Wednesday, 27 October 2010

Ideologically driven failed policy - the White Paper

Dr Grumble has beaten me to it, this excellent article which neatly summarises exactly what the government's NHS white paper actually means is absolutely essential reading:

"Behind the technicalities, what do the government’s plans for the NHS really mean? Stewart Player and Colin Leys expose the reality of the health service white paper......"

Those who read this blog regularly will understand it well. The ideology behind it is so deeply flawed. The white paper just continues the same old flawed policy which the previous Labour government inflicted upon the unsuspecting public.

The introduction of pseudo-competition and the market has been shown to fail before, private firms invariably only do the easy work for a nice tidy profit, the left over work which is much less profitable and a lot trickier is left to the public sector, a public sector which I may add is being dismantled, it is so much harder for hospitals to work effectively when they lose essential working chunks of their arms and legs, as they are sold off to private firms. Commissioning is at the centre of this wasteful reform, a process which oversees the pseudo market and results in a hell of a lot of expensive and inefficient bureaucracy.

Critics of the article's authors, Leys and Player, love to simply claim that their writing is ideologically driven nonsense. The great irony in this is that the actual reform, the white paper itself, is ideologically driven nonsense. There is no decent evidence that any aspect of these reforms will spend tax payer's money more effectively in delivering health care, thus to criticise the white paper's critics for being ideologically driven is nonsensical, the white paper is evidence free, it is hot air, actually there is a lot of decent evidence which shows that various white paper policies have failed time and time again in the past. ISTCs, PBC, PFI, Choose and Book et cetera have been shown to be an ideological bonfire of tax payer's cash, there is no decent argument or evidence which says that the new white paper will be anything but more of the same needless incineration of tax payer's cash.

Tuesday, 26 October 2010

Cuts, cuts and more cuts

I have no problem with the reality of a recession and belts being tightened, this is just an inevitability and part of life. One thing I do resent is the fact that the last government spent so recklessly off the balance sheet in the form of various PFI schemes.

Numerous NHS Trusts around the country are now paying for the government's errors, they are having to service these PFI contracts and a disproportionate amount of money has to be fenced off to do this. These costs cannot be trimmed, the contracts were set in stone years ago, it is as if the government sold its soul and we are now paying the price, there is no going back.

So while essential services are cut, while patients suffer as PCTs restrict access to essential operations and medicines, it is ridiculous that there is no risk to the income of the private firms who have their hands in the NHS' till. These private firms and guaranteed their profit, they will get their money come what may. The system is all wrong, how can this be right when the blind old man with cataracts is not guaranteed a fix, or the limping old lady with a painful hip is not guaranteed a reasonably speedy operation?

Cuts to local government budgets for social care are going to compound this problem. We are already massively short of beds as it is, so with winter coming and money short, as well as our increasingly aged population, there are some very stormy times ahead.

Saturday, 23 October 2010

Apologies, I am still alive

I apologise for my lack of posting recently, it has been for a mixture of reasons. Firstly I have been pretty busy having just moved jobs, secondly I have been generally disillusioned with politics and health care for the past few weeks and thirdly I sometimes just get a bit lazy. Maybe Dr Crippen's absence is part of the reason too, everyone in the medical blogosphere must miss his excellent writing and razor sharp insight into all matters health related.

I was having a quiet pint last night in a very pleasant pub and there was a certain book by 'Dr' Gilliam McKeith on a shelf there. A few of us began to browse through the aforesaid Dr's book and became rather obvious that it was full of complete and utter bullsh*t. It was very well produced from a publishing point of view, very shiny and well presented, enough to convince the ignorant reader that there may be some 'science' and 'truth' within. However when one skated beneath the surface it was clear that there was very little in there that was not based on the meanderings of a stupid fool.

So why am I rambling on about Gillian McKeith you ask? Well, it has motivated me to start making the effort to do a bit of writing again, I am fed up with the low quality rubbish that gets fed to us in the media a lot of the time, especially concerning science, medicine and politics. There are just so many uneducated quacks out there in so many different forms peddling useless rubbish to unsuspecting members of the public, and this culture is propagated by a lot of rather low quality journalism covering all matters scientific.

Anyway that's about it from me for today, I will try hard to cover a few health related matters with a decent amount of cynicism in the forthcoming weeks, there have just been so many health related issues in the news of late that it's been hard to know where to start. The government's ridiculously stupid white paper has been a big story, while the mismanagement of medical training and the EWTD has been another big one, the failure of 'minor injuries units' is also a story that I intend to cover in the not too distant future.

One massive contradiction in recent days has been the massive cuts that are taking place in the NHS throughout the UK in recent weeks, but at the same time the government is ring fencing the NHS' budget. Something quite clearly does not add up. Is this because various NHS Trusts have been saddled with massive bills for PFI deals and they also know that the new crackpot government reforms are going to see more and more money kept away from secondary care, then poured into the coffers of various government friendly private health care corporations? That would be my cynical explanation, billions are being ring fenced to pay for the stupid new rearrangement of the bureaucrats' deckchairs, while more cash will be squeezed away from the front line. New government, same old reforms taking us backwards, no change really.