Tag Archives: Secretary of State for Health

NHS needs YOU!

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Make a New Year Resolution in 2012

 

Help Save YOUR NHS!

 

Doctors, nurses, technicians, physios, patients, etc.  The NHS belongs to YOU.

It is NOT free – Your taxes pay for it.  It’s OUR money that pays to run the service.

I don’t know whose idea it was to hand over the NHS to politicians.  But politicians are supposed to be OUR servants, so let’s make them earn OUR taxes in 2012.

Whitehall gossip says La La is only kept on because apparently he gave Cameron his first job in politics.  Moles in the House say backbenchers are starting to regard him as tedious.

However, the Health and Social Services Bill will be rolled out to the sound of loud drums.  Some time this year.  So before the foreseen problems start to bite, make sure you have made your position clear and have your potential treatment and care set up.

Here’s what YOU do

  1. If you work  IN/FOR the NHS, phone the whistleblowers’ line if something is wrong:   o8000 724 725
  2.  email Andrew Lansley what you think  need sorting out/changing :    lansleya@parliament.uk
  3. Or, if you live in his constituency write to him as your MP
  4. If you want a reply, write to your MP asking him/her to pass this on Lansley.  If a Minister receives a letter from an MP on behalf of a constituent, they HAVE to reply.
  5. Ward Sisters should exert their authority and get rid of time-wasting useless paperwork.  When I went into hospital as a Teenager, Sister ruled the ward.   She would have sent back any paperwork that didn’t provide a beneficial outcome for patients – along with a stern warning not to waste her and her staff’s time.

What happens when Bill is released?

Whitehall Watchers say it won’t work, and are saying it will quietly be dropped, but not before patients will have found even more problems and restrictions.  Whoever is next Secretary of State for Health will have lots of headline-grabbing opportunities to overturn it.  This won’t do any good, but will keep officials so busy they won’t have time to upset doctors by appearing in wards for photo-opportunities when they are not wanted.  So hopefully those who know what we want will be left alone to get on with providing it.

Nothing will really change except waiting times; they will get l o n g e r  and l o n g e r (sorry, I don’t believe that New Year is time to pull wool over eyes).

If you belong to the BMA, Royal Colleges, Confed, NAPC, Alliance or any other Union, etc. ask; ‘what did they really do for me last year?’   Did all the sabre-rattling and media opportunities gain anything?  As the NHS is saving 20% of its budget, are they cutting subscriptions by 20%?  If the answer is ‘no’, maybe you don’t need them and could save your sub.

Demand for NHS will go up.  So isn’t it time for the NHS be frank?

Maybe (don’t read the rest of this sentence if you are of a nervous disposition), think the unthinkable, and the NHS should start to charge for some services.  If someone doesn’t turn up for an appointment, selfishly taking up time that could have been given to another patient, charge them a fee BEFORE they are allowed to re-book.  Unless they have notified you in advance to cancel.

Patients should be told how much each NHS procedure costs THEM.  There is this assumption that the service is ‘FREE’.  It is NOT, but people have the idea that the NHS Good Fairy distributes its largesse willy-nilly.

Treat Patients as valuable market researchers

Hospitals MUST involve patients more.  When they moan about waiting times, get the Receptionists to ask them to join a Patient Forum.  It is disgusting that so few hospitals have such a thing, believing PALS will do the job.  Perhaps if some CEOs talked to patients they would hear of new and innovative ways of keeping down waiting times, saving money, etc.

And get hospitals to publish budgets for each and every department.  Encourage patients to help staff save money (you would be surprised what might happen).

And forget Cameron’s knee-jerk reaction to the reports that nurses don’t have time to look after patients.  They don’t, but major reason is all the form-filling they have to do – and now Cameron is suggesting yet more of same.  Instead, hospitals should adopt Roy Lilley’s brilliant, simple suggestion:

He needs three clear-plastic Boxes stationed by the entrance door to every ward and clinic of every hospital and surgery. They are marked ‘Fabulous’, ‘Fair Enough’ and ‘Frightful’. Every patient should be given a red token and every visitor a green token and on every visit, they should be asked to pop their token into whichever box they think is right. No forms, no data, no audit just commonsense. www.nhsmanagers.net

Staff must do their bit too

Ask yourself this simple question, “Is this good enough for my family?”

If it’s not, fix it.

If you can’t fix it; tell someone who can make it good enough for your family and theirs.

If that doesn’t work; tell La La direct.  He’s paid a lot of money to put patients, not politicians, first.

Don’t be like the Hospital Governor I met at Nick Clegg’s first hospital ‘Consultation’.  She moaned to me about appalling treatment she had had in an upstairs ward.  When I could get a word in edgeways, I asked “what did the hospital say?”   With a look of horror, she replied, “I couldn’t possibly tell them – I’m a Governor”.

There are far too many people who just want the kudos of saying ‘I’m a Hospital Governor’.  If they don’t work on behalf of patients, chuck them off the Board and invite on some patients.

And remember, if YOU don’t do anything, we end up with the NHS WE will deserve – apathetic, badly-run and one of worst services in Europe.

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Andrew Lansley Rap – or you can watch him on hospital TV

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Listen to the Rap -

Warning – use ear defenders

and keep a teenager in the room to translate.

But it gets funnier and more understandable as you go along.

 

If this wasn’t bad enough, wait until you see this……

The NHS has a new weapon

They want to send you home quicker, and save money.

So Andrew Lansley’s face will stare down at hospital patients from their bedside TVs – and if you don’t like it you pay £5 to register and turn him off!

Trying to contact the providers, Hospedia, to ask why?  They were strangely silent.

So not only are you to be chased from your bed by Lansley’s glare – if you don’t like it you  pay the NHS to turn him off.  So it’s a win-win situation for hospitals.

What the papers say

Should you have the misfortune to be hospitalised you will now be greeted by a never-ending video of Andrew Lansley. The Health Secretary’s face appears on bedside screens on a permanent North Korea-style loop, welcoming patients to hospital and asking them to thank NHS staff for looking after them.

To turn Lansley off, patients must register under a pay-as-you-go system which sees them charged £5 a day to access television, email and phone services. Those who do not register are continuously greeted by the Health Secretary saying:

Hello, I’m Andrew Lansley, the Health Secretary.

 I just want to take a few moments to say that your care while you’re here in hospital really matters to me. I hope it’s as good quality care as we can possibly make it and I do hope you’ll join me in thanking all the staff who are looking after you while you’re here.

Give me the Rap any day.

The Independent reported that “In some wards with multiple beds, the screens have the effect of a television showroom, with dozens of Lansleys staring down on the ill.” One man who visited an elderly relative said: “It was eerie. Everywhere you looked there was Andrew Lansley. My mother-in-law had to keep topping up the machine just to escape him.”

Lansley appeared on Today to defend himself, saying he wanted patients to have “as comfortable and as high quality a stay as possible” (a pledge that sits uncomfortably with Lansley TV) and to ensure that they thanked NHS staff. But shouldn’t praise be voluntary? And what of those patients who suffer inadequate care?

Somehow I don’t think  Secretary of State TV is going to rival Strictly Come Dancing.  But anyone who can work out how to turn off Lansley, without costing a fiver, deserves a medal.  Lansley himself didn’t know how when interviewed on Today.

Stop Press

Natalie Howells, Marketing Communications Manager of Hospedia emails me to say:
“Patients can switch off the informational video in one of 2 ways. Firstly, registration costs patients nothing and provides them access to free radio services. Secondly, each bedside system has an off switch on the front of the screen, which can be used to switch the bedside screen off”.

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Dr. Grumpy has a very appropriate gripe

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Things that make him grumpy

 

In his latest email,he says,

“I have nothing against doctors making money. Hell, I’m trying to do that myself.

So medical journals are full of ads offering ways for doctors to increase revenue. Some of them practical, some hokey, and some that really piss me off.

Like this one:


“I have nothing against doctors who are doing concierge work, or sinking money into tech stuff, or marketing their practice.

But what ticks me off about this ad is that of the 4 things they claim to offer, doing what’s best for patients is the very last thing listed”.

And good for him…….. he says

“If I ever reach the point where making money, investing in gadgets, or marketing my practice take precedence over doing what’s right for patients, I hope someone tells me it’s time to hang it up.

And if you’ve reached that point and don’t see a problem with it, than maybe you’ve forgotten why you became a doctor”.

No-one listens to Andrew Lansley

Over on this side of the pond, Lansley keeps on spouting his mantra about putting patients first – but no-one listens, least of all the NHS.

I have lost count of the conferences that are being organised by associations and entrepreneurs to grab some of the NHS ‘development’ cash that is floating past.  Each one purports to be about ‘putting patients first’.  And NONE of them has a single patient, or patient representative actually speaking.

But they will all make money for the organisers as the conferences regurgitate the bottomless pit of money available in NHS for ‘training’;  heaven forbid an actual patient gets up and tells the medics what WE want.  We are only patients. 

 

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How much are we costing the NHS?

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Various pills

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AND HOW MUCH NHS FUNDS ARE YOU THROWING AWAY?

 

So you don’t like the tablets?  They make you feel ill (particularly if they are for cancer).

You don’t tell your doctor, but just quietly throw them in the rubbish bin.

 

Anecdotal evidence shows that frequently patients are afraid to tell doctors they aren’t taking drugs any more

- so isn’t  it time doctors reviewed our medicines on a regular basis?

When it comes to the expensive drugs, why not ask us outright if we are still taking them?  People would be less inclined to lie when faced with an outright question, and this might save the NHS a whole lot of money.

By keeping quiet, we are costing the NHS £millions every year.

NHS surveys have said that over 60% of us are known to give up on the five-year hormone therapy course after cancer, because we don’t like side effects. Fine – as long as we tell our doctor and these are struck off our prescription list.

Sitting in a waiting room talking to fellow patients (as one does), we swop ‘woes’.  That’s fine – we can discuss the merits of ginger for hot flushes, and which cream works best on dry skin.  But what really worries me is when I am told “Oh – I’ve given up on that drug – but don’t tell my doctor”.

OK – it’s their descision if they don’t want to take a drug any longer.  The more patients that draw attention to this the better, then drug companies might look into side effects and do something to help prevent them.

But just not tell the doctor, so they keep on prescribing?  No wonder the NHS is running out of money.  Drugs can cost from £20 a month to hundreds or even thousands.

What happens in the States?

There, because of the way insurance works, patients seem more aware of drug costs.  But they say Doctors often don’t know how much laboratory/blood tests cost.

As reported by the WSJ Health Blog,

A new study finds that simply making physicians aware of the cost of regular blood tests cut the daily bill for the tests by as much as 27% … At the beginning of the program, the daily cost per non-intensive care patient was $147.73. Over the 11 weeks of the study, that dipped as low as $108.11 in the eighth week.

As the report says, “rather than proposing grand plans, like reforming Medicare, which often come to a political standstill, it’s small ideas like this that will help get health costs under control.

Recently, I went to see a doctor privately.  He needed blood tests, but as I was paying for these myself, he spent some time going through my notes to check if I had had tests done within the time frame.  Eventually I came out with a bill of £110 – instead of the £404 it would have cost in laboratory charges if the NHS were paying.

Why?  Because on the NHS often doctors don’t have time to go through your notes, so issue a blanket request for blood tests.  You are going to have the Vampires taking blood (bless them), so they might as well fill one or two more phials whilst they are at it. The cost comes at the laboratory, which charges individually for each test done.

So think about it – and help save the NHS millions.  Don’t throw pills away – own up!

And if the NHS extended appointment time from ten minutes to twenty or even thirty minutes, this actually might save them (and us) a lot of money.

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La La Lansley behaving like Bull in NHS china shop

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Bull

Health Bill looks set to smash valuable services

Having admitted NHS is in debt –

it’s time for Lansley to co-operate with private sector sensibly ~ and involve patients in buying services

But current proposals look set to upset patients and medics even further.

This week saw enough ‘meetings’ to satisfy the most ardent of politicians, but it remains to be seen if the NHS hierachy are actually going to listen to sensible patients’ ideas for making NHS work.

In the agenda for the Health Bill (nicknamed the Unhealthy Bill), Lansley has gone into a service (that was running moderately successfully) like the proverbial Bull in a China Shop, and managed the difficult feat of upsetting just about everyone, except the GPs that signed the letter in the Telegraph.

The bill is supposed to save the NHS vast amounts of money, but nowhere can I find mention of where NHS could be saving money – except for cutting essential staff and services.  Doing this will leave more expensive messes for NHS to handle – but that’s for the future (something we are notoriously bad at handling).

Where money could be saved

Today comes a repeat of story on how the service hasn’t managed to get its store cupboard sorted out;  over a 1000 different types of catheter;  more styles of rubber gloves than the busiest chef could ever use; paper bought in dribs and drabs, instead of bulk orders.  One paper reckoned the NHS would save £500 million a year if they copied private business when ordering.

Then it’s simple things such as providing services and making sure money isn’t wasted needlessly. Talking to a health professional in my area of London, we couldn’t understand why there was such a low take-up for mammograms – until it hit us.  Many of the residents live in houses worth millions – they would be aware of importance of regular check-ups, in fact their personal doctor would remind them if they forgot. But they would be having these privately. Hence they don’t appear in statistics.

Scarce NHS resources had been used to find out why the low take-up? But because the NHS refuses to share information with the private sector, staff admin time had been wasted in a useless exercise to find out why.

Taking this a step further, many patients previously were happy to entrust their healthcare to the NHS, so why are  many now choosing to pay ‘double’ to go privately?  It’s not rocket science to ask some of these people just what it is that makes them lay out hard-earned cash.  Then perhaps following the Continental way of working together, so both public and private sector benefit.

Private medicine can benefit everyone

Let’s forget political posturing, and encourage more schemes such as using private companies to supply chemo treatment in patients’ homes.  Mentioned elsewhere, this services cleverly ‘uses’ VAT saved to pay for a specialised nurse to administer this.   There must be thousands of similar ways the NHS could save money, and give people a better service.  I cannot understand why French patients can be treated in small wards or single rooms, when NHS patients are treated in the MRSA-rife public wards.  Even though both countries’ patients pay roughly the same for healthcare.

Asking the right questions could be a very cheap way of finding out what patients actually consider important.

Yet we have the ‘Consultation’ exercise, which the NHS hierachy is trying to keep to Staff and medics.  Witness pathetic Patient Forum exercise ‘using patients’.  Looking through, one find ONE patient involved amongst the 46 named advisors.

When the Coalition Government was announced, Andrew Lansley was appointed Secretary of State for Health.  Less than a year after the election, his Health Bill has made the Government deeply unpopular.  Previously, in time-honoured fashion, he would have been sacked – albeit the way the Prime Minister does this is always with a letter saying how much he has ‘valued the contribution you made’.  And other platitudes.

But Lansley isn’t going to get the sack, because the Coalition is in the mire, and no-one is brave enough to administer the coup de grace.  But it was obvious when the first ‘Consultation’ over the Health Bill was assembled, into the room stepped not La La Lansley, but Nick Clegg.

A floundering, Clegg cut short the promised one hour consultation after 30 mins – questions were getting too near the knuckle.  I was promised an answer to my question, but so far haven’t received this (memo to self – re-send email yet again).

Clegg has promised “a louder Lib Dem voice” in government and says he will show the party is “a moderating influence on the Conservatives”.  The Lib Dem leader said he expected significant changes to the planned NHS revamp and would block the legislation unless he was happy with it, but told the BBC there would be no redrawing of the coalition agreement.

The Lib Dems suffered huge losses in Scottish and English elections and were defeated in the AV referendum.  The referendum on changing the way the UK elects MPs was a key concession secured by the Liberal Democrats as the price of forming a coalition government with the Conservatives almost exactly a year ago.  But the rejection of the proposal by 13,013,123 votes to 6,152,607, in only the second ever UK-wide referendum, potentially marks a new phase in the relationship between the two parties.

Critics have suggested the Lib Dems could be wiped out at the next general election unless they do more to re-establish their party identity within the coalition.  Clegg says “We’ve got to show people where we are a moderating voice on the Conservatives. We need to stand up for our values and say that loud and clear. That is the lesson I learn.”

So perhaps if he comes out with the truth – that the Unhealthy Bill should be scrapped and the NHS start again, softly, softly, one area at a time – Clegg will gain the recognition he seeks.

At present, the controversial NHS reform bill gives GPs control of much of the NHS budget and hands them the responsibility for commissioning patient services.  Patients across Britain are already experiencing delays, refusal of procedures, threats to take away drugs, etc.

So whilst the bill is currently on a “pause” in its progression through Parliament – it’s time for everyone to make their feelings known to their MP.  And if you belong to the LibDems, remind them that Mr Clegg said it was “getting the bill right was now my number one priority”.

As he has admitted, “A lot of people have said to me – and I basically think they’re right – ‘You’re going too fast, you’re trying to meet artificial deadlines, you’re forcing GPs to take on commissioning roles when they don’t want to or aren’t able to.’”

And tell Politicians to stop playing media football with the NHS – remember, when they are old and forgotten, they are going to need the service.  Will they want to be placed in mixed wards, with fewer nurses, denied life-saving drugs?  I think not.

Footnote:  I think the Dept. Health is already giving up.  On the infamous Patient Forum website, readers must be getting fed up with fact that their voice is only going to be added to ‘comments’, and absolutely no guarantee that anyone with clout will read it.  Already, there is a section TAKE PART IN WEBCHAT TODAY – announcing an event that took place two days ago.

So PLEASE – really listen to the public, and stop messing with the NHS.  We all agree it needs sorting out, but not by bulls smashing valuable services.

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Oh dear! Back to reality after that uplifting Wedding

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MPs Warn – Patient Care being put at Risk

Patients’ Association issues warning

 

In a recent Newsletter, the Patients’ Association says the Public Accounts Committee in the House of Commons has warned that patient care could be put at risk, if the Government’s plans for GP commissioning go ahead.

After a lovely day when our local hospital had TV screens showing Kate and William’s gorgeous wedding, with even the doctors sneaking long looks, came a stark warning from the Patients’ Association,  highlighting the report from the Public Accounts Committee.

I suspect many readers have found that their care is already being cut in their area;  now MPs have said that seeking these reforms while asking the NHS to make £20 billion in savings would endanger services and put patients at risk.

But the sad fact is, if the NHS were managed like Tesco or John Lewis there would probably be no need for the massive cuts envisaged.  Anyone who has run a company can see examples of waste and over-spending almost every time they step over the threshhold of an NHS hospital.  The Dept. Health needs a ‘Health Check’ from the Chief Executives who run global companies – and then, unlike Gerry Robinson’s TV documentaries pointing out waste across the NHS – needs to act on what they are told.

Savings

Recently the NHS discovered they have ‘overpaid’ over half a billion when ordering drugs.  What company would allow this to happen?

Business leaders have said that the NHS needs to take a look at where it is wasting money.  Hospitals in USA run 24/7 – most NHS hospitals have almost shut down by 3 pm on a Friday afternoon, snoozing away until Monday morning.   Excuse is staff overtime costs – but these are minor in comparison with capital costs of  expensive machinery lying unused over a weekend.    Charing Cross Hospital is trialling using its Imaging Dept. over the weekend, and patients and staff are delighted.  I suspect the accountants are pleased too.  So will others please follow their example.

You only have to look at private hospitals v. NHS and compare usage of expensive radiotherapy machinery – private hospitals work their machines 12 hours a day – NHS hospitals often work 8 hours a day in radiotherapy units.

BUT – when I wanted a newer drug (approved by NICE in 2009), I was told local hospital didn’t stock it because it was so much more expensive.  No-one cared that this drug was supposed to have less side effects for cancer patients.  Anyway,when I  offered to pay to ‘top-up’ the difference in cost, the hospital got stroppy and said I would have to go elsewhere.  Anyone remember Alan Johnston promising we could have top-ups?

Fears about Andrew Lansley’s reforms

La La Lansley has announced his ‘shake up’, which as far as most can see is getting rid of vital parts of the NHS, and promises are being ‘forgotten’ :

  • promise that cancer patients will see a Consultant within two weeks has been scrapped in many areas
  • promise to ‘ring fence’ NHS spending has been forgotten
  • promise NOT to sack frontline staff is being flouted everywhere
  • and as was told to Nick Clegg at his first ‘consultation’ meeting, GPs have already put ‘rationing’ in place in many areas

NHS Administrators should realise that patients are not fools – they see what is going on, and are getting angry at the lies and excuses that can be trotted out when patients are short-changed over treatment

The Chairman of the Public Accounts Committee, Margaret Hodge MP, has said “The Department of Health acknowledged the risks associated with this radical shake-up of the NHS.  Whilst the reforms could complement the imperative of achieving £20bn efficiency gains by 2014/15, the reorganisation might also distract those responsible for making the savings while safeguarding standards of patient care.

We were also concerned that the Department has not yet developed a high quality risk management protocol for either the commissioning or providing bodies. The Department acknowledged that some health trusts and some GP practices had some way to go to achieve foundation trust status or become commissioning consortia. The Department must have effective systems in place to deal with failure so that whatever happens, the interests of both patients and taxpayers are protected.”

Dr Hamish Meldrum, Chair of the British Medical Association commented on the Public Accounts Committee warning saying, “The Public Accounts Committee is right to highlight the risks posed by such a massive restructuring at a time of financial crisis. However, it is not just the timing, but also the direction of travel of these reforms that will cause problems. We share the concerns of the PAC that the consequences of increasing competition in the NHS have not been fully addressed.”

Exactly – and what’s the betting the private sector will run rings around NHS Trust Governors with no experience in dealing with contracts, and reading the small print?  We see where this has been happening in our local Trust hospital every time we walk through its doors, and count how many lifts will have ‘OUT OF ORDER’ signs that day. Lifts that have to take patients on trolleys to operations – and wait because a lift isn’t working.  Meanwhile an expensive team of experts is waiting in Theatre – all gowned up and no-one to work on.

The Secretary of State for Health, Andrew Lansley has responded to criticism, saying, “The efficiency challenge and our reforms are inextricably linked. Our reforms help the NHS make savings, because getting rid of tiers of bureaucracy will mean an extra £1.7bn each year to reinvest in patient care. And if we don’t give doctors and nurses the power to make decisions for their patients, then quality of care will suffer.”

But he is so out of touch he doesn’t realise that it is not the ‘tiers of bureaucracy’ that are being reduced, but senior Specialist Nurses, Physios, OTs, etc. that are being made redundant;  as ‘team leaders’ they are put down as Administrators.

Meeting Ministers to make your point

If you are worried, or angry, or already suffering cuts, phone your hospital and ask when is a Minister coming to ‘Consult’ in your area,to whom you can voice your concerns?

  • More than likely you will be told “I don’t know”
  • In which case  get on to the Press Office of the major hospital in your area, and ask them.
  • And if they don’t know, ask your local MP’s office.

When Clegg came to see us, we were given five days warning – but enough people turned up to be able to let him know patients aren’t happy.

Patients’ Association (PA) reply:

The PA says “The Government promised us that the savings bei:ng demanded of the NHS would not impact on patient care and that services would not be affected.However, for months now it has become clearer that the NHS is struggling to make these savings while continuing to deliver high quality services for patients”.

On top of this, the NHS is undergoing the largest restructure in its history. There is widespread concern that the NHS will not cope well having to reorganize and make savings at the same time.

The Government needs to step back and realize the irreparable damage they could be doing to the NHS.

And making money

  • get foreigner visitors to pay.  Most are insured, and we have to pay when we go to their countries
  • let us pay for top-ups if we wish – this week I tried to pay extra for a more expensive drug which I was told wouldn’t give me such bad side effects.  I have an email from the hospital which says it is too expensive, and totally ignores I have offered to pay.  So I will probably get nasty side effects as I have had cancer – which the NHS will use precious resources to treat.  I weep!
  • and with all the complaints re hospital food, get together with a good take-away restaurant and offer patients a choice, if they pay for it.  And if hospitals are sensible, they can put on a ‘handling charge’.

After all, the dreadful telephones used in many hospitals that cost patients’ friends a fortune to phone you, are supposedly making the hospitals money.  So if they can make money this way, why not make it by giving patients what they want and are happy to pay for?

To read Public Accounts Committee report, please visit http://www.publications.parliament.uk/pa/cm201012/cmselect/cmpubacc/764/76402.htm

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Health Minister accused of cowardice

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Andrew Lansley, British politician and Shadow ...

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Andrew Lansley slated by conference delegates

Sadly it seems he lacks the guts to face thousands of nurses at their annual conference

No wonder 96% voted to say they had no confidence  in the Minister.

Instead of addressing the whole conference at the Royal College of Nursing Congress in Liverpool, Lansley spent about 45 minutes in a Q & A session with 60 people.

Left holding the can in his absence, his junior minister Anne Milton addressed the conference, and drew ironic  laughter when she  attempted to justify Government’s cuts, claiming its reforms would put nurses “in the driving seat”.

One delegate likened her statement to a kid showing off sitting in an abandoned car, pretending to drive.

 

Cancer Nurses unavailable for specialist duties

On top of his cowardly actions, Lansley and his plans drew angry comments as it was announced up to 38% of cancer care staff are being taken away from their specialist duties to fill gaps on general wards, and casualty staff complaining that A & E waiting times are going up.

Mind you, even opting to face only 50 people, instead of address the whole conference as would normally be expected from a Minister of Health, I reckon Lansley had a hard time.  Although no-one tore him limb from limb (although they might like to);  they only have to remember the day when Tony Blair bounced in to the Women’s Institute conference, all smiles and beams.  His smile was dramatically wiped off his face as the audience gave him a slow hand-clap, and aides admitted years after that this had given him a huge shock.

Still, the current dis-satisfaction, massive petitions against closures, etc. have already wiped the smiles off Dept. Health officials, and privately David Cameron’s face-saving exercise of allowing time for ‘reflection’ is seen as the Government having to climb down.

Video

This is an interview with Andrew Lansley where he starts out to explain what he wants to achieve, and I don’t think anyone would disagree that getting rid of tick boxes, targets, top-heavy administration etc. is what we all want.  What he doesn’t explain is how he didn’t see what was coming, such as how Administrators would never sack themselves, but look around for others to sack instead;  how easiest way to achieve cost cutting is to cut down on drugs, instead of thinking through how savings can be achieved, etc.

http://about.doctors.net.uk/Assets/Commissioning/Andrew-Lansley-NHS-reform

This could be achive footage soon – there is no doubt that Lansley will be made the scapegoat for this unpopular bill, which at the beginning had the complete support of Tweedledum and Tweedledee (aka Cameron and Clegg), but no-one was clever enough to see problems coming. Question is, will Lansley be pushed asap, or will he hang on in a face-saving exercise for Coalition, until a ‘natural break’ occurs and he is shunted sideways.  The spin doctors must be hard at work trying to see what’s best.

 

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Here's where the NHS can save money

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NHS Overspends £500 million on basic supplies


Now if you or I overspent by even £500 – we’d know about it.

There are precious few companies today that would allow employees to overspend by even £50

But it seems the NHS can throw £500 million around with gay abandon – and no-one seems to worry about checking the bills.

For ages I have been saying that if each Trust appointed one genuine business man or woman to oversee budgets, they would be able to show them how to save money – without all the cuts needed.

Now here comes proof:  National Audit Office (NAO) says “hospitals could be saving half a billion pounds a year if they reconsidered the way in which they purchase basic supplies”.

Why Hospitals need business-trained executives to oversee budgets

Can’t you just imagine what would happen if Alan Sugar, Nicola Horlicks, Gerry Robinson etc. cast their eyes over a hospital’s accounts?  They would soon come up with questions:  why are Trusts being allowed to order basics such as gloves, paper, etc. from different suppliers?

The NAO report “The procurement of consumables by NHS acute and Foundation Trusts” has revealed a lack of information and the fragmented purchasing attitude of Trusts. The severity of the problem is directly linked to the lack of central control over procurement. With the Health and Social Care Bill proposing that all hospital Trusts become Foundation Trusts, there are concerns this trend will accelerate.

Translation:  someone who understands accounts and purchasing should take the NHS by the throat and teach it good basic business principles.  Otherwise money is going to continue to pour down the drain.

Overspend by nearly £1 million per Trust

According to the report, the average trust could save £900,000

  • if they bought the same type and volume of products
  • and paid the lowest available price.

Could you imagine M & S or Tesco allowing each store to buy overalls, floor cleaning equipment, or any other basics from different companies?  No, a central office negotiates the price with a major supplier – and they award the contract to the company that provides the best overall product at a reasonable price.

But the NAO said “great variation in the range of basic supplies purchased by different trusts was also discovered. Trusts that NAO examined bought “

  • 21 different types of A4 paper
  • 652 different types of surgical and examination glove
  • 1,751 different cannulas
  • 260 different administration sets

Some variations were particularly striking. For example, the purchase numbers of hospital gloves varied significantly. While one trust operated with 13 different types of glove, another needed 177.

NAO concluded that “if hospital trusts were to amalgamate small, ad-hoc orders into larger, less frequent ones, rationalise and standardise product choices and strike committed volume deals across multiple trusts, they could make overall savings of at least £500 million, around 10 per cent of the total NHS consumables expenditure of £4.6 billion”.

So what is La La Lansley doing?

His office loves sending out press release after press release – but so far – NOTHING.

The head of the National Audit Office, Amyas Morse, says  “In the new NHS of constrained budgets, Trust chief executives should consider procurement as a strategic priority. Given the scale of the potential savings which the NHS is currently failing to capture, we believe it is important to find effective ways to hold trusts directly to account to Parliament for their procurement practices.”

Er – sorry.  La La has announced the Government were considering the launch of a review “to help hospitals get better value for money from procurement, drawing on the expertise of Government advisers.”

Now why do stables and bolted doors come to my suspicious mind?

So should the companies making millions out of NHS be quaking in their shoes?  Er – not exactly.  According to La La Lansley, “We are therefore considering launching a review to help hospitals get better value for money from procurement, drawing on the advice of government advisers,” he said.

So that’s all right then.  CEOs of companies that supply rubber gloves, canulas, gowns etc. can get back on the golf course – knowing full well by the time the review comes out, the next Government will be in.

What can you do?

Have a look at the names of the non-executive Trust officials of your local hospital.  Is there a noted businessman amongst them?  If so, ask them what they are doing to scrutinise bills.

If not – suggest that a noted local businessman be asked to run their eyes over the accounts – and say where they think savings could be made.

But this will be difficult.  Contracts for services from cleaning to lift maintenance are awarded to certain companies – and they won’t want to be moved.  We have been trying to find out how our local hospitals can have allowed the firm that put in the telephone system to get away with it – last time I wanted Pysiotherapy the phone rang and rang;  eventually a voice said “Accident and Emergency”.

So far letters to the Chief Executive go unanswered.

To download the report “The procurement of consumables by NHS acute and Foundation trusts”, follow the link: http://www.nao.org.uk/publications/1011/nhs_procurement.aspx
The Guardian article: http://www.guardian.co.uk/society/2011/feb/02/hospitals-waste-money-says-nao-report

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Do we really want to choose where to be treated in NHS?

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The Choices
I don’t need a doctor to make this choice    Orin Zebest via Flickr

NHS launches choice and information revolution

The NHS seems to be spending vast amounts on trying to get us to handle our bookings, even for operations, but somewhere, they seem to have lost me.

Choices didn’t help those patients at Mid-Staffs.  Their relatives found a wall of silence and fudging – imagine what they must have felt like when trying to go elsewhere, and finding they were told there was no room (what many who do know where they want to go are being told).

Now the NHS is publicly wringing its hands, but one can’t help worrying where the next problem is going to happen, and how much choice patients get when everyone closes ranks.

What we do want

Talk in the waiting rooms and the coffee shop is what we really want is time to talk over options with our GP.  They should know of any reports of bad practice in local hospitals, take time to talk over choices, discuss ease and accessability, and most important  – what aftercare different hospitals provide.  The doctor will know the answers – but how many of us will?

When cancer pills meant I needed a seven hour operation to repair damage, I had no idea whom I wanted to do the operation.  Choice was futile – I relied on my favourite GP to send me to who would be best for me.  We discussed where would be best hospital for me.  I wanted the most competent person in case anything went wrong.  Ease of access for friends and family was nice, but most important to me was the best outcome possible.  And I would not have known how to find this.

I might have looked up possible surgeons on websites;  then if I had paid attention to mortality figues, chosen the one with the lowest rate.  But that would have been stupid:  a good surgeon is bound to have more ‘no hope’ cases referred to them, hence a less glamorous rate, than a newly qualified young cardiac surgeon.

My doctor chose Mr. Mario Petrou, and I would never have known this marvellous genius existed if I hadn’t been steered towards him by someone who knew his work.

‘Patient Choice’  is another NHS red herring.

The daily deluge of press releases from Dept. Health recently announced “Patients will have more choice and a louder voice under major proposals set out today by Health Secretary Andrew Lansley”.

And went on to say the White Paper, ‘Equity and excellence: Liberating the NHS’,  set out the Government’s ambition to give people more control over their own care, from choice of GP to which consultant-led team they are treated by. Today, two consultations – on Patient Choice and on Information – set out proposals to meet that ambition.

Proposals to increase the choices that patients and service users have about their care include:
* allow patients to choose services from any willing provider;
* choice of provider for diagnosis;
* choice of which team, led by a named consultant, that they want to be seen by and what that treatment is after diagnosis;
* extending maternity choice to include pre-conception, antenatal, and postnatal care;
* choice of treatment and provider in mental health services;
* improving the choice of end of life care, moving towards a national choice offer in the future to support those who wish to die at home.

So what is reality like?

Looking back on all the procedures, operations, tests etc. I have had in the past years, the only time I thought I would try and make a choice, I ended up in a total muddle – with not one NHS Hospital able to give me the information I really wanted :

I wanted to know, “if  I have the procedure done at your hospital, will I be able to pay extra for a single room? “

With MRSA rife, I wanted to be treated as I would in a European hospital, where single rooms mean MRSA is rare.

According to Lansley, “The first principle of the White Paper is that the NHS should ensure that for patients, “no decision about me, without me” is the invariable practice. To realise this means patients must have more say and more choice.

Fine words which meant nothing.  In reality trying to find out which hospitals in London offered single rooms is impossible for a member of the public

  • Dept. Health said they didn’t know which Trusts offered these;  they didn’t have a list and I would have to phone every hospital in London myself and ask them
  • PCT said they hadn’t a clue which hospitals in London offered this service
  • Chelsea and Westminster fell over themselves to offer me a room in their private wing at £550 per night,  but they certainly didn’t offer single rooms at the around £50, which friends had said they had paid in hospitals outside London
  • NHS Choices were astonished I wanted to know this
  • There is a report on Hillingdon Hospital’s Bevan Ward coming out – where single rooms are on ofer – but no-one knows when, and when I phoned they promised to call back.  You’ve guessed!  I am still waiting.

So thanks a bunch Lansley – I didn’t get a choice.

So the comment “We want to go further than simply offering people a choice of hospital. Patients should have choice at every stage of the journey – where they register with a GP, where they go for tests, who they see for treatment, and what care or treatment they receive from any willing provider rings hollow.

Please give us what we DO want

Lansley says,  “Patients and service users should be in control and involved as much as they want to be in every decision about what, where, how and from whom they want to receive care. By giving people real choice over their care, we can build a patient-centred NHS that achieves outcomes for patients that are among the best in the world.”

The reality is most people will say they

  • want enough time with the GP to go through all the options, and get the GP to help them choose the best centre or hospital for them.  Private patients get this (see my experience with heart op above), so why not NHS?
  • want to be able to book an appointment for tests within a minute of phoning – not wait up to 30 minutes for the call centre to answer
  • pay for an 01 telephone call, or if not a cheap local rate when holding on and holding on for Choose and Book.  A year ago the Dept Health promised they would phase out 0870 numbers.  Sneakily they have changed these to 0345 – in case you don’t know, that costs 6.8 pence per minute.  If offered one of these just go to http://www.saynoto0870.com, and they have the 01 numbers for many of these high cost lines.
  • and patients want to be told the results of tests within a few hours of having them done.

Most patients seem resigned to waiting days or even weeks for their consultant to tell them results. But if you can’t wait (and why should you?),  you can turn Lansley’s words round.

When I went to Chelsea and Westminster for tests, they tried to tell me I would hear from my Consultant within two weeks.  As one test was for possible C. Dif that I would have picked up in their hospital, I hit the roof and started to  quote Lansley back at them.

I got my results within 30 minutes.

So it’s worthwhile jotting down a few of the platitudes quoted by Dept. Health.  You never know when you can use them when asking for results.

No-one seems very bothered about Choices.  When Dept. Health asked for a response on enabling people to register with the GP of their choice, only 5,400 bothered to respond, out of over 50 million.

The Choice consultation can be found at: http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_119651

Enhanced by ZemantaSo good luck with getting what you want – just keep a few Lansley quotes up your sleeve for emergency use!

Lansley now wants to help NHS Whistleblowers

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Free helpline


NHS and social care staff who have concerns about patient care, will be able to access a new, free whistleblowing helpline

08000 724 725

set up on Health Secretary Andrew Lansley’s orders.

Operated by the Royal Mencap Society, an independent body, the whistleblowers‘ Helpline will operate

  • weekdays between 08.00-18.00
  • out of hours answering service will be available weekends and public holidays.

The Dept. of Health is funding this.  Callers will get the benefit of Mencap’s caring staff, but the calls will be paid for by DH,  and is more likely to be used because it will be seen as impartial.

Lansley has said he wants to get the voluntary sector more involved with the NHS, and Mencap, with their record of superb service championing those with learning disabilities, will certainly provide a caring service.

At last there is an attempt to give some validity to those who want to comment on the way the NHS is – or isn’t – working, but are scared that their complaints may rebound on them if they contact an NHS office.  Hopefully Mencap will be seen to be impartial.

 

Why start this now?

One case study gives a graphic example.  This concerned a Senior NHS Consultant who won a whistleblowing claim, but in doing sadly had been barred from looking after his patients.

It was sad on two counts –Dr. Ramon Prieknash

1.     a competent consultant was barred from looking after  his patients after he tried to whistleblow and bring up short-comings of hospital where he worked.
2.    Now an NHS trust is going to have to pay out compensation for possibly destroying a doctor’s career.

Ramon Niekrash, a senior Consultant Urologist at the Queen Elizabeth Hospital, repeatedly raised concerns about the impact of cost-cutting measures on the health and safety of patients and was subsequently excluded (suspended) from the hospital.  Now he has won his claim that his exclusion was on the ground of whistleblowing.

A series of letters sent by him from 2005 onwards relating to the standard of care, well-being of patients and clinical governance led to him being branded a ‘trouble-maker’ and excluded in April 2008. The Tribunal was drawn to the conclusion that his exclusion was on the ground that he had raised these concerns. Furthermore, letters written by management within the Trust around the time of his whistleblowing were found to be clearly defamatory in the derogatory comments made about Mr Niekrash.

Mr Niekrash, who was lead urology cancer clinician, spoke out as cost-cutting, namely the reduction of specialist nurses and closure of the specialist Urology Ward, began to have a negative impact on the standard of care and the ability to provide a safe and effective service under established guidelines. In 2007 Mr Niekrash made further allegations of widespread bullying in the Surgical Directorate in an attempt to achieve cost cuts.

Responses to the judgment
Arpita Dutt, partner in the award-winning Employment Team at Russell Jones & Walker who represented Mr Niekrash said:

“The decision to exclude Mr Niekrash was exceptional and unjustified and has had an ongoing adverse impact on his reputation, practice and his health, and we are delighted that the Tribunal’s judgment reflects this.

Does this sound familiar?

Anyone who has tried to complain about NHS short-comings will confirm that many letters we send often received no response, which leads to writing further letters, in order to progress the issues.

Or else one receives an automatically-generated response, which bears no relation to the matter we wrote about.

Or the whistleblower was ‘bullied’, as Mr. Niekrash confirmed.

Does these sound familiar?  It is almost reassuring to find that it is not only patients who experience this, but Medical staff as well.

Vanessa Bourne, Head of Special Projects of the Patients Association says: ‘It is essential that clinicians speak out against failings in patient’s safety. …… Patients must not carry the can for management failures.’

So now staff can contact an impartial helpline.

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