Tag Archives: nhs reform

Revised Section 75 regs mire CCGs in a legal minefield

12 Mar

Further trouble not less after Government tables revised regulations on competition for providers. Who would be a Commissioner?

NHS will order doctors to work at weekends

16 Dec

ImageHere is a list of my objections to the proposal by Commissioning Board medical director Sir Bruce Keogh announced in today’s Sunday Times for general practice in UK to be open for business at weekends



  1. For GP, it may be practices, not doctors ordered to be “open”
  2. Cannot see this working unless adequate resources released to pay the support staff, let alone the extra doctors. And the support staff will need to agree to work too!
  3. Will not be helpful for patients unless hospital services are also fully open for business when we are. At least Bruce Keogh understands this
  4. The idea that this is necessary is politically driven and not based on evidence. Accept that some areas may benefit from this (e.g. inner city populations) but rural areas and leafy suburbs unlikely to benefit.

It would be better to spend the money on a EHR which OOH GPs can access at any time (and write in!) – allows centralised OOH service allowing those who wish to work unsocial hours to do so.

In short, the proposal should be strongly resisted at the present time. Doctors (and nurses) need to be nurtured not threatened to get the best from us!

Finally, does the public really want their GPs to be available 7 days a week?

EXCLUSIVE: Secret Tory steering committee working overtime to ready NHS for mass privatisation

11 Nov

Sadly what surprises me about this news is that no-one has spotted such a working party earlier, say at the start of the NHS in 1948.

The Slog

Enquiries by The Slog in the later hours of yesterday evening confirmed that an informal but extremely powerful Working Group has been set up by the Coalition – separate from both NHS management and the Department for Health – to assess the best way to facilitate the handover of NHS Hospital Trusts to the private sector.

Although details are hazy as yet, a picture is emerging of a Group very obviously dominated by privateers and anti-State lobbyists. To the best of my knowledge thus far, not a single member of it is closely associated with (or technically proficient in the understanding of) Britain’s rapidly expanding mutuality sector.

In the midst of blanket 24/7 coverage of paedophiles under every care home bed alongside easily the most boring Presidential election since 1972, this NHS story may not gain much traction immediately; but it is nevertheless the clearest sign yet to emerge of…

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A Trojan Horse – NHS reform paves way for privatisation

16 Feb

Drop the Bill

As I write this, the e-petition asking that the Health and Social Care Bill be dropped as passed 132,000 signatures.  This fantastic level of support is only surpassed by fuel prices, immigration and Hillsborough disaster.

With all the activity it has made me think about why so many people are worried about the implications of? the Bill.  Last week in conversation with some business friends it became apparent that a key reason some businesses are resilient while others fail is the constancy of the core business.

What is the core business of the NHS?  It is the delivery of health care.  Who delivers this?  Healthcare professionals.

Now, if your core business is fixed and the key people who deliver the product cannot go anywhere, your business will not fail even if the reorganisations, of which the NHS has known many, are destined to be short-lived.

UK readers may recall the launch of a fantastic sauce which was originally only available at Nottinghill Carnival: Reggae Reggae sauce.  After a wonderful boost from members of the Dragons Den, Reggae Reggae sauce took off.  Great!  Yet, the key person involved in the product lost control of his business and sales and marketing folks thought to exploit the trade name by launching other products http://www.reggae-reggae.co.uk/go/products.  Soft drinks and frozen snacks are not as catchy as the sauce – and the business is not thriving.

Back to the NHS.  Imagine for a moment private firms and individuals are eyeing NHS businesses eagerly waiting for the opportunity to pounce to acquire profitable elements.  What would make this attractive?  To my mind, if employee costs were lowered by eroding General Practice profits and reducing value of pensions the prospect of assuming any NHS business would be more attractive.

It is clear the business itself will survive, if not thrive, while the core activity (healthcare) and the key people (HCPs) remain.  A no-brainer.  Whatever and whoever gets control of NHS cannot fail to make money.

This then is my concern about the NHS reforms which are proposed.  There is a hidden danger inside this behemoth document – hidden within the document are opportunities to savage the public ownership of NHS.

The Trojan horse of privatisation is the risk faced by the country if the Health and Social Care Bill is permitted to pass into law.  This must be stopped.

STOP PRESS – UPDATE Friday 17th Feb 2012

Along with RCR and RCPath, RCGP is not invited to crisis talks with Prime Minister on Monday 20th Feb 2012 to discuss the Health and Social Care Bill.

This is power politics in action and it shows HMG is running scared of the largest group of doctors who, BTW, are supposed to be in the driving seat for the reforms.

A cynical ploy to placate the medical elites. A blatant abuse of power.
A message to the public that this Government is unfit to look after the Country perhaps unless surrounded by sycophants.

So, will RCGP hold its own summit to defy HMG. I hope so! Come on Clare and Iona – continue our College’s defiance and get on the Social Media pages to launch an alternative to Cameron’s cosy gathering.

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.)

Illusions of Autonomy

Where medical ethics and human behaviour meet, by Dr Philip Berry

Enjoying every second

Cada lugar, cada rincón, cada momento compartido arreglando el mundo entre imprescindibles

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