tag:blogger.com,1999:blog-7462652546051300479.post5379050482652598305..comments2024-02-13T00:08:04.640+00:00Comments on NHS Vault: Cost of diabetesrichard.bloggerhttp://www.blogger.com/profile/10589364986804437392noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-7462652546051300479.post-8059467046775806382011-09-01T10:02:30.483+01:002011-09-01T10:02:30.483+01:00Look forward to reading your 'monumental rant&...Look forward to reading your 'monumental rant'. Could the NHS think a little, and realise it's own 'clinic' system is adding to costs?<br />When a doctor has ten minutes in which to speak to a patient whom they have probably never seen before, but give them a check-up when they have a long-term condition - of course the doctor sees that there are no visible signs of deteriation, then ticks the box to "come back in six months". When actually an investigation might uncover an underlying condition, which if treated in time would be sorted. But waiting six months could turn this into a crisis - ergo costing more.Verite Reily Collinshttp://www.after-cancer.comnoreply@blogger.comtag:blogger.com,1999:blog-7462652546051300479.post-71653289166553541952011-08-29T11:36:23.140+01:002011-08-29T11:36:23.140+01:00"However, since half of hospital care is not ..."However, since half of hospital care is not on tariff, and neither is most primary care and community services, there is still a lot of scope for competitive tendering."<br /><br />So do you think social enterprise trusts (formally provider arms of PCTs) will be in a weak position when the time comes to compete in a few years time? (I am not referring to small SEs with one type of provision by the way)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7462652546051300479.post-31871106175206512792011-08-28T23:14:49.527+01:002011-08-28T23:14:49.527+01:00"Is this not like the health subsiduaries of ..."Is this not like the health subsiduaries of the big transnationals? Surely when they tender for contracts they will undercut the NHS and 3rd sector providers??"<br /><br />Cameron and Lansley assured us that there will be no competitive tendering, and every provider is supposed to be paid the same rate. However, since half of hospital care is not on tariff, and neither is most primary care and community services, there is still a lot of scope for competitive tendering. Currently the East of England SHA is outsourcing £300m of services to the private sector through competitive tendering.<br /><br />Even so, I do not believe that the private sector can undercut the NHS unless they deliberately take a loss. Circle, for example, is paid up to 20% more than the NHS for the same work and does not have to supply emergency services (they can even use NHS staff) and yet they make a loss (IIRC £23m on a turnover of £62m). Their fancy hospital in Bath makes a loss of between £6m and £7m every year.<br /><br />If the private sector cannot match the NHS cost-effectiveness, this raises the question of why do they want to be involved? The policies that are being push will eventually lead to co-pay and insurance. In that situation the more expensive private providers will be able to charge the patient extra - and that is where the market will arise.richard.bloggerhttps://www.blogger.com/profile/10589364986804437392noreply@blogger.comtag:blogger.com,1999:blog-7462652546051300479.post-91878866824441027812011-08-28T14:48:30.117+01:002011-08-28T14:48:30.117+01:00Richard, surely there wont be a market in the new ...Richard, surely there wont be a market in the new 'NHS'. <br />When the supermarket with garage opens on the outskirts of town it can afford to make no profit on its fuel, using the parent business (the food store) to keep it afloat until all the indepepndent garages are out of business.<br /><br />Is this not like the health subsiduaries of the big transnationals? Surely when they tender for contracts they will undercut the NHS and 3rd sector providers??<br /><br />This is not the neoliberal ideal as the market entry criteria are not equal. Everything is weighted in favour of the big companies. Those who think this marketisation of health services will bring improvement are either muppets or puppetsAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-7462652546051300479.post-7159173663555405162011-08-28T12:35:57.689+01:002011-08-28T12:35:57.689+01:00A healthcare market will cost more than the single...A healthcare market will cost more than the single-provider NHS. It is very simple. To have a market there has to be excess capacity in the multiple providers to allow patients to switch and the providers have to do marketing to get patients to choose them. <br /><br />Of course, if we have a single provider then we have the problem of ensuring that quality is kept high and patients are treated with respect (and yes, choice: of clinician and appointment time). It is not impossible to ensure these things happen in the NHS, but the government is ignoring these issues because they think "the market" will solve them. It won't.richard.bloggerhttps://www.blogger.com/profile/10589364986804437392noreply@blogger.comtag:blogger.com,1999:blog-7462652546051300479.post-13620568544290083762011-08-27T15:51:45.514+01:002011-08-27T15:51:45.514+01:00Your article has made clear to me why I receive a ...Your article has made clear to me why I receive a 'demand' that I attend for diabetic retinal screening every year, when I have told them this is done in hospital. <br />Like the flu jab I assume this reminder comes because someone is getting a fee for referring/carrying out procedure. Had six calls last year re flu jab, until I lost my temper and shouted that I had told them repeatedly I was on a cancer drug and jab was not advised. <br /><br />Local hospital has outsourced its retinal screening to a company. It used to be Sally (excellent nurse) who did this; as I have an ulcer in my eye she would administer an anaesthetic drop (cost around 50p) before putting in die. Now that it is a company that does this, they haven't costed in for the anaesthetic, so doesn't have it available. <br /> <br />So now hospital arranges for me to be screened by my Consultant (cost £60+?. Total waste of a highly-paid professional's time.<br /><br />As you say, the NHS is losing money in a ridiculous way. It needs to get its act together before it goes totally bankrupt.Verite Reily Collinshttp://www.after-cancer.comnoreply@blogger.comtag:blogger.com,1999:blog-7462652546051300479.post-24298008448828152842011-08-25T09:21:12.062+01:002011-08-25T09:21:12.062+01:00Had rep at meeting yesterday re drugs for painful ...Had rep at meeting yesterday re drugs for painful diabetic peripheral neuropathy. Said to him that his drugs should actually save money. Much PDPN keeps pt awake at night. Lack of/poor sleep upsets metabolism (and is shown to increase sensetivity to pain anyway). Lack of sleep = poorer diabetic control and all that entails. <br />Yet, we are constantly writing to GPs asking them to help the pt with their pain! Is it the increased cost of another drug? What about the whole picture? Perhaps there is no longer a whole picture with everyone seemingly working for a different company/enterprise/trust - just lots of individualistic and competing interests?Anonymousnoreply@blogger.com