- At some point an influential figure (whether that is a government minister, the prime minister, the CEO of a large NHS trust or a healthcare professional body) will say that NHS patients should expect to pay for cataract removal. The argument will be that patients pay for Lasik or spectacles to be able to see and this is no different, logically or morally, to having to pay for a cataract operation to see. This will be described as not being in contradiction to the NHS ethos of free-at-the-point-of-use because that principle will always apply to life threatening conditions (see what they've done there?).
- There will be a rationalisation of prescription charges. This will result in people who are being treated for cancer will find that their cancer drugs will no longer be subject to prescription charges. The flip side is that the DH will make up for the loss of prescription charges in one area by introducing them in another area. The Department will review the entire prescription charges policy and they will take the view that only essential, life-giving drugs will be exempt from prescription charges. So for example insulin will be exempt but drugs to treat hypertension - where there will be no immediate effect on mortality if the patients stopped taking the drug - will be regarded as non-essential and hence subject to prescription charges. The government will say that prescription charges for preventative drugs will reflect their policy of patients taking more responsibility for their health.
- The Francis report will be published some time early in 2012. Some parts of the Press will use it to say that the entire NHS is not fit for purpose and the BBC, as usual, will find some obscure person and quote them saying that the NHS needs a complete overhaul. Andrew Lansley will silently punch the air when he hears this on the 8am news bulletin on Radio 4. However, the significant part of the Francis report will be the sections that show how local and national Conservative politicians have exploited and conflated what happened at Mid Staffs for political gain. The question is whether there will be a backlash against those politicians.
- At some point there will be yet another scandal in care homes and CQC will be pilloried for not noticing the issues, and worse, for producing a glowing report for a clearly failing care home. Since CQC is a vital gangplank of Lansley's plans he will (yet again) make just a few derrogatory comments and leave CQC and its inadequate budget, largely unchanged. This will lay the foundations for yet more scandals in 2013.
- The Department of Health will finally do what it should have done in the Autumn of 2010 and announce a minimum population that each CCG has to cover before it will be authorised. There will be upheaval as pathfinder CCGs merge and there will be a lot of grumbling as people say that local decision making is being moved to large faceless organisations. (The counter argument that it would have been better to have left PCTs alone will be lost in the din.) In the run up to the April 2013 handover date, there will be fewer than 200 CCGs, maybe as low as, (umm) the 152 PCTs they are supposed to replace.
- The Health and Social Care Act will get Royal Assent. There will be a lot of huffing and puffing (or perhaps wheezing) in the Lords during the Report stage. There will also be heated debates in the Commons when consideration the Lords amendments. Labour, as always, will have an uncoordinated attack; Lib Dem MPs will give speeches saying, effectively, what they didn't like about the NHS under Labour but will be clueless about the effect of the Bill; and Tory MPs will say that Lansley is a god because they have been whipped to say it. If we are lucky (it's a big if) the Secretary of State will be forced to retain the responsibility for the NHS and for determining whether the NHS charges for treatment. But it is a big if.
Friday, 30 December 2011
NHS Predictions for 2012
I am not a betting man so I will not put money on these predictions. Here are my fears for the coming year (I have no hopes because I can only see things getting worse).