"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan

Saturday, 6 November 2010

Bloody Blairites

I suppose they don't have to allow me to comment on the articles on their website. but it does smack of cowardice. I mean, all I am is a moderately lefty amateur with a passion for the NHS, and ProgressOnline are a well funded website edited by professional politicians who should be able to put up a cogent argument against my comments. (To be fair to ProgressOnline, I think the main problem was that I was posting a long comment - see below - but once I had chopped it into two, then got past the Captcha - after about 10 tries - I was given a reply that said because there was a URL in my response - there wasn't - it would have to be moderated. This means that my comments are not on the site. That either indicates incompetent, badly thought out website software, or censorship. Which would ProgressOnline prefer?)

Progress have an article called "Labour can seize on this reckless NHS reform" written by Ralph Michell who is described as "head of policy for a charitable organisation but is writing in a personal capacity". I'll let you know which charity at the bottom of this post, when you'll go, "oh, that makes sense". Anyway, since the Blairites won't allow me to comment on what is frankly a disgusting article, I have posted by comments here:

I had to check to make sure this was not a posting on Conservative Home.

"Labour should mount a bold attack on the government's policy of ringfencing NHS spending"
While I agree that the "ring fence" was political expediency, only Tories (and that would appear to include Ralph Michell) actually believe that any "ring fence" exists. Please, before you spout right wing nonsense can you first look up some of the statistics? The Kings Fund (like, umm, independent experts on the NHS) say that the NHS needs to have a 5% to 6% real terms increase every year to take into account the aging population and healthcare inflation (which is typically TWICE CPI). Therefore any responsible government would agree to real terms increases. As we know from the CSR we do not have a real terms increase because £1bn a year is to be taken from the NHS to pay for social care that has NEVER been their responsibility. Since this social care commitment is being done to make up (only partly) for the massive cuts in local authority funding (and hence their social care funding) it means that it is a real cut in the so-called "ring fenced" budget. The NHS "ring fence" does not exist: does that make you feel happy?

"The NHS consumes more than £100 billion a year of public money, and there is patently scope for it to be more efficient and make a significant contribution to reducing the deficit."
Where on earth have you been for the last ten months? In the 2010 NHS Operating Framework, published at the beginning of the year, Andy Burnham, said that the NHS must make £15bn to £20bn "efficiency savings" by 2014. That's about £5bn of efficiency savings every year. Let's see: that would be the entire public health budget, or most of the NHS training budget, or half of prescribing costs. What would you do, cut public health in the first year, then most of training in the second year, then half of prescribing costs in the third year, and then the remaining prescribing costs in the final year?

Oh right, you would actually make the NHS more *efficient*. The evidence is that there is not much fat to be trimmed. Even the Tories admit this, the Guardian reports that a Tory "health insider" says that "a fifth of everything the NHS does today will have to stop". That means cuts. That means that patients will have to go to the private sector to get the treatment or (I guess your "solution") beg a charity for it.

These "efficiency savings" are wreaking havoc in the service right now. In my county the PCT has stopped all "non-urgent" treatments. (The only treatments that are being done are: cancer - everyone's favourite disease, it is a pity if you have a non-cancerous heart condition - A&E and fractures. EVERYTHING else is non-urgent!) Do you know what that means? An elderly woman needing a hip replacement will be told that she will have to be in pain and immobile for another 6 months (at least) because first Andy Burnham, then Andrew Lansley (and presumably now Ralph Michell) think that it will be "more efficient" that way. What utter and obscene nonsense!

"Arguing that the NHS is different ... will not wash", says who? Someone who knows nothing at all? The fact is that the NHS is the bottom line. It is the last line of defence, there is nothing to protect you after the NHS. The NHS has to pick up the pieces and repair the consequences of failures in every other service. You mention social care, yet the first thing that social care providers do when there are any problems is pass the client on to the NHS. It is frankly disgusting that anyone could argue for a cut to the NHS.

"Second, Labour should attack the government's economic incompetence on the NHS."
I don't know if you have noticed, but the NHS is currently running under the policies of the last Labour government. Any attack on the NHS now will be an attack on Labour.

"One hundred and fifty-two primary care trusts and 10 strategic health authorities will be wound up"
Not an expert on the NHS I see. The SHAs were due to be wound up anyway. When an NHS Trust becomes a Foundation Trust it is take out of SHA control, so under Labour SHAs were getting more and more irrelevant and would have been reformed, or maybe abolished when the NHS Trusts in the SHA's area became FTs. As to PCTs well Labour's plans were to hand commissioning over to GPs through Practice Based Commissioning, which is not quite the same as GP commissioning, but not far off. And if you were paying attention you'll see that the Kings Fund says that consortia need to be at least 500k people and most commentators agree: there will be about 80 consortia. The 500 figure was an initial estimate by some newspapers based on PBC. It is clear that such consortia would be far too small and would not have financial stability.

Of course, you may have noticed that 152 PCTs will be replaced with 80 consortia and largely staffed by PCT commissioners. You may also have noticed that the NHS Board cannot do its commissioning work from London, and will need regional officers, and some people (Sir Philip Green, for example) suggest that there should be 10 regional offices. Is this "re-inventing the wheel"? Yes it is. But that has happened frequently in the NHS.

You casually mention Foundation Trusts, but this is the main area where Labour can get a popular campaign against the Tories. The problem is that you spoil it by making exactly the same argument as Lansley does.

"It should look to make greater use of organisations outside the NHS (including community groups, or peer support groups like those run by third sector organisations)"
No! No! No! This is NOT the attitude to take. The reason is quite simple: this is EXACTLY Lansley's plans (have you actually read the White Paper? it does not appear so). Now let's see. An elderly woman has ulcers on her legs and needs the dressings changed frequently. So let's ask a "community group" if they could give it a go, I mean all you have to do is take the old dressing off, throw it away and stick a new one on. What's difficult about that? No need for a trained nurse, eh? Oh right, it does need a trained nurse, but you don't want to pay him/her? The fact is that the vast majority of the work being done by the NHS needs highly skilled, trained staff. You simply cannot shunt that work onto untrained volunteers. What about if something goes wrong? Who is responsible?

"It should argue clearly for shutting inefficient hospitals."
And who will do the hip operations, cataract replacements, cancer treatments? Oh let me guess, either 1) voluntary "poor house" hospitals paid for by charity contributions by rich people with a conscience (doesn't it just make your heart sing that there are such lovely people around?) or b) private hospitals where the exorbitant costs are paid using a co-payment by the patient. Nice. Point me to an "inefficient NHS hospital", then have a look at how much it costs to perform their procedures (say, a diagnostic test, or an operation). I will accept your assertion only if you can find me an alternative that is safe and of equal quality, but costs less. Please do not spout Lansley's propaganda.

I would argue that in some places, for historical reasons, there are too many hospitals and that there is an argument to close the excess hospitals. But equally so, there are some areas with too few hospitals and they need a new one built. Over all, the NHS is very efficient compared to just about any healthcare system you could mention.

"The National Care Service which Labour started to articulate in government, free at the point of need, could form the basis for such a vision."
Now we can finally agree on something. But the NCS is NOT and alternative to the NHS. We need BOTH. And the NHS needs new funding, it MUST NOT be funded from NHS funds (like Lansley is trying to do now).

OK so who do you think this Ralph Michell is? Other than the lame talk about attacking Conservative policies, he does sound like a wet Tory, doesn't he? (Read the original article, if you can stomach it.) He says that the NHS wastes money (heard that somewhere? perhaps in a Tory election leaflet?). He says that NHS services should be done by the voluntary sector (again, where have you read that before?). OK so I went a little over the top about DIY community health services, but it is the natural conclusion of his ludicrous plans.

So Ralph Michell's Twitter profile says he is
Head of policy at the Association of Chief Executives of Voluntary Organisations (ACEVO), interested in third sector, charity, politics 
Let's remember what the "third sector" really is. They are charities (who have staff that need to be paid) and "social enterprises" (ie, not for profit, but still private, companies, that have staff to be paid). These charities and "social enterprises" have boards of directors and chief executives on very generous salaries. They have also got rather fat on the funding from New Labour.None of these charities and "social enterprises" would stand up to the financial scrutiny that the NHS suffers. None of these charities and "social enterprises" could withstand the Conservative government instigated, media bile that has been throw at the NHS. They feel that they are untouchable because they have a cuddly image. But they really are the bad guys.

These charities and "social enterprises" are in competition with the NHS. They are in competition because they do the same stuff as the NHS (or they see a business opportunity in doing what the NHS does) and the only source of funding is the taxpayer. They want NHS money. That is why Michell is against the so-called NHS "ring fence" because he sees that it is a threat to his (and the other chief execs and directors) fat pay packets.

Their website congratulates the last government on neutering the "NHS as preferred provider". They are no friends of the NHS and as such no Labour supporter who supports the NHS should have anything to do with them.Sadly, these horrible people were pulling Blair's strings and are now salivating over Cameron's plans. They really make my heart sink.

By the way, if anyone from Progress is reading this, I allow ANYONE to post comments. I want to debate, it is a pity that you do not.

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