First study on the non-emergency 111 scheme.

Hangin’ on…

V 111

I protested, then I grumbled – it didn’t do any good. The excellent NHS Direct was closed down at great expense by NHS England to save money and reduce the numbers attending Accident and Emergency.

Now Sir Bruce Keogh has recommended that the 111 non-emergency line be upgraded with adequate numbers of clinical staff – in effect going back to a poorer version of of NHS Direct.

Now we know why;

The next day out comes a properly researched report from, of all places The Department of Health who evaluated the 4 pilot areas results.

Of course, you and I would have carried out a pilot, evaluated it and then decided whether to roll it out nationwide.

The findings were that emergency ambulance call outs did not fall (why would they?) in fact they rose by 3 %.

The numbers attending A and E rose.

Nice one.

Neil Harris

(a don’t stop till you drop production)

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Sir Bruce Keogh - could do better.

Some of you will realise that compared to the truly dreadful Sir David Nicholson (Chief executive NHS England) so often described as ‘The Man with no Shame’ I hold Sir Bruce Keogh in some regard. He’s the NHS England Medical Director and has different priorities.

He’s just issued a report on Accident and Emergency treatment and it’s quite good. ‘Quite’ because I have some issues, good because it is at least intended to improve things.

1) Reduce the number of A and E’s dealing with Strokes, Heart Attacks and Trauma.

Great idea – in London the number of Stroke units were reduced from over 20 to 8 with the result that the death rate fell dramatically and outcomes improved.

For these three areas specialising works really well, getting early, good treatment is vital.

Before stroke victims waited all weekend for someone to turn up – by then it was too late. Heart Attacks are not the killers they were because of specialisation. Complex trauma needs highly skilled surgeons.

2) A revamped and improved 111 service – with more clinicians and Nurses available on the phone to reduce the number of A and E admissions. Great idea – that’s what we were arguing for when NHS England closed down NHS direct which did that.

Sir David Nicholson – well done again. You just finished off NHS Direct and still have time to watch the failing 111 service being turned back into a pale shadow of NHS Direct at enormous public expense to try and put right another mistake of yours.

3) Improved paramedics, dealing with more cases at home rather than taking them to A and E – who could object to that.

Problems;

1) Where I have a real problem was watching Sir Bruce on a ‘Newsnight’ interview last night. He repeated the nonsense that 40% attending A and E do not need to do so.

It’s nonsense because no one knows that until after the event. The 40% includes all who attend with suspected broken bones for an X-Ray, the abdominal pains, the suspected thrombosis etc. All require tests no Doctor does or paramedic can do. Failing to send those people in for the tests is just negligent; no Doctor would take the risk. So the 40 % includes those who needed a test but luckily they then didn’t need treatment.

2) Keogh expects to downgrade 70 out of 170 A and E’s.

The problem with that is that we have a pretend market not planning. It won’t be the best A and E’s that survive it will be the pushiest, grabbiest Foundation trusts. The others will lose the revenue from admitted patients and decline further.

Losing Cardiology, Stroke and Trauma will remove a massive proportion of any hospitals revenue and that means more closures.

No planning means no concern for local communities and no real search for expertise.

PFI contracts are so binding (an act of parliament could easily unbind them) that being lumbered with a catastrophic PFI is likely to safeguard a poor and inefficient hospital rather than ensure that quality survives.

So Sir Bruce, this paper doesn’t get full marks from me, which is a shame. You were doing quite well up till now. Don’t forget that while you may be thinking about best practise, the managers are only thinking about money.

Neil Harris

(a don’t stop till you drop production)

If you also look at helpmesortoutstpeters.blogspot.com I warn you that tomorrow this article will be repeated - I'm not so well at the moment and the Doctors seem to be out for revenge! Normal service will soon be resumed.

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Time for a big fight.

The article below came from ‘The Independent’ today although the medical Director of NHS London has been very busy briefing the press today and appeared just now (1900hrs) on Channel Four News.

For good measure, my inability to sleep wasn’t helped by listening to BBC News 24 last week where Sir David Nicholson appeared on ‘HardTalk’, a half hour interview. There, he was reading from the same page, only arguing for nationwide hospital closures.

As a result I’ve put a couple of old articles up on ‘Pages’ on the right hand side of this Blog – setting out the arguments as to why shutting A and E’s is a death sentence for many.

Nicholson should have long gone by now but he has stayed on. It’s to push this argument – he’s touting for a seat in the house of lords and some nice part-time QUANGO jobs after he’s gone.

During his ‘HardTalk’ interview he had no answer as to why 2000 of his NHS managers earn more than the Prime Minister or why he will not accept responsibility for the scandal at Mid-Staffs NHS Trust which was part of his responsibility.

What he said was the NHS must consult with the public and yet not be constrained by elections. What he meant by that is that the NHS should be free of any democratic control which will be replaced by sham consultation exercises which all health service campaigners are very familiar with.

Kashmira Gander  

 Sunday 13 October 2013

 The medical director of the NHS for the capital has warned that services are at “breaking point” and that patients are unsafe.

 

 

Dr Andy Mitchell has said that London’s health system is “unsustainable” the day before NHS England will publish a report stating that it can no longer afford to staff all of its hospitals at safe levels.

In an interview with The Sunday Times, Dr Mitchell stated that the public must face up to the reality that hospitals are overstretched and that patients receive an inadequate service.

“They don’t understand how watered down these services are. What we cannot do is carry on with the idea that all hospitals provide a whole range of services. That is completely unsustainable and would become, frankly, unsafe, and is becoming unsafe in many areas.

“The public isn’t really sufficiently aware, that many places don’t meet acceptable standards of care. The expectation is that, as they walk into hospital, they get high-quality service, and in fact, they don’t in many places,” he said.

He admitted he felt anxious about revealing the system’s safety issues because of his “responsibility to change it and improve it” but stated that his team “are trying to patch up all the time.”

 

However, a report by NHS England says the health service cannot afford to staff all its hospitals at safe levels, especially at weekends.

A combination of zero financial growth forecast for the NHS and increasing demands from an ageing and growing population means the public needs to accept that hospitals must be shut or downgraded to medical centres, according to the document.

Current problems in London are seen as a symptom for problems that will blight the country as a whole, with health chiefs forecasting that half the capital's causality departments will have to shut to make the service sustainable. Sir David Nicholson, the outgoing chief executive of NHS England, has warned of a massive funding gap if NHS services are run in the same way as they are now, with the report revealing that maintaining hospitals at their current standard would lead to a £4 billion shortfall over the next seven years in London, a gap that will be part of a £30 billion funding gap by 2020 across the country.

The number of hospitals offering emergency surgery and treating patients who have suddenly become seriously ill must also be reduced. Meanwhile paediatric and maternity departments need to be cut and centralised, making it easier to staff institutions at safe levels. The remainder will become urgent care centres run by GPs to deal with minor injuries and out –of-hours calls.

Shadow Health Secretary Andy Burnham said: “The severity of this funding crisis is entirely of David Cameron’s making. People pleaded with him to stop the reorganisation so the NHS could focus on the financial challenge. He refused to listen and threw the entire system into chaos. The result has been three lost years in the NHS and billions wasted on back-office restructuring.”

We’ve got a very big fight on our hands.

Neil Harris

(a don’t stop till you drop production)

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Mid Staffordshire Hospital updated again.

I keep hoping it will be the last time I Blog about Mid Stafford Hospital trust but it just keeps getting worse.
Recently, one nurse was struck off and another had a limited suspension. One of those two continues to be a manager at that trust - I'm still waiting for the decision as to whether she is a fit person to still be working there.

This weekend, the real victims of all this, the patients, were marching in their thousands. They want to keep Stafford Hospital open, with its Accident and Emergency and Maternity unit and why not?

Haven't they earnt the right to have a good, functioning local hospital to put right all the wrongs that have been done to them?

The only response from the NHS has been to merge this failed trust out of existence and to pay for it all? Shut down Stafford hospital.

meanwhile the managers went on to better things - big payouts or promotions.

What about the lead Clinicians?

 BBC News - 23 September 2013
No action over Stafford Hospital doctorsBy Nick Triggle

Health correspondent, BBC News


Four senior doctors who worked at Stafford Hospital at the height of the neglect
and abuse scandal will not face disciplinary action.
Dr John Gibson, Dr Valerie Suarez, Dr David Durrans and Dr Dermot Mulherin, who
all held senior management positions, were investigated by the General Medical
Council.
But the regulator has now said it is dropping the cases.
Legal advice found there was "no realistic prospect" of success.
The decision comes after widespread criticism when the public inquiry was
published in February that those responsible for the scandal have not been held
to account.
At the time, Prime Minister David Cameron said the likes of the GMC and the
Nursing and Midwifery Council had "some difficult questions to answer".
Since then three nurses have been struck off the register - with one
disciplinary hearing ongoing.
The GMC has given warnings and advice to other doctors who worked at Stafford
Hospital.
But as yet no-one has been struck off for their role in providing medical care -
one doctor has been erased from the register for fraud.
'Systematic management problems'

GMC chief executive Niall Dickson said: "Following the extensive investigations
we have undertaken there is not the evidence to establish either misconduct or
impairment against any of the doctors."
The GMC got legal advice from Tom Kark QC, who worked on the public inquiry,
after taking statements from 26 witnesses.
Mr Kark advised the GMC that while there was evidence that would have
demonstrated there were systematic management problems at the trust - none of it
could be attributed to any individual doctor.
However, Mr Dickson said he was in talks with the Department of Health to relax
the regulatory framework under which the regulator operates.
At the moment, the GMC has to not only prove that a doctor's performance fell
below what was expected, but that they also provide an ongoing risk to patients.
The GMC believes the system would be improved if cases were only judged on what
the individual has done.
"We are not a doctors club. We are not here to protect doctors," Mr Dickson
added.
But Katherine Murphy, of the Patients Association, said while it would be unfair
to comment on the four individuals, serious questions needed to be asked about
the regulatory process.
"The general delay in holding individuals to account for failings at Stafford is
outrageous.
"Years on, and after huge numbers of avoidable deaths, we have still only just
scratched the surface of holding the nurses, clinicians and managers to account
for the failings that occurred."

Neil Harris
(a don't stop till you drop production)
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More Mid Staffordshire Hospital fallout.

This report from the BBC News website brings to an end one of the more shocking incidents from the scandal at Mid Staffordshire Hospital.

I would have used a report from The Nursing Times, usually very reliable but not today. Their report wasn’t helpful and a comment made by a reader (a nurse?) afterwards sought to belittle the episode.

For the record neglect is generally very difficult to prove. This pair were guilty of a number of different acts of cruelty – the failure to test or provide insulin just being the easiest to prove;

Nurse struck off for Stafford Hospital deathGillian Astbury Gillian Astbury died at Stafford Hospital in April 2007

A nurse has been struck off after failing to identify a patient who died at Stafford Hospital was diabetic.

Gillian Astbury, 66, died at the hospital in April 2007 after not receiving insulin.

In July, a Nursing and Midwifery Council panel found former Stafford nurses Jeannette Coulson and Ann King guilty of misconduct.

King has been struck off by the panel, while Coulson was given a caution for a period of three years.

During the earlier hearing, King was also found to have lied about having changing patients' dressings and giving them medication, while Coulson admitted swearing at staff.

The panel heard the pair had failed to carry out blood-sugar level tests on Ms Astbury.

She was admitted to Stafford Hospital a week after suffering a stroke on 1 April 2007.

She did not receive insulin for 48 hours, and was discovered collapsed in a bed at 22:30 on 10 April.

 

In a statement, Ms Astbury's daughter Kate Beeson said: "While we are happy that the conclusion of the NMC hearing draws a line under the case, whatever the ruling, nothing can bring my mother back, and nothing can truly reflect the severity of the nurses' negligence.

 

"We have been fighting for justice for several, very tiring years. Since her tragic death, I have been unable to put my mother to rest.

 

"Today's judgment, and all of the effort that has gone into getting to this stage, will be completely in vain if others in a similar position do not step out and make their voices heard.

 

"It is important that those responsible are brought to account and people need to speak up in order to make that happen."

 

In a statement, the Mid Staffordshire NHS Foundation Trust said its thoughts were with Ms Astbury's family and apologised for the "appalling care" she received.

 

It added that both nurses had since left the trust.

The trust is itself facing a prosecution over Ms Astbury's death, brought by the Health and Safety Executive, under the health and safety at work act.

What was important was the creation of a ‘culture’ where this behaviour became acceptable, just as bullying becomes ‘acceptable’ and was probably also present.

Neil Harris

(a don’t stop till you drop production)

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Everything changes yet everything stays the same.

The Internet is a funny thing – very useful as a research tool at times, sometimes weird.

Last week Google News threw up something spooky from leftfield – I homed in on it because I thought it was another new privatisation, then I realised it was a very old article from 2006 and it seemed to have been put out by the Guardian by accident. I’ve put my comments at the end;

 

A secret plan to privatise an entire tier of the NHS in England was revealed prematurely yesterday when the Department of Health asked multinational firms to manage services worth up to £64bn.

The department's commercial directorate placed an advertisement in the EU official journal inviting companies to begin "a competitive dialogue" about how they could take over the purchasing of healthcare for millions of NHS patients.

The advertisement should not have appeared until after ministers announced the policy next month.

Unison called on the TUC to convene an emergency meeting to respond to the government's "fundamental breach of trust". Frank Dobson, the former health secretary, said: "If this is not privatisation of the health service, I don't know what is. It is about putting multinational companies in the driving seat of the NHS."

Lord Warner, the health minister, defended the policy in a statement to the Guardian at 3.46pm yesterday but had changed tack at 6.05pm. He said he was withdrawing the advertisement to correct "a drafting error", but insisted the contracting out of NHS management would go ahead.

The advertisement asked firms to show how they could benefit patients if they took over responsibility for buying healthcare from NHS hospitals, private clinics and charities. The plan would give private firms responsibility for deciding which treatments and services would be made available to patients - and whether NHS or private hospitals would provide them.

Under the present system, this commissioning work is handled by local NHS managers employed by primary care trusts. Under the new system, the PCTs would contract out the commissioning to big healthcare management consortiums with greater purchasing muscle.

Contenders for the contracts are likely to include big US companies such as United Health and Kaiser Permanente. They may be joined by British insurers such as Bupa and PPP and their EU rivals.

The advertisement, in the Official Journal of the European Union, said the NHS was making a "step change from a service provider to a commissioning-led organisation". The PCTs would be able to contract out procurement, financial management and human resources. Initially there would be a four-year framework agreement covering the whole of England, but the value would depend on how many PCTs agreed to the scheme. It was not clear last night how much pressure there would be on them to do so.

 

Karen Jennings, head of health at the public service union Unison, said: "This is such a fundamental breach of trust that we are asking the TUC to get together a meeting of all health unions to thrash out a strategy. It is a contract to privatise the whole of primary care across the UK.

 

"There is a real danger that contracts will be awarded to the bidder promising the largest savings. It is a fundamental change in Labour party policy. It is a disgrace that jobs of health visitors, community midwives, occupational therapists and district nurses are under threat or may be transferred to the private sector."

Lord Warner said: "The government has no plans to privatise the NHS." He added that the contract advertised in the official journal would give PCTs access to expert help to improve commissioning of services, without going through expensive and time-consuming local tenders.

Now, I would never have searched this out unless it had been thrown out randomly. What’s interesting is that the policy (as far as I know) was never carried out by the then Labour Government of Tony Blair, it was drowned in protests.

What is interesting is that, with a bit of tweeking, this is roughly what happened this year; the Primary Care Trusts were abolished at enormous expense and with the loss of all those years experience in organising medical services. In their place came the CCG’s – commissioning groups of local Doctors’s but, in reality controlled by central guidelines and forced to put all NHS services out to tender.

Which in effect, is the privatisation of that segment of healthcare revealed by accident in 2006 – it’s just that it won’t be managed by efficient multinationals but by amateurish groups of busy doctors.

Different government, slightly different proposals, same effect. The common theme is the civil servants of the Department of Health and the bureaucrats of the NHS – like Sir David Nicholson. And that nobody ever voted for any of this.

Everything changes yet everything stays the same.

(Proust)

Neil Harris

(a don’t stop till you drop production)

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The end of NHS Direct.

Hangin’ on…

The Largest provider of the NHS England ‘111’ non-emergency telephone service is walking away from its contracts.

NHS Direct used to cover the whole of England with its fine telephone advice service – provided by nurses. It got the axe to save money (thanks to Sir David Nicholson).

The creating of the ‘111’ service has been one big problem, as this Blog has reported before and as these  two stories today confirm;

NHS Direct won 11 of the 46 regional contracts for the new service, covering 34% of the population.

In June it pulled out of two areas, Cornwall and North Essex but now says the remaining nine are "financially unsustainable" as well. It had complained that the volume of calls at North West and West Midlands had fallen short by 30 to 40% of the contracted amounts and the service was now  "financially unsustainable". There haven’t been enough calls to make it pay (people don’t trust the service) and the calls take too long (unqualified staff).

Here’s the real problem;

NHS Direct used to be paid more than £20 per call while the payment to the new 111 call centres is only between £7 and £9 per call. This reflects that NHS Direct was based on advice from nurses, the new service uses call centre staff and a computer check list.

 

 NHS Direct has lost £2.8m since April and was "heading for a deficit of £26m if we continue to run the same volume of 111 services until the end of this financial year".

 

The organisation is now seeking a "managed transfer" of its 111 contracts, which have between two and five years left to run, to another provider.  

NHS Direct's current 111 services are;

Buckinghamshire

East London and the City

South East London

Sutton and Merton

West Midlands

Lancashire and Cumbria

Greater Manchester

Merseyside and Cheshire

Somerset

 

‘111’ was supposed to be running in April, some areas won’t now have coverage until next year – the NHS Direct areas will have a pretty uncertain future until a new operator can be found.

 

                            =======//=======

There’s no harmony at ‘Harmoni’, a private ‘111’ provider. Channel 4’s Dispatches programme has been doing some snooping and found  ‘staff shortages, long waits for callers and some cases of ambulances being called out unnecessarily.’

 

One call centre manager is recorded saying that ‘the service was "unsafe" at weekends because there were too few staff to deal with the calls coming in.’

NHS Direct was a real success story, appreciated by all of us who used it. It gave good, helpful advice and saved unnecessary visits to A and E which was saving the NHS money and saving patients unnecessary problems as well.

NHS Direct walking away from the ‘111’ contracts kills off the remainder of the organisation and ensures that it won’t be economically viable to revive it. So, while we will regret it, I doubt NHS England will.

Meanwhile, I’m sure Nicholson, so keen on leaving behind his ‘legacy’, can chalk this one up as another victory – I don’t.

 

Neil Harris

(a don’t stop till you drop production)

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Our friends up north.

Now that ‘Sir’ David Nicholson has been doing the media round for the last fortnight, I suspect he’s off on a nice holiday before he retires. The media were toothless with him – there is now period of ‘public consultation’, when that’s over we will get a big closure programme.

As a taster; Trafford General Hospital in Manchester is to lose its Accident And Emergency, the Health Minister announces.

The sadness of it is that this was the birthplace of the NHS (65 years old last week) and it’s founder Aneurin Bevan was introduced to its ‘first’ patient, 13 year old Sylvia Beckingham. She’d be 78 years old now – I wonder what she thinks about it?

Except, the next door hospitals - Manchester Royal Infirmary and Wythenshawe, aren’t meeting their 95% target for treating A and E patients within 4 hours – so the closure has to wait for them to pull their socks up.

That shouldn’t take long – the summer is usually quieter. It will be fun next winter…

As I keep saying, if you shut the A and E, you shut the hospital.

Neil Harris.

(a don’t stop till you drop production)

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Shouldn't have waited.

Anyway I delayed going to Tesco’s and I regret it now.

“First I just want to say how well supported the NHS has been by the government”.

That was how  ‘Sir’ David Nicholson started his interview with BBC4’s Today programme, and that was all it was, really.

With an aging population, more chronic diseases, better survival, greater expectations, no more money – there will be a shortfall of £30 Billion in 10 years’ time.

So the plan;

1) Better organisation of services

That means cuts. His example was the reduction in provision of Stroke services in London, which had the worst outcomes in the country. The reduction from 31 hospitals to 8 was held up as a great improvement.

Actually, the problem was that the 31 weren’t providing any specialist stroke care at all, other than caring for someone – no scans, no drugs – no specialists.

The eight are great because now people are treated properly. You could do that in the 31 if you wanted to and if you had the money.

Outcomes might well be even better with quick local specialised stroke treatment.

2) Prevention in the community.

3) Efficiency and productivity.

And that was it.

A week and a half of leaking, following his big speech and all it comes down to is cuts, closures and queues.

Thanks for nothing.

Neil Harris

(a don’t stop till you drop production)

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The long wait is over.

We finally got there; lumbering ‘Sir’ David Nicholson dragged himself out of bed today, Thursday, with his long anticipated pronouncement on the future of the NHS.

There you are, you are about to retire with a big fat pension and you have a chance to be provocative before you leave – you could do some good, challenge the cowardly politicians, act as a spokesman for the poor, stick up for the staff, put forward a courageous plan, demand more expenditure for a better NHS.

Eh, no. The big plan, the brave new future – close loads of hospitals.

Is that it?

Just what the government wants?

Lazy bones wasn’t as early as I was – he is being interviewed after 8-00 am, I’m going shopping.

At 0710 am I was listening to Anita Charlesworth, chief economist with ‘The Nuffield Trust’ – normally I’m not a fan, it’s a private charitable trust with a research wing, while at the same time it is also a major provider  ‘non-profit’ private medical services. It may be non-profit but lots of people make a lot of money out of it.

Anyway, Ms Charlesworth did the right thing – she quoted Carol Propper of Imperial College, London and her study which showed that merging hospitals did not lead to greater efficiency, lower costs or better patient outcomes. It was the basis of my series ‘Merger mania’ on my other Blog and is on ‘pages’ here.

So much for Nicholson.

Of course, Carol Propper won’t be getting honoured, while I bet Nicholson will soon be a ‘Lord’ and will wander into a series of well-paid part time posts, to ease the pain of his retirement.

He is going to say that without the cuts there will be ‘many more mid-staffs hospitals’ – at which point I may need to ring 111 about my blood pressure – he was ‘in charge’ of the NHS area which brought us the mid staffs hospitals scandal.

More to follow…after Tesco’s.

Neil Harris

(a don’t stop till you drop production)  

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Happy 65th birthday, the present comes later.

OK, here’s a clue to what’s coming– I unearthed this today although it was published on Friday 5/7/13.

I had to do some checking first – it’s written by a ‘David Nicholson’ and is in The Guardian newpapers ‘Comment is Free’ section of their website, so he might have been any David Nicholson. He could have been a ‘Dave Nicholson’. Or ‘Davey’.

Actually it is the ‘Sir’ David Nicholson - he must have been adopting his ‘man of the people’ disguise for the Guardian readers. The quotes are in italics, my sour comments are in bigtype;

 

The NHS must adapt if it is to survive another 65 years

Responding to massive cultural changes is key to the NHS's future – but putting patients first must remain at its core

David Nicholson      

 

Blah, Blah, Blah…

healthcare system that is free to everyone at the point of delivery, based on clinical need, not ability to pay.

Meaningless platitudes…

The world moves on and all institutions must adapt to survive.

Excuses…

We are caring for a growing number of patients, and their needs are changing as more people live longer, many with long-term conditions. Our budget will not keep pace with rising demand

It’s all your fault really…

the expectations of our patients are changing 

No, what I meant to say was that it was the health workers fault as well…

We must ensure that in every part of the NHS we have a culture that puts patients first – no ifs and no buts

Luckily, none of it was my fault…

thousands of words have been written about the public inquiry into the tragedy at Mid-Staffordshire NHS Foundation Trust. But at the heart of the report was a simple idea: listen to patients and do something about what they tell you.

This is where the B/S/  begins…

Patient power must drive the NHS of the future.

Perhaps this wasn’t the best example …

Look at how the banking and retail industries have modernised by investing in involving their customers.

They went bankrupt and we had to spend billions to bail them out…

 We can do something similar.

It’s a D.I.Y. internet only, can’t find a human, call centre in Nepal, computer says no, no one gives a d@#n world..

We can build an NHS in which patients not only help manage their treatment, they take more responsibility for their records, booking appointments, and organising what happens.

If you think its bad now…

That could truly transform the relationship between the NHS, patients and communities.

Then again, as all the Banks are bankrupt perhaps its not such a bad analogy….

Around the world, countries are responding differently to the age of financial austerity and the rising costs of healthcare. In this country we have said: we are not going to reduce what we offer, we are not going to compromise on care being free at point-of-use, and we are not going to invest more money. So the way to square the circle is to redesign services.

No, of course that’s impossible so…

But as a nation we have a poor record at making this change happen. Too often, legitimate but competing interests collide to create inertia, which means patients do not get the care they should.

The government is wonderful… I agree with everything my bosses say….

We should recognise the commitment of the government to the NHS and its continued protection of the NHS budget. And there are two measures in the coalition government's NHS reforms which offer a way through.

I think they might be stupid enough to believe this….

Locally, the creation of clinical commissioning groups means clinicians will lead service redesign for our NHS.

The future belongs to me…..

Nationally, the creation of NHS England, independent from the government, frees the NHS to produce a long-term NHS strategy.

No more political control, no more democratic control… we can use those clever PR people to have pretend consultations so that we can do want…what we always wanted to do….

A strategy produced with the public and based not on reduction of what we offer, but on change to the way we deliver.

Because we know best what you really want, even if you think you want something completely different…

Political campaigns often cite the slogan "Save the NHS". But salvation lies in renewal, not the status quo.

What everybody wants is for you to go before your ‘vision’ does any more harm.

We want local control – by patients, by clinicians and by health workers, by democratically elected councillors, accountable to us, the electorate.

We want democratically elected governments to be responsible for the money we pay, preparing national strategies with the finest medical minds, concerned only with outcomes.

We may even want some more money spent – taken from areas where we don’t want it spent.

We don’t want grey, anonymous managers telling us what we should have.

We want Doctors running hospitals, helped by managers and not the other way round.

 We don’t want hospital trusts removed from our democracy, making money for individuals and corporations out of the taxes we pay.

And I think you should resign now and shut up for the future, ‘Sir’ David.

Neil Harris

(a don’t stop till you drop production)   

 

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Last chance.

This was meant to be serious analysis, backed up by academic research as compared to my old Blog;

 helpmesortoutstpeters.blogspot.com

Which is all about having fun while you fight back.

But this is serious in another way – the leaks to the press keep coming (check out my last two Blog entries about ‘Sir’ David Nicholson, the head of the NHS and his plans for our future).

Two days ago the stories being leaked were that the NHS faces a deficit of £20 Billion ‘and something must be done’. That’s the bureaucratic code for cutting wages, firing people and closing hospitals.

Yesterday, I read more leaks (it’s the same guy, folks – you can tell it’s a bureaucrat because if it was a politician it would be in all the [papers simultaneously).

Now someone is briefing the press that it’s going to be a £30 Billion shortfall. That’s a lot of closures, pay cuts and layoffs.

Expect the real story to come out later in the week, when lazybones can be bothered to do some more briefing, issue a ‘report’, demand some action.

I already Blogged about ‘Sir David Nicholson and his desire to leave a legacy (The future belongs to us) and get a lordship to add to his undeserved knighthood.

Here’s the political lowdown; the managers know that there is 2 years before an election; this is the last chance to do something unpopular (that means unwanted, undemocratic).

In two years’ time closing hospitals won’t win any votes.

After the election – Labour isn’t going to do this.

The Lib-dems aren’t going to be making any decisions and the Tories are going to lose.

So, now is the last chance to mess us around – if we let them.

Don’t.

Neil Harris

(a don’t stop till you drop production)

helpmesortoutthenhs.blogspot.com

Nicholson's great big plan is coming.

I’ve got that terrible sinking feeling, the one that the captain of a great oil tanker has when he can see the reef two miles ahead, he’s turned the wheel (it’s only a little knob these days) but nothing is going to turn the ship in time. It’s the lack of control that’s so depressing.

During the last few days there have been a series of articles in the press quoting unnamed ‘senior NHS managers’, and that is a code for a briefing from the head of the NHS; ‘Sir’ David Nicholson who is always described by The Daily Mail as the ‘Man with no shame’ because he won’t resign.

In my recent Blog ‘The Future belongs to us’, I pointed out how often his recent speech at the NHS Confederation referred to making major, fundamental reforms in the time he has left – outside the control of the press or politicians.

All the press briefings (senior managers) are saying that the NHS will run out of money and that fundamental reforms are needed before it’s too late. Coupled with Nicholson’s stated wish to avoid the short-termism and localism of politicians as well as his irritation with the press disagreeing with him;

We are in for a plan to shut all local hospitals, sell off the land, build huge monster regional hospitals, paid for by the Private Finance Initiative.

Everything will be a Foundation Trust – so we have no democratic control, no democratic input, and with the PFI – no financial control.

Of course we will be paying for it all.

Oh, and Sir David Nicholson ends up as Lord Nicholson of Mid Staffordshire as a reward for all the dirty work he has done on behalf of the politicians.

If we let him….

Neil Harris

(a don’t stop till you drop production)

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