Hewitt Defends NHS Shakeup Including CLosure of A&Es

Discussion in 'Current Affairs, News and Analysis' started by Sven, Sep 19, 2006.

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  1. Having accessed the NHS extensively at most levels I actually think that things have progressed under this government. However, the changes envisiged are going to undo everything that they have built up. Closing A&Es - the waiting times are going to shoot back up to the bad old days under Tory rule when people were waiting 18 hours to get seen.

    In short some of the proposals are :-
    *Movement of Some Out Patient Facilities to Custom built buildings - can NHS Trusts afford to pay more building maintainance, Heat and Lighting etc???
    *A&E closures - nuff said
    *Private Hospitals to do much more than elective surgery
  2. It's not so much the structural/logistics stuff (which most of this appears to be about), as the operational issues: I'd like to feel that the risk of infection was acceptable across the board - but it simply isn't... Basic hygiene shouldn't be beyond us in this day and age - but apparently it is.
  3. Just closed my local A&E its only been open 5 years after the entire hospital was virtually rebuilt from scratch at a cost of >£60M, also looking at closing child services part of which is the special care baby unit where my daughter spent the first two weeks of her life and I cannot praise the staff and facility highly enough.

    A state of the art 3 star trust was merged with 3 ancient under permorming 1 star trusts, who ran the whole shooting match not the "good" hospital no the worst performing one of the 4.

    The NHS is one of the most wasteful 'corrupt' organisations in the country (yes I know that corrupt is a little contentious) as organisations merge and new jobs are to be given out the entire process works not on who is the best man for the job but more along the lines of he's my oppo lets see him right, all well and good if your employing a domestic on £10K a year but this should not be the case when you are employing a £120K chief exec and the like.

    There seems to be no reward for success but plenty for failure the organisation that MrsZippy works for is up for an award as best organisation of its kind in the country but has just been merged as part of yet another New Labour re-org as MrsZippy says "It's ok for Tony his Job is only on the line every 5 years he puts mine on the line every 3"

    That enough bumping of my gums off for a cuppa

  4. In my area we have fought off the proposal by Harrogate trust to close our hospital - not least because we would have to travel 21 miles (and those east of my town would have longer journeys) to get such services as A&E, ante natal, natal and post natal etc etc.

    Looks like the Trust is going to get it by the back door
  5. If you look at the calder valley and where the proposed cuts in A&E etc are to fall, then people will die as a result of these ill thought out cuts.

    take a towns like Todmorden or Hebden Bridge at the moment they have access to Hospitals in Burnley, Rochdale and Halifax all Currently "General Hospitals" under the new proposals these three will become locality hospitals losing emergence care etc, they will in effect become little more than 'cottage' hospitals, that will mean that the population will now have to travel for emergency care to Oldham, Blackburn or Huddersfield in some cases a full 20 miles further than they currently need to.

    Childcare will soon be in the same boat, when MissZippy was born we needed neo-natal intensive care for her, luckily enough MrsZippy was a little eager to deliver so they had no choice but to make space in the local SCBU, they were talking of sending us to the nearest available SCBU bed in KENT FFS, Now if they close the beds they are talking of in the North West where would she have gone then assuming those places that would have been available had backfilled into the remaining beds I can only assume abroad?

  6. I think you are all missing the big picture..

    Q: What does the NHS currently do that the private sector doesn't?
    A: Emergency work

    Q: Why?
    A: Because it requires lots of extra staff (not just in A&Es, but also surgical, medical, anaesthetic specialities. Its unpredictable in through-put. And generally expensive.

    So if we remove the A&Es then no emergency admissions to that hospital, so it becomes an elective (i.e. planned operations) and rehab (for medical patients recuperating closer to home) centre. Which is kind of like a private hospital.

    So then they are attractive to being taken over by private companies.

    Or am I being cynical?

  7. Sh1t

    Thanks Jim. You have opened my eyes
  8. Probably, but, but if you've been in an A&E recently you'll wonder where all of the staff have gone, now heres the cynical bit a little girl that lives near me broke her leg late last Saturday goes to A&E "oh yes you've broken your leg, you need an x-ray but that dept is closed at the weekend you will have to come back on Monday" Fine thinks I until MrsZippy pipes up (with NHS deputy director of Finance head on) and says "You do know it's all about revenue generation don't you".

    Turns out that Hospitals have had the way they are funded changed and are no longer paid per case but per visit so the implication is that extra facilities are closed out of hours not because of the lack of use but to generate more visits and therfore more income. now that is cynical.

  9. This is what management consultants (such as the ones who really decide Bliar's grubby little policies) call 'knife and forking' a problem. If what you want to achieve would start a civil war if implemented in one fell swoop, 'knife and fork' it into little changes. The gravity of each small change is insufficient to distract the great unwashed from the page with the nipples on it and unlikely ever to be 'joined-up' by them to reveal the true intent. Well spotted S_J.
  10. Have to refute this a little, though the whole current Chief Exec/Director recruitment process for the restructured PCT's has been farcical.
    Chief Executives do not appoint themselves, neither do their friends/fellows/oppos. They have been recruited via Assessment Centres out-sourced from the NHS at considerable cost to the taxpayer. They are then held in a pool until a similar exercise has been conducted for Chairs of the PCTs. It is very much appointment on merit, I can think of one hopeless but ambitious and politically astute current Chief Exec who has not been appointed, though at obscene cost!

    Then they have paired Chief Execs and Chairs and appointed to PCT areas. Any areas not appointed to (typically the 'poison chalice' PCTs with horrendous debt, my own being a case in point...) were then advertised externally.

    Problem is that the process has taken MUCH longer than envisaged, now there's a surprise.... This means that most PCTs have only just had Chief Exec appts confirmed for organisations that come into play on Oct 1st! Director recruitment processes are only now getting underway, so most won't be interviewed until a week after the new PCTs come into being.

    My PCT is a perfect example of this. We've only just had a Chief Exec appointed but still don't have a Chair and we're going to start our new life with NO directors and therefore NO strategic direction or senior management structure in place........

    Once again the NHS gets used as a political football. More change for change's sake when the old systems would work if only someone let us get on with it for long enough to work through the problems!!

    Rant over, taking medication now.......
  11. As I say Corrupt may be a little contentious but I do know of a number of examples where you knew exactly how the PCT would be made up when you found out who the chief exec was (certainly at director level) and of more than one or two individuals who have not been appointed to a post because their face doesn't fit all of which are better 'at the job' than the appointees. That is not to say that the NHS is alone in that I know it happens in all sorts of places.
  12. Well since I'm seconded to the NHS at the moment I see all these changes daily.
    Re the payment per visit:

    Sitting in my GP office I see a patient who as a result of hearing their story and performing some blood tests I am worried they have a cancer. From the bloods I know its probably in the bowels - but where in the bowels? Unfortunately I can't tell. Several years ago, drop a letter into the local consultant who would perform all the relevant tests to exclude a cancer.

    Now it's a two week referral, but I have to specify upper or lower bowel. They will perform an endoscopy of their relevant bit (often not by the consultant but a technician) If there's no cancer they refer back to me. I then refer to the other one and ask them to look. No one takes ownership of the patient. I have to wait for letters to come back, before sending another one off. So several weeks elapse between thought and diagnosis. But the two week wait is preserved.

    Why don't the specialities say to their other hospital colleagues "Here mate have a look at this one, I've got a funny feeling and its not my area"? Because they've now been banned from doing consultant to consultant referrals because of revenue loss and payment by "Patient episodes"

  13. The NHS and the PCTs just seem to have a habit of wasting money in any which way they can!
    I am now a student nurse, but before worked for the NHS and in the private sector in a different medical role. Private hospitals cannot cope if surgery goes wrong etc, and as said above those people where it does will end up back in A&E in an NHS hospital.
    My mother is a senior nurse, currently working under the PCT, last year she was NHS and the year before that she PCT, at the end of last year the department in which she runs (designed to keep elderly patients in their homes and arranging care etc) was told that it would not be funded anymore, therefore everyone would have to be placed in other jobs, either at the same grade, lower or higher.
    My mother was shifted from a band 7 post to a band 8b post, where she went from earning £32k a year to £50k a year, they closed down the department and instead reopened 2 separate departments to do pretty much the same job, so now they are employing 20 staff instead of 10 and paying for two departments with separate budgets and 2 people to run the departments, and my mother to oversea them both - What on earth is the logic in all that they are now spending twice as much!!!!

    closing A&E departments is just stupid, but at the rate the NHS waste money it was going to happen, there are staff and job cuts happening all over the place, students graduating without jobs and as said above hygiene standards are still not up to scratch, although this is not down to a budget issue, it's down to staff negligence!
    NHS is such a great organisation (well if was and could be again) But the people running it need a good kick up the ass, again like most government organisations it's being run by people that really know nothing about patient care and what the health service really needs!
    In my previous job, the NHS decided they didn't want to fund my employment full time so decided that I had to reduce my hours to part time. I therefore went to a private company where I was paid nearly £30 an hour as a locum working across the South of England, I ended up working at my NHS hospital as a locum, filling in the hours I would of been working if still working full time with the NHS, so instead of them paying me a full time rate (which would of cost them less than half it would as a locum) they paid for me to locum there at £30 and hour for 2 days a week 7am-6pm - again a total waste of money and no logic what so ever!!

    As I said the NHS just seems to waste money for a past time, spends in areas and on things which are totally not needed and then wonders why areas have to shut, staff leave and why the targets set out in the NHS Plan etc are not met!! Closing A&E departments is going to cause a whole host of problems, and I think it is going to get worse before it gets better! One particular hospital in the south has £10million worth of equipment sat in a store cupboard which they bought with donations and trust money, problem is they will not pay for any of the staff to be trained how to use it!
    so really there is £10million quid in a cupboard!! MAD
  14. Certainly in our area Director appts. have been out-sourced in the same way as the CE appts., though obviously the CE has a say as it's his train set. We have some very good directors, one being my boss, Commissioning chap, but he wants to work closer to where he lives, unfortunately.

    My PCT is one of the few that is commissioner AND provider and crosses county boundaries, so we're having to split most services 2 ways and one service is going in SIX different directions......