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NHS reforms

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Ministers have hit back at critics as they unveiled legislation seeking to shake-up the NHS in England, saying change is a "necessity not an option".

The Health and Social Care Bill will allow GPs to get control of most of the NHS budget from 2013.

Ahead of its publication, unions had warned it could undermine the NHS.

But Health Secretary Andrew Lansley spelt out how essential services would be protected and GPs supported, saying it was not as radical as claimed.

Speaking after the bill was laid in Parliament, Mr Lansley accepted there were "new and distinctive" elements but said it was more about evolution as it built on many of the changes introduced by Labour.

Competition
Choice, use of the private sector and setting hospitals free as foundation trusts were all started under the previous government.

He said unions were always "against competition", but they were wrong in saying it would lead to the destruction of the health service.

He said: "Modernising the NHS is a necessity, not an option, in order to meet rising need in the future we need to make changes."

Under the plans, GPs working in consortia will take on responsibility for "buying in" the bulk of hospital and community services for their patients.

In the process, all 151 primary care trusts (PCTS) and strategic health authorities will be disbanded.

In the lead up to the bill's publication, fears were voiced that hospitals could go bust as the plans include opening up the NHS to "any willing provider".

Critics have also questioned whether GPs have the experience and skills to handle such huge budgets - they will have control of about 80% of the NHS budget.

The timing has also been questioned, as the health service is being asked to save money in coming years.

But in setting out the details of the bill, Mr Lansley said the national independent board would support GP consortia as they were established.

He also said while trusts could go under regulators would be able to step in to ensure "essential" services continued.

Savings
And documents released alongside the bill claimed the changes would save money.

While the overhaul will cost £1.4bn, this would be paid for through savings within two years, the paper suggested.

By 2015, £5bn could be saved through cutting the number of people working in management and administration.

Earlier, during exchanges at prime minister's questions, David Cameron was accused of being "arrogant" for going ahead with the moves despite warnings from unions and health experts.

Labour leader Ed Miliband said medical staff had warned of "potentially disastrous" consequences for the health service.

But the prime minister said the government was "reforming the NHS so that we have got the best in Europe".

The changes were first set out in a white paper published last summer. They apply solely to England - Scotland, Wales and Northern Ireland have different systems.


But despite Mr Lansley's attempts to answer the critics, health staff and independent experts still said they were worried.

Karen Jennings, head of health at Unison, said: "This Titanic health bill threatens to sink our NHS. The only survivors will be the private health companies that are circling like sharks, waiting to move in and make a killing."

Professor Chris Ham, chief executive of the King's Fund health think-tank, was more measured.

He said getting GPs more involved was a good move, but warned the changes were at risk from "the combination of the funding squeeze and the speed and scale of the reforms".

Shadow health secretary John Healey said: "It's a huge upheaval which will put unnecessary extra pressure on the NHS and could open up all parts of the NHS to competition from private health companies."


GP view: How patients may benefit

Dr Ken Aswani, a GP in Waltham Forest, on the outskirts of London, is at the forefront of the changes. He is the lead doctor in one of the consortia which is piloting the changes for the government.

"We will be looking to build on what we have been doing in recent years. That means getting services out of hospital and into the community where they are more accessible."

One example of this that is already up and running is in dermatology care. There are now three clinics linked to GP centres across the borough where nurses, specially-trained GPs and hospital consultants work together to see people with skin problems.

Dr Aswani says: "It is much quicker now and patients do not have to travel as far."

GP view: How patients could suffer

Dr Helena McKeown, a GP based in Wiltshire, describes herself as a sceptic. She believes one danger is that consortia may decide that some of the more marginal services are not a priority for funding.

She also fears local hospitals could be hit as private sector providers look to win more NHS contracts. She gives the example of ophthalmology departments which rely on cataract operations for income.

"Private firms will want the cataracts as they are less risky and less complex, but the consequence of that is the local hospital department could suffer.

"This could happen all across the hospital. I see it as like that game Jenga - if you pull too many blocks out the whole thing topples down."

http://www.bbc.co.uk/news/health-12217668

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What does everyone think about these changes? There's so many needless jobs that public money is being wasted on, and bureaucracy. Privatisation is far more efficient and productive than the public sector.

One problem with the UK is that they have an arrogance and ignorance that the NHS is an amazing service, when actually it's not. You only need to read some of The Mirror to see this, "The whole world envies the NHS" and "David Cameron calling the service second rate is an insult to the service". When the fact is, it is second rate, and the whole world most definitely does not envy it. http://www.photius.com/rankings/healthranks.html - 18th, why are we to be satisfied with 18th? Especially when it is our money being poured in.

One only needs to look at other countries such as Germany and France, where their health services are far, far better under privatisation.

I can only see as cutting out wasted money and resources and improving the quality and efficiency of the service as a brilliant thing.

That's my views, how about yours? Discuss!

EDIT: May be some formatting errors in the article from the way I copied it from the BBC, may be better off reading the actual thing. :)
 
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What does everyone think about these changes? There's so many needless jobs that public money is being wasted on, and bureaucracy. Privatisation is far more efficient and productive than the public sector.

One problem with the UK is that they have an arrogance and ignorance that the NHS is an amazing service, when actually it's not. You only need to read some of The Mirror to see this, "The whole world envies the NHS" and "David Cameron calling the service second rate is an insult to the service". When the fact is, it is second rate, and the whole world most definitely does not envy it. http://www.photius.com/rankings/healthranks.html - 18th, why are we to be satisfied with 18th? Especially when it is our money being poured in.

One only needs to look at other countries such as Germany and France, where their health services are far, far better under privatisation.

I can only see as cutting out wasted money and resources and improving the quality and efficiency of the service as a brilliant thing.

That's my views, how about yours? Discuss!

EDIT: May be some formatting errors in the article from the way I copied it from the BBC, may be better off reading the actual thing. :)
I think I'd be happier with an NHS that did some of the middle stuff poorly, but had a good record against cancer and remained free at the point of demand. We have that and inevitably it costs a fortune.

I'm never convinced in the nonsense abour beuracracy and non jobs. These are red herrings to help us feel less bad about culling jobs.

Not everyone in the NHS is a Nurse: but then I want Nurses tending to the sick, not answering the phone, or updating their website, or completing the paperwork - which is always derided but always necessary.

You say provatisation is a good thing. Maybe for phones or interenet service provision; because it provides choice. You don't have a choice when your spleen explodes. You need treatment, and whether you get it shouldn't depend on whether you can afford it and the treatment you get shouldn't be compromised or biased by the agenda of a private heathcare sponsor.
 
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I think I'd be happier with an NHS that did some of the middle stuff poorly, but had a good record against cancer and remained free at the point of demand. We have that and inevitably it costs a fortune.

I'm never convinced in the nonsense abour beuracracy and non jobs. These are red herrings to help us feel less bad about culling jobs.

Not everyone in the NHS is a Nurse: but then I want Nurses tending to the sick, not answering the phone, or updating their website, or completing the paperwork - which is always derided but always necessary.

You say provatisation is a good thing. Maybe for phones or interenet service provision; because it provides choice. You don't have a choice when your spleen explodes. You need treatment, and whether you get it shouldn't depend on whether you can afford it and the treatment you get shouldn't be compromised or biased by the agenda of a private heathcare sponsor.
Why shouldn't we cut jobs that we simply do not need. There's a huge opportunity cost of artificially creating non-needed employment, when that money could be far better spent on something actually useful such as medicines and research. Gordon Brown decided to spend his way out of recession, with money that he didn't have, and money that wouldn't see a return on it. This is a fundamental error, which broke his very own spending rules.

Lets imagine each non-necessary admin job earned £20,000 per year. That means we're paying out £500 million per year which we simply don't need to. The Government is losing over £150bn a year, I don't see why we should be spending so much for the sake of unemployment figures and artificially propping up a public sector.

Public sector spending is starting to get out of control, I'm not by any means saying get rid of essentials, but we pay out so much a year for bureaucracy needlessly crowding out the private sector - That part of the economy that actually contributes financially. The more we spend recklessly in the public sector by loans is less money the private firms can borrow to invest and increase our economic growth.

I don't think you understand what privatisation is. The public sector is funded by the Government, they're given money, and thus spend it simply because they have it. They don't have any incentive to spend wisely and productively without wanting a profit. Private firms need profit to stay afloat, with a partly or completely private health service, it must function in a way that makes a profit, and a large one to stay alive. This means the health service becomes far more efficient and productive. Why do you think we'd be back in the dark ages where the rich get everything? There's insurance and tax schemes to help those who cannot afford the treatments. I saw a video in my economics class comparing the German healthcare system. The patient care was 100 times better than ours, to the point where people from our own country were willing to pay and go there. They have more available treatments, and see more patients than ours. The less well off receive tax breaks and insurance schemes to ensure they can afford treatment, and if I remember rightly, the cost of their health service was less or very similar to ours right now.
 
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I guess people will look at this in one of two ways; Money or Competence..

Those who value money more than anything (even though we will probably see none of this money) will say this is a great idea, why do we need these people to do jobs when the GP's can handle it themselves.

Those who value a fully functioning NHS will not be able to understand why GP's will be given even more work to cope with when there are managers trained to do these jobs.

My opinion would be bias, mainly because I think Cameron is a tool.
 
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