Tag Archives: health service management

Royal College of Surgeons of England ends quiet alliance with sister Colleges

8 Mar


At the EGM of the RCSEng tonight the illustrious Royal College Surgeons rejected joining with RCGP, BMA, RCN and other health bodies in rejecting the Health and Social Care Bill.

A clear break in the unity of the medical profession has happened.

The RCSEng folks should be ashamed of themselves for paying lipservice to the democratic process. The pre-meeting vote for withdrawal of the bill was in favour of this stance (84% of the 175 delegates).

In my opinion, history will show that this is the day (night) when the Royal of College of Surgeons loses whatever respect it held with its colleagues in the health service.

It is postulated that the RCSEng would not ally with the others because it wishes to remain apolitical so as not threaten its charitable status.

Whatever happened to the duty of surgeons to uphold the welfare of the citizens who are served by its members?

Has No 10 blackmailed, sorry persuaded, RCSEng executive that they risk something precious if they reject the health bill AND ally with the rebels?

A meeting stuffed with ex-PRCS’s and a Lord or 2 and a sitting member of the Government surely had nothing to do with an independent vote.

Primary care, where the bulk of the Health and Social Care Bill is focussed, has been betrayed by our (general) surgical colleagues.

Perhaps some of these surgeons should stop calling themselves doctors and accept they are primarily technicians who have no part to play in the politics of healthcare.

Grassroots surgeons and doctors who are dedicated to the welfare of their patients and work hard despite the constraints of an enlarging bureaucracy must stop being in thrall to the “elites” who populate the medical establishment. The top dogs, esp in RCSEng, but also in some of the other colleges, have shown their true colours – better to keep the government happy than nurture the respect of members of their institutions.

A very sad period in our profession is drawing to close with tonight’s decision.

In the past the RCSEng has been the worst offender in looking after doctors in training, esp GPs in training rotating through their specialties. That was over 10 years ago.

Presently, surgeons are no longer being included in undergraduate teaching clinical rotations because the teaching has been shoddy if present at all.

RCSEng is responsible for helping train the doctors of tomorrow. Well, I for one would like to see this role diluted further because frankly the surgeons cannot be trusted now to communicate the proper values we need for team working between disciplines.

Actions do have consequences. I would like to see the other medical royal colleges aggressively attack the RCSEng for failing to vote to join hands to protect the NHS.

Here are the motions and the votes:
(a)Considers that the Health and Social Care Bill, if passed, will damage the NHS and widen healthcare inequalities, with detrimental effects on education, training and patient care in England. ( Total votes cast 175)

For -101
Against -70
Abstain – 4

(b)Cannot support the Health and Social Care Bill without seeing the NHS reform Risk Register (Total votes cast 176)

For – 93
Against – 70
Abstain – 13

(C) Calls upon the RCS (England) to publically call for withdrawal of the Health and Social Care Bill (Total votes cast 176)

For – 76
Against – 99
Abstain -1

(D) Calls upon the RCS (England) to seek alliance with the BMA, RCN, RCM and other willing Royal Colleges and NHS stakeholders organisations to collectively call for the withdrawal of the Health and Social Care Bill. (Total votes cast 176)

For – 71
Against – 101
Abstain – 4

(e)Calls upon the RCS (England) to hold a joint press conference with the BMA and other willing Royal Colleges and NHS stakeholder organisations, to make a joint public statement calling for the Bill to be withdrawn. (Total votes cast 176)

For – 70
Against – 104
Abstain -2

Managed Competition for Medicare? Sobering Lessons from the Netherlands — NEJM

22 Jun

Managed Competition for Medicare? Sobering Lessons from the Netherlands — NEJM.

 

Discussions about U.S. health care reform are often parochial, with scant attention paid to other countries’ experiences. It is thus surprising that in the ongoing debate over Medicare, some U.S. commentators have turned to the Netherlands as a model of regulated competition among private insurance companies.1 The Dutch experience is particularly relevant given the proposal by Congressman Paul Ryan (R-WI) to eliminate traditional Medicare and instead provide beneficiaries with vouchers to purchase private insurance. (The Republican majority in the House passed the Ryan plan as part of the 2012 budget resolution, but it was defeated in the Senate.)

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