privatisation.

    They aren’t. That is just a scare tactic. Funding for operations will still come from the NHS pool, so how will they be a slide towards private healthcare. The NHS already buys “capacity” from private hospitals, so nothing is really changing on that front.
    Will it mean funding diverted away from NHS hospitals? What will happen to the people who decide to stay on NHS waiting lists?

    Now this is where things get interesting, and I was briefed on this aspect last week.

    Basically hospitals get paid a certain figure for each operation they carry out. We agree to do x number of operations at the start of the year for x amount. A contract between the hospital and Primary Care Trusts (PCT).

    A PCT is a group of local GPs, they received their funding from your Strategic Health Authority (who overlook all health needs in your area, including mental health, social needs, GPs, hospitals etc) and the PCT then contracts the work to certain hospitals.

    What will happen here is that the contract will be with the new units, which are known as Diagnostic Treatment Centres (DTCs). They will receive the same amount per operation from the PCT that the original hospital did.

    And this is where things get a little murky.

    The Govt will (and are currently) play up on this point.

    What they haven’t made wholly public is the existence of a central pool which will “top up” these contracts to make them more “palatable” and to help with “set-up” costs.

    This money isn’t “new money” and will have to come from existing NHS funds…

    From a patient’s point of view, you will remain an NHS patient. All that will happen is that you will be given the choice of where your operation will take place. As these new centres will have no existing waiting list, the wait will be shorter. People currently on the list will be able to choose to go to these centres, so they won’t lose out.
    Originally posted by kevlar85
    You have these big "treatment centre" buildings and they treat everything, cataracts, hip replacements, pregnant women, stroke victims the lot. Then you have a "walk in centre" where the public can come in and get treated for any accidents that befall them. We could also have "community service vehicles" which pick up the injured quickly and take them to the "treatment centres" and you'd call for these "community service vehicles" on a memorable number like "NHS Direct". You could have these services run by a "compulsory universal insurance contribution" taken from peoples wages and it could be run by one company which would have "community involvement" as the public would elect "managers" to a London headquarters who would steer these centres in a stated direction.

    Very good! Except to say that most of the DoH comes from Leeds rather than London…

    But missing one major point. The NHS doesn’t currently have enough capacity to treat the number of people needing operations.

    Thanks to years of under-funding, it would require an enormous injection of cash to give us enough.

    “Ah”, I hear you say, “but didn’t the Chancellor just give the NHS an extra 9%, in the budget?”

    Well, yes he did, and then he took 7.4% back thanks to the increase in NI contributions. So we only actually ended up with a 1.6% increase.

    To give us the amount of cash we actually need would, as you say, require a huge increase in taxes.
    New Labour is a lot like Animal Farm "private good, public baaaaad" said the New Labour backbenchers.

    Actually they say the opposite! It’s the front bench and the Tories who think “private good”




    So what do I think about these DTCs?

    Well, if you thought that was complicated then wait for this…

    Currently when you need an operation you have to be admitted to hospital. Well, that’s what most of the public seem to think. Actually this isn’t true.

    75% of all elective (i.e. non-emergency) operations could be done as a day case. The culture in this country though means that people seem to think that they need a bed and an overnight stay to recover. The centres won’t offer such a choice (in the main) and so patients will be encouraged to leave the unit on the same day as they have their operation. When you consider that the US runs a system in which the public expects to be admitted on the morning of their operation and to go home later in the day, what we are suggesting isn’t that radical. We are just moving into the 21st century at last.

    Secondly, the 25% of people who do need a bed have to share resources with emergency cases. Naturally the emergencies will always take precedence and so we cancel the operations of the elective patients. In fact, in the first quarter of this financial year, the NHS cancelled over 14,000 operations either on the day that the operation was to take place, or worst still after the patient was sitting in a bed.

    Now, imagine that. How pissed off would you be?

    So let’s add another variable. Someone comes in for a routine operation and stays in a bed – filling a ward. Now you turn up as an emergency and need a bed. How would you feel knowing that someone coming in to – for example – have their varicose veins sorted, is sitting in that bed?

    What the NHS is trying to do, is to separate these two “streams” of patient. The emergencies and the “routine” surgery.

    It’s something which I have been arguing for, and so I support the ideal behind this change.

    The NHS does need the extra capacity, room to carry out the number of operations which the medical condition of the population demands. This will achieve that.

    Don’t get me wrong, I’m not comfortable with the private companies involved. I’m not comfortable that people will be making a profit from this. However, at the end of the day, if this means that people will not have to wait so long for an operation, if this means that emergency patient won’t have to wait to get a bed, then I am all for it.

    There is one question still unanswered though. Currently these companies will be banned from employing “current” NHS staff, because we don’t have enough now. Consequently they are having to go abroad for their staff. Do you think they will find enough? What happens if they don’t?

    Already moves are being made to employ doctors from the UK to work in these centres… in addition to their exiting NHS contracts and private work...

    Added to that (so really there are two questions) is the one about training and clinical skills. If we take these operations outside of the current NHS hospitals, without using NHS staff, then how will junior doctors be trained on these cases and what will happen to the skills of current doctors who will no longer see some many cases. Think about what happens to your skills if you don’t use them anymore…

    That is what worries me.
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Originally posted by Man Of Kent

    Very good! Except to say that most of the DoH comes from Leeds rather than London…
    I was referring to the politicians in Westminster but point taken. :)

    But missing one major point. The NHS doesn’t currently have enough capacity to treat the number of people needing operations.

    Thanks to years of under-funding, it would require an enormous injection of cash to give us enough.

    “Ah”, I hear you say, “but didn’t the Chancellor just give the NHS an extra 9%, in the budget?”

    Well, yes he did, and then he took 7.4% back thanks to the increase in NI contributions. So we only actually ended up with a 1.6% increase.

    To give us the amount of cash we actually need would, as you say, require a huge increase in taxes.

    Forgive me if this is a stupid question but why don't they just build more wards for operations? Surely it was save time and money instead of messing about with contractors and private money. Also why don't they just take public sector workers off the tax rolls? As they're paid by the government isn't it silly for them just to give the money back? Why not just take the amount they pay in taxes off their wages?

    Actually they say the opposite! It’s the front bench and the Tories who think “private good”
    Yeah but the front bench is New Labour - New Labour and the Labour Party aren't the same thing. :)
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Originally posted by kevlar85
    Forgive me if this is a stupid question but why don't they just build more wards for operations?

    Because it's not just about buildings or beds. That is something which the public get wrong, but for once the Govt seems to understand.

    We just don't have enough surgeons.

    In the NHS a consultant surgeon will cost over £250,000 per year. Each consultant has a registrar and two juniors, a secretary and will only work for seven sessions (i.e. 3.5 days per week) and that is something laid down under existing consultant contracts.

    The Govt has tried to correct this through new contract agreements but the BMA won't have any change.

    So, part of the solution is this route. Get someone else to employ a doctor, on a privately agreed contract. basically the private company can ask the consultant to work 10 sessions (five days) per week, without all the "trimmings"...

    This (by proxy) could get the NHS an additional three theatre lists per week - of up to 15 operations.

    That's every surgeon who is employed by the private company.

    Now can you see the benefit in that...

    Also why don't they just take public sector workers off the tax rolls? As they're paid by the government isn't it silly for them just to give the money back? Why not just take the amount they pay in taxes off their wages?

    I've suggested that! Not sure how far it's gone... I'm still too much of a small fish. Everything I say gets "washed" at least three times before it hits the minister...

    Just think of the recruitment that could bring - "work for the NHS and never pay tax!"...

    I would lay money that you would see people return in droves. But then look how much money the treasury gets from us in tax...
  • Former MemberFormer Member Posts: 1,876,324 The Mix Honorary Guru
    Here's an interesting story about the new hospital in Norwich

    Story

    This at a time when a report is published suggesting that 3,500 "elderly" people are being kept in hospital because there is no place from them to get their care outside...
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