[Closed] NHS Reforms defeated in House of Lords - What does that mean?

Commons will override the amendments again. The condems will probably again attempt to claim its a finance bill so they don't have to put it thru the lords again.

All the lords can do is delay and even then by not much in the face of a determined Government. The only hope is the lib dem mps grow a pair.

It will get pushed through, but be implemented behind schedule, meaning that the reforms will be given the usual year to 18 months to bed in before being ripped up and the whole shebang reorganised again.

I was half-listening to R4 last night where is was said there is no mechanism to withdraw the bill as such - it could be bounced between the houses for ages being effectively and eventually watered down to nothing. I don't know if this is actual-factual-fact (TM)

Ah ok so when is the next election due?

What TJ said. Expect to see some really dodgy carryings on from Call-Me-Dave.

He knows he can't get this legislation through 'democratically' as the Lib Dems look like they're feeling a bit queasy about it.

But... In an indication of their respect for representative democracy - The Tory's are already well down the road of enacting this legislation, without waiting for it to actually be 'legislation'.

I believe the Israeli army refer to this practice as establishing 'facts on the ground'. Pretend to be going through some type of negotiation/process, while doing what the **** you like, ploughing on with your agenda regardless.

They need to get the legislation through at some point though. I expect to see them using some pretty dubious tactics. Guillotine motions and anti-terror legislation to prevent parliamentary debate and drive it through, as an absolute mockery of the word 'democracy'

A bit like John Majors government did with privatising the railways. Unfortunately, this legislation will have a very similar effect on the health service. It is de facto privatisation. And once the genie is out of the bottle.....

Utterly depressing!

Condems claim it is a finance bill and just force it through is the most likely outcome

It is unlikely the Lib Dems will grow a pair- really unlikely

H of Lords can only delay- bounce back and forth but iirc it is limited to 18 mths delay.
FFS it is an awful day for democracy when we have two parties in co-alition govt and we still have to rely on unelected peers to show the will of the people
Who would have thunk it

Binners is right - they are already enacting it on the ground

All the changes are going ahead full bore, I can't see how they can stop the ball rolling now as so much damage has already been done it can't be repaired.

Its the speed of change and the work in progress that I guess I was thinking about.

I work for a part of the NHS that will no longer (if the reforms go ahead) exist in a years time. I wouldn't say its irreversable yet, but millions will have already been spent in the changes we are already implementing/have implemented.

I personally beleive the NHS could do with a shake up, in some areas it is woeful and could do with a good kick up the backside, which some of this change may bring, but I don't think the overall system is as flawed as David is making out.

Most importantly, its nowhere near as flawed as the system he's keen to emulate... America's

The care is great. If you can afford it. Which most people can't. In which case, you can die in the gutter for all we care

I amjust so glad the con dems cannot eff up the nhs here

Your amusingly named condems are just the latest in a line of politicians who truly condemn the NHS. The whole system is frankly beyond reform and the current absurd process is just another woeful example.

So a bill is introduced too quickly and without sufficient reasoning. It then progresses through the legislation process before finally running into opposition. Then a seemingly endless catalogue of amendments including more than 100 recent changes in the past few days.....cue, "camels...horses...committees."

What organisation would then survive the introduction of botched compromises that will need to be re-done as soon as they are implemented (ok, the EU but that's another story)? As The Guardian writer concluded yesterday, "The real tragedy, however, is that this floundering plan is not just causing chaos, but wrecking the chances of real reform."

Plus ca change, rien na change!

I didn't realise that, until they were forced to drop it to 5% by pressure from the Lords, that the govt proposals included the fact that NHS hospitals could offer up to 49% of their surgery to private companies. 49%!

Obviously this would still allow them to say that the majority of surgery time would be available to NHS patients 🙄

And I still cannot get my head around the fact that seemingly no-one in the various professions involved in the delivery of the NHS wants the bill, they all think it will be a disaster.

And why the obsession that Doctors are the best people to run the NHS? Of course they're not, they're the best people to treat the patients. Like it or not, a massive organisation like the NHS needs a massive management structure to make sure the bills get paid, the bins get emptied, the bogs get cleaned, the cotton wool balls get bought etc etc etc etc. That in turn needs skilled managers at varying levels. Abolishing the SHA's may sound great, but the functions they provide will just be provided by someone else because they are still needed, at the same cost.

interesting listening to Alan Millburn on this, it seems that Labours politicking has got in the way of a very good bill that would in its original format have brought a great change to the NHS, shame that politics gets in the way of reforming the NHS.

Imagine a world in which 49% of schools were private, run by corporations, and who by law have to prioritise profit before education. And you're close to what Lansley dreams of.

The hand grenade contained within the bill is the separation of doctors 'commissioning' services and NHS hospitals 'supplying' them

Once that essential division is in place, then the NHS is open to the legal enforcement of EU competition law, which states that any services commissioned have to be open to bidding from 'any qualified supplier'

That means that private healthcare companies can legally demand access to the 'market' in healthcare.

Will they be interested in all services the NHS provides. Of course not. They'll cherrypick the profitable bits. Then leave a rump public service dealing with long-term care etc that they can't be arsed with, while they cream profits off

This is Call me Daves ultimate aim. Remember this:

[img] [/img]

Essentially, he's not lying. The same money will go into the NHS. Its just that less will be spent on providing front-line care. An awful lot of it will be going into the pockets of his friends in the private health businesss. Its bloody scandalous!! And the general public need to wake up pretty damn quick, before they've dismantled the whole structure of universal healthcare

Really sancho - hardly a single person who actually works in the NHS has anythign good to say about this bill at all.

It will increase bureaucracy, decrease accountability, make co operation and planning harder, increase costs and is designed to prepare the service for privatisation.

teamhurtmore - Member

. The whole system is frankly beyond reform

rubbish - it is one of the most cost effective systems in the world . It does not need reform - it needs the stupidity of the last management structure fiddling to be removed and then to be left to get on with it - as has happened in Scotland.

This bill was only ever intended for one purpose - to prepare the NHS for wholesale privatisation.

It seems that Labours politicking has got in the way of a very good bill that would in its original format have brought a great change to the NHS, shame that politics gets in the way of reforming the NHS.

No one apart form fanatical right wing pro competition anti NHS folk think this is anything other than a bag of shite- yes it is great change in the sense it changes a great deal not in the sense the changes would be great

rubbish - it is one of the most cost effective systems in the world

People forget what an achievement this is given the NHS directly employs more than any other organisation in the world, other than the Indian railways, and the Chinese Army! This efficiency is achieved without competition being the driving force, it is achieved through dedication and a commitment to care.

Sancho - it is very interesting to read/listen to Millburn not least because he almost sounds as if he has joined the conservatives ( http://blogs.telegraph.co.uk/news/janetdaley/100136011/alan-milburn-applies-for-the-job/) but also because he now sounds closer to the Adam Smith Institute than the Labour Party!!

[b]According to Millburn:[/b]

The Health and Social Care Bill is a patchwork quilt of complexity, compromise and confusion. It is incapable of giving the NHS the clarity and direction it needs. It is a roadblock to meaningful reform.

Health and social care should be better integrated, rather than being forced into artificial silos that suit planners instead of patients.

Control should be decentralised.

Payment should be by results.

The private sector should play a greater role.

And patients should become active participants in their healthcare, rather than mere passive recipients.

And finally as if quoting the ASI DIRECTLY, he concludes:

Patients should get their own personal budgets, "so that they can buy the services that are right for them".

Politicians rarely fail to disappoint but at least Politics never fails to surprise and amuse!!

TJ - we have been round that roundabout too many times. No need to repeat, just agree to disagree.

Leave the NHS alone i say. It works to some degree. What does need reforming is the amount of useless paperwork, that your expected to fill out to make the desk jockeys happy.

We are very lucky to have free healthcare in this country, some people don't realise how much some procedures that they are getting for free under the NHS costs if you were to pay for them.

Hernia surgery for example, that will be £7,000 a route Cystoscopy will set you back £1000. Dressing for said Hernia a box of 10 that will cost you £20. TTO's from Hospital are free so you get away with Prescription charges.

What does need reforming, is better staffing levels, stop spunking money on Agency staff. Get RGN's, Doctors and Health Care Assistants into the wards. RGN's etc on long term sick mostly due to stress of running wards on bare bones staff. That needs addressing.

Also, more incentive for student nurses to do the training and get the understaffed wards filled. How is a Trainee Nurse expected to train on £200 a month. Which involves 40 hours a week in Uni and 40 hour weeks on a Hospital ward. They are supposed to be Supernumery, but are used to make up the numbers.

Make it more picky and get it back to the way it used to be 100 places per year and get them on a Band 3 Salary and bring back the Nursing Schools.

its funny how politicians talk about personal empowermen
Seriously WTF do i know about medical treatment compared to a medical professional?
I would no more ask me about this than i would ask a doctor about the education system or a nurse for careers advice or a banker to fix my car.

It is just a way of letting vocal opinionated middle class busy bodies have a say in everything even when they know F all
Bit like STW but with actual powers 😯

Why can't I have a say in how airplane wings are dsigned or car braking systems? after all I knw f all about their operation.

Political posturing and tbh i dont actually understand what the point is in empowerting people when they dont have the knowledge base to use the"power"

His change makes it look lie Blair stayed on the radical left wing of labour

wont somebody think of the children

no really ive worked with inner city kids in america and the UK
probably the biggest difference between the 2 sets of children is their access to basic healthcare and the american kids are a lot worse of because off it
and private healthcare is the main factor imho
http://www.bbc.co.uk/news/magazine-15193530

and before someone accuses me for dragging such an emotive issue into the debate, im well aware that the people who will suffer the most from these 'reforms' will be oaps

Preparing the NHS for privatisation.

LOL, very funny, the problem is the last Government already opened up the NHS to private companies, so this bill is simply an extension of that.
Privatising the NHS is very different from letting private companies get involved in running parts of the service, or Trusts trating private patients as they do now.

Hospitals allowing 49% of time to be given to private patients, The Royal Marsden already allocates 30% of its time to private patients, and that is regarded as one of the best hospitals in the country and it hasnt affected waiting times etc. so still dont see the problem.

This whole cock-up reminds me of the Thatcherite dream of cutting down the civil service. Which actually ended up increasing its size.

Genius.

The Royal Marsden already allocates 30% of its time to private patients, and that is regarded as one of the best hospitals in the country and it hasnt affected waiting times etc. so still dont see the problem.

This is the approach of a politician: choose a specific example, describe it in isolation and then turn it into a general rule.

the royal marsden is infact desperate to opt out of the NHS

theyve asked several times to go 100% private because of the ridiculous amounts of cash they rake in from their celeb patients, they are based in Chelsea and Kensington after all the richest borough in the country and one with the longest life expectancy of any city borough too

the NHS has always said no to their requests but im sure that the tories next step will be to let them leave the NHS and save their expertise for the 'haves'
see borris already axing the congestion charge for the same area

Oh, and the purpose of the NHS is conveniently captured in its name: National Health Service.

All the words we need to know....

hardly a single person who actually works in the NHS has anythign good to say about this bill at all.

People with vested interests in maintaining the status quo in resistent to change shocker 🙄

I think its interesting that the people are now cheering on the House of Lords blocking the will of the democratically elected government, are the same people who were not so long ago telling us how unrepresentative, undemocratic and anachronistic the continued existence of the House of Lords was...

Teamhurtmore / Sancho - its interesting that almost none of the professionals agree with you - ie those who actually know what is going on in the service.

Teh only people who say this bill is good are those ideologically opposed to state healthcare, those who are set to make profits out of it and thse who do not understand the issues but arte taken in by the tory propaganda.

How about this - from the body that sets the standards for GPs -note it has no trade union functions

The Royal College of General Practitioners – the UK's largest medical Royal College – has today written to the Prime Minister calling for the complete withdrawal of the Health and Social Care Bill.

Despite the number and extent of the amendments, the College remains concerned that the Bill will cause irreparable damage to patient care and jeopardise the NHS.

“We support a greater role for GPs in the planning, design and delivery of services within their local communities, but as the organisation representing the views of over 44,000 GPs, we cannot support a Bill that will damage the care and services that GPs deliver to patients and ultimately bring about the demise of a unified, national health service.

http://www.rcgp.org.uk/news/press_releases_and_statements/rcgp_calls_for_bill_withdrawal.aspx

The Royal Marsden is primarily a cancer hospital so nothing to do with local celebs, but again dont let reality get in the way of your views.

and again, picking one example, is what you would expect to substantiate an argument, I dont hold it up as a answer to the NHS more a indicator that allowing NHS hospitals to treat private patients is not the death of the NHS and has not affected waiting times again, arguments put against the treatment of private patients, (which is already happening)

and where do you think celebs go to get their cancer treated?

i am aware as ive worked there and at the adjoing institute of cancer research

Or how about this?

Vested interests I hear you cry - well in 30 years of working in the NHS I have never seen such concerted concern from such a range of bodies. never.

Its not about vested interests - its about the interests of patients.

We are the representative and professional bodies representing the majority of doctors, nurses, midwives and physiotherapy staff in the NHS. For months our members have been telling us about the chaotic way the reforms are being implemented on the ground, before the legislation has even been passed (Report, 7 February). It has been an unnecessary distraction when the NHS should be focusing on a far more important issue: finding the £20bn in efficiency savings it needs to make at a time when demand is increasing. We are concerned that the bill will mean we end up with a service where it is harder for patients to receive joined-up care. Eleventh-hour tinkering in the form of amendments is not enough; we call on the government to do the sensible thing – withdraw the bill and work with clinicians to bring stability back to the NHS.

The ill-advised bill enters its Lords report stage today. We call upon peers to vote against it.
Dr Peter Carter Chief executive and general secretary, Royal College of Nursing, Dr Hamish Meldrum Chairman, BMA Council, Professor Cathy Warwick General secretary, Royal College of Midwives, Dr Helena Johnson Chair, Chartered Society of Physiotherapy

the doctors I know are all for it.
And kimbers do you honestly think that the Royal Marsden is some kind of celebrity cancer hospital. lol

Yeah right - All the royal colleges and the BMA are agaisnt it and the vast majority of Doctors in every poll carries out.

People with vested interests in maintaining the status quo in resistent to change shocker

Jesus Christ Z-11! Anyone who doesn't want to see the NHS get ****ed over are now Bob Crow are they. They're not fighting for their own greed. They're trying to save a public service

While, of course, bank chiefs trousering bonuses are some kind of knights of capitalist purity! FFS! Get a grip!

GP's, midwives, consultants and surgeons are hardly renowned as arsey socialists. Communists even.

What's it like living in your world?

Sancho - you're just extrapolating the example of one hospital and indicating that the rule applies across all hospitals and healthcare services delivered by the NHS.

A scientist might tell you that it wasn't sufficiently statistically relevant.

I'm pleased that the Royal Marsden (Bullheart's choice of venue, I believe)is able to treat 100% NHS demand with 70% capacity, but I spsuect that rule is unlikely to be repeated across the rest of the Service. I'm also pleased, therefore, that it's a hospital available to any NHS user, from anywhere in the country - if it's postcode limited, your argument is further diminished....

problem is TJ youre wrong on that, the vast majority of doctors are not polled, and are not consulted by their bodies.
its odd that the reforms are already underway, if the doctors etc were against it would they not be stopping the reforms.

The problem with this bill is that politics is making a mess of it.

well of course the RM isnt chocka full of celebs on chemo

the new private wing at the chelsea site was specifically built with the purpose of treating well-off patients

http://www.independent.co.uk/life-style/health-and-families/health-news/royal-marsden-seeks-wealthy-patients-as-budget-cuts-bite-2351638.html

Sancho - stop being ridiculous.

The rcgps polled it members and the overwhelming response meant they for the first time ever got involved and told the government to stop. Thats how serious this is that the body that ensures standards are met by GPs are for teh first time ever getting involved politically.

Three quarters of respondents to a poll carried out by the RCGP said they thought it appropriate to seek the withdrawal of the Health and Social Care Bill. The last of three surveys commissioned by RCGP Chair Dr Clare Gerada, the poll found that GPs are increasingly concerned about the Bill and the effect it poses to patient care.

So TJ, why are the GPs putting in place the reforms?

TandemJeremy - Member
Teamhurtmore / Sancho - its interesting that almost none of the professionals agree with [b]you[/b]

Yawn TJ - I know reading what people actually say is not your strong suit but, please, I even bolded Millburn's name to avoid ambiguity and to help you out this time?????

JY - so true, and yet so many want greater levels of government is all aspects of our lives. The mind boggles really!! Front page of Torygraph today - government intervention in dog ownership, boardroom composition, university places. Mostly well meaning but flawed in understanding and execution.

So Kimbers what is your point on that article, is it bad that a NHS hospital makes £48 million a year from private patients whilst still meeting its targets under the NHS and providing outstanding care for NHS patients at the same time.

People with vested interests in maintaining the status quo in resistent to change shocker

I think its interesting that the people are now cheering on the House of Lords blocking the will of the democratically elected government,

Teamhurtmore - I was replying to your direct views as expressed above

So Kimbers what is your point on that article, is it bad that a NHS hospital makes £48 million a year from private patients whilst still meeting its targets under the NHS and providing outstanding care for NHS patients at the same time.

the point is that to use this as a an exemplar of how all NHS hospitals could be is unwise.It is is in the richest borough in the country and therefore it is atypical by definition ..FFS how explicit does this point need to made for you to get it?

It is not a great example of an "average" NHS hospital whatever your politics.

my point is that when they finally get their wish and are able to leave the nhs, it will be a sad day, this bill is the next step towards that

I dont use it as an example of all NHS Hospitals, but the principles are there.

using the example I see it as a good thing that NHS hospitals can make extra money treating private patients, in fact a lot of people who have private medical get treatment from NHS now, so nothing is changing dramatically, just the percentage that can be earned in private work.
when I had my eyes done it was by a NHS doctor in a NHS hospital but it was a private operation and I was happy with that arrangement.

I think there is too much hysteria about this and the argument too often breaks down

kimbers the bill is doing nothing to privatise hospitals

Sancho - yes it is - thats the whole point of it. Are you really that ill-informed? It will allow and encourage privet health providers to take over the functions of hospital - so while the actual buildings may not be privatised the functions will be transferred to the private sector - and in some cases the buildings will be as well

really - I suggest you read up on this and look into the history of it.

The only people who say this bill is good are those ideologically opposed to state healthcare, those who are set to make profits out of it and thse who do not understand the issues but are taken in by the tory propaganda.

when I had my eyes done it was by a NHS doctor in a NHS hospital but it was a private operation and I was happy with that arrangement.

So Sancho, what motivated you to make this decision ie, have a private operation in an NHS hospital by a NHS doctor?

Well Junky - when the NHS was first introduced, the BMA voted 85% against joining it, in fact they campaigned pretty heavily against it

so yes, maybe we should have listened to the experts... or do you want to pick and choose which experts you listen to.

It's not just the unions, opposition groups and professional bodies that are opposed to it.
This editorial last week was unprecedented; the three biggest players in the British medical media coming together. An excellent summary of the situation too [url= http://www.bmj.com/highwire/filestream/563512/field_highwire_article_pdf/0.pdf ]BMJ/HSJ/NT editorial[/url]

my motivation was that the surgeon was one of the best in his field and the equipment was the best available and I had most confidence in the success of the operation.
the cost I thought was worth paying.

But this bill is not about privatising the NHS there is too much delirium going on about this.
allowing private companies to operate in the field of health care is happening already and works very well, the privatisation of the NHS is not happening.
if I have mis read the bill, can someone point out the sentence that I missed defining privatisation.

To repeat my earlier post Sancho

[i]The hand grenade contained within the bill is the separation of doctors 'commissioning' services and NHS hospitals 'supplying' them

Once that essential division is in place, then the NHS is open to the legal enforcement of EU competition law, which states that any services commissioned have to be open to bidding from 'any qualified supplier'

That means that private healthcare companies can legally demand access to the 'market' in healthcare.

Will they be interested in all services the NHS provides. Of course not. They'll cherrypick the profitable bits. Then leave a rump public service dealing with long-term care etc that they can't be arsed with, while they cream profits off[/i]

opening up the NHS to EU competition law means they don't have to come out and say they're privatising it.They haven't got the balls for that. But Private companies will then legally be able to demand to tender for every piece of NHS work. So privatisation will be the end result. And the Tories know this full well!!!

I disagree with your point binners.

Works the other way also. NHS patients are being Treated in Private Hospitals for example, due to the ever increasing waiting lists.

Using myself for example, routine Hernia surgery i had to wait over the 18 week maximum waiting list target for my local Hospital and was therefore, re booked into a BMI hospital. From seeing the GP to having the actual Op took 2 weeks.

You just have to ask for this service to see if your local NHS offers it.

Sok thanks for the post. Interesting article that not just because of the acceptance that some reform is necessary and initially welcome, but then botched (my points early) but the importance placed on the issue that binners raises here ie the split between commissioners and providers (page 2) and the role of choice and competition. Ignoring the facile idea that New Labour were Tories in disguise, and assuming that the BMJ are correct, why has there been a 30 year misalignment between governments and the NHS on this fundamental issue?

Sancho you raise an issue that always makes me question the argument that if the doctors are against reform then it must be correct for us all to be against it. I spent my social life surrounded by doctors (surgeons and consultants especially) who work in both the public and private sectors. And why on earth would they not oppose reforms to a current situation that serves their interests so well? A steady guaranteed income from the NHS, and lucrative work from the private sector. So why do they get the latter? Presumably because, like you, people perceive that they will be treated better (on subjective criteria) if they pay to go privately. So it is in the interests of my mates to maintain a real or perceived difference between the service they provide privately and the service that is free-for-all. Hardly a recipe for universal improvement in the provision of healthcare in the UK? A blatant conflict of interest that will ensure that they vote for the status quo.

Surgeon friend to my neighbour. Yep, can do that operation for you easily. Tomorrow if you pay me, June if you want it on the NHS. Only difference is the timing. Turkeys, Christmas anyone?

Sancho - the whole plan was dreamt up to privatise the NHS - and thats its intention. You follow it back to when the tories were in opposition and its made clear this is so.

The aim of this bill is to provide the structure to do so. Its been set up by advisors to private health companies. Private healthcare is always more expensive with worse outcomes than state run.

thats why the whole medical and paramedical profession bar a tiny minority are against it

the split between commissioners and providers (page 2) and the role of choice and competition. Ignoring the facile idea that New Labour were Tories in disguise, and assuming that the BMJ are correct, why has there been a 30 year misalignment between governments and the NHS on this fundamental issue?

there hasn't - Once again you argue from false premises and show your rightwing bias.

Labour removed the previous attempt at a provider/ commissioner split and competition does not work in healthcare.

This is the first time ever that there has been a serious attempt to take the NHS to a commisioner of care only with providers competeing.

"Private healthcare is always more expensive with worse outcomes than state run."

Not strictly true. The local tertiary hospital costs more to do some opps than it does in the local private hospital so some of the opps are commissioned at the private hosp. In that way you could actually end up if you live in this area having your opp done in a private hospital on the NHS already.

There are also privately run NHS Branded hospitals in place, one such which 'specialises' in Orthopaedic work. Its already proved expensive in the fact that patients often get complications that then getting followed up at main NHS hospitals as these 'centres' can only do the opps and not patient care.

TJ - again? I am quoting that article from the BMJ, nothing to do with my premise or perceived bias. What should I do, submit to TJ bashing as per, or read what the experts in the field are saying?

To clarify again (!?!)[b][u] according to the BMJ[/u][/b]

There has been a [b]broad consensus[/b] among policy makers from [b]all major parties[/b] for over [b]30 years[/b] about what is needed to deliver an effective and efficient health service. [b]Cornerstones[/b] of this world view[b] include a division between commissioners and health providers and the use of choice and competition to drive improvement.[/b] Yet relatively [b]few healthcare staff share these views[/b]...

Now please behave yourself!

My only problem with the whole thing is the fact that GP's will determine your treatment.
GP's are shit and more often than not miss the obvious signs of diseases and so allow disease to get hold and become harder to treat.

A NHS for my mind would do away with GP's and put all treatment in hospitals.

Funkydunc the private hospitals arenot paying the full costs and the state hospitals will be being nominally charged a premium to make the private look cheaper. ( called the comparator IIRC)

Private hospitals do not pay for the training of the staff.

"My only problem with the whole thing is the fact that GP's will determine your treatment.
GP's are shit and more often than not miss the obvious signs of diseases and so allow disease to get hold and become harder to treat.

A NHS for my mind would do away with GP's and put all treatment in hospitals."

That whole statement just shows your ignorance and lack of understanding of what the reforms are about (the good or bad bits of the reform...)

Sancho - does your obvious distaste for GP's come from them constantly prescribing you the wrong medication?

Keep trying. They'll get there in the end

bwfc et al.

Yes, if you only ever want a hernia in life, that's fine, pop down to your local private hospital.
But what happens when your elderly mother is struggling to control her diabetes, who is going to provide that care? She falls and breaks her hip, but private providers aren't interested in providing complex care. So, they fix her hip (if she's lucky) but there's no-one there to review her diabetes which was off causing her to fall in the first place. And there's no-one there to provide any rehab and get her ready to go home. But the private provide won't do it, they've taken their money for the op. So, in fact, no-one will do it, and no-one will have the obligation anymore to provide comprehensive health care.

Private providers will cherry pick the nice, neat, discrete healthcare. It's what you and I need now but it's not what are families and we will need in future years as we start to age.

Funky dunc, my little comment is not meant as an understanding of my view on the reforms, its my annoyance at my GP, who is shit.
I am having to get treatment for Nephrotic Syndrome at the moment diagnosed by a mate who happens to be the consultant in A&E in BRI, the GP diagnosed my symptoms as my age and to accept it.

sok, the NHS will provide the care for your elderly mother as it does now, please dont get hysterical about "Privatisation of the NHS".

Its not happening and the doomsday scenarios of private American style health care arent happening either.

And there's another problem too.

Services provided by the NHS are free at the point of delivery for everybody in the UK, regardless of social factors or ability to pay. However, much of public health (prevention of disease and provision of effective and efficient services) is being moved to the local authorities. And local authority services are not free at the point of delivery. In fact, they are almost invariably means tested.

Some services currently provided by the NHS will no longer be part of the NHS and will therefore be open to normal local authority funding arrangements, which includes means testing. Just as much care for the elderly is means tested, it becomes possible that all these other services will also be means tested. Oh, and these servicecs include health services for children and young people, health promotion and education, stop smoking services, drug and alcohol, and sexual health services.

You best start a health insurance policy. And one for your kids too.

Sancho - you've missed the point. There will be no 'NHS' to provide these integrated services as there will no longer be a requirement for anyone to provide these.
Could you highlight the differences in the current American system and the future English system, I'm not clear how you think they'll be different.
And my mother doesn't have diabetes but thanks for your concern.

OK, really not trying to troll here but why on earth do you still listen to and maintain the House of Lords. (Regardless of whether the current gov. is any use.)

They´re not an elected body and as far as I can see and their purpose seems to be checking out Bills and (usually) refusing to accept them.

Wouldn´t a publicly electable body be much more qualified?

I have family living in the UK which is why I keep in touch with what´s happening there though personally it doesn´t affect me.

Re-reading the BMJ article it is telling how often the word 'patient' comes up.

Re-reading the BMJ article it is telling how often the word 'patient' comes up.

I'm not sure what your point is - are you saying this is proof of their oh-so-vested producer interest?

Besides, whatever AL's homely rhetoric, the ConDem reforms will not be putting "the patient" at the centre of things.

On the other hand, the likes of [url= http://www.guardian.co.uk/commentisfree/2012/feb/08/nhs-professional-service-ripe-reengineering?INTCMP=SRCH ]Ali Parsa[/url] will be very well placed indeed.

Will this bill take effect in Scotland?

Will this bill take effect in Scotland?

No.

STW would crash if it did. 😀

Good - carry on as you were because I simply dont care what happens to the NHS in England.

SBZ - NHS scotland is run from holyrood - that s why we have no wasteful foundation hospitals - no private treament centres taking money out of the NHS and none of this nonsense will apply

i predict health tourists from England becoming a real issue tho