Skip to main content

Good news for Health Care?


And so we turn full circle. Health care is once again being restored to local regional governance.  The announcement today that the £6bn health and social care budget for Greater Manchester will be taken over by regional councils under devolved NHS powers is in one sense good news.  Local control will allow more joined up health and social care that is responsive to local needs.  But there are concerns and these have been given by he BMA.

The Tories always have a desire to mess about with the organisation of the NHS. They most often do so in the hope that it will save money - that is 'cut' NHS funding.  For this reason I am always wary of moves to reorganise health care provision.  They fiddle with the deck chairs whilst the ship is allowed to sink, and then give as a reason the sinking of the ship.  It runs a bit like this. The ship is sinking so lets reorganise all the deck chairs so that it sinks more slowly.  The ship continues to sink and so the deck chairs are moved once again, trying to shift the ballast.  This is how it is with NHS reform, when the bottom line is really funding.  A well funded NHS is second to none.  But it isn't well funded, or at least not well enough.

Yet again it means a reorganisation of a health service still reeling from the impact of the unnecessary reorganisation imposed by the coalition government.   The Prime Minister, Mr Cameron,  promised no top down reorganisation of he NHS, yet immediately set about imposing confused and ill-judged reforms. He promised the NHS budget would be protected from the austerity cuts, yet £20 bn has been taken out of the NHS budget for England under he guise of 'efficiency savings'.  These efficiency savings have left a strain on overworked front-line staff.

Responding to the announcement that the health and social care budget for Greater Manchester will be taken over by regional councils, Dr Mark Porter, BMA council chair, said:

“There is no doubt that patients would benefit from more joined-up health and social care. However, any plans to do so would have to be underpinned by clear funding to ensure that an already dangerously over-stretched NHS budget isn't used to prop up a woefully underfunded social care budget.

“These wide sweeping changes will affect millions of people. We need to look carefully at exactly how they will affect the commissioning and delivery of services, and what the impact on patient care will be. We must also ensure clinicians have a central role in decisions over health care, something which was undermined by the Health and Social Care Act 2012.

“We need assurances on who is responsible if these changes go wrong. Doctors believe the secretary of state for health should have the duty to provide a universal and comprehensive health service, and must take responsibility for guaranteeing national standards in the of quality care across the country, especially if the delivery of care is to be devolved to local authorities.

“The NHS has just undergone unprecedented upheaval, there must be no more games with our health service and we need to avoid a situation where the NHS moves from being a national to a local political football.”

The reform is good in principle, but it must be put into effect with care. It must be made clear who is responsible for ensuring a universal and comprehensive health service across the country and how best this can be achieved.

Comments

Popular posts from this blog

Ian Duncan-Smith says he wants to make those on benefits 'better people'!

By any account, the government's austerity strategy is utilitarian. It justifies its approach by the presumed potential ends. It's objective is to cut the deficit, but it has also adopted another objective which is specifically targeted. It seeks to drive people off benefits and 'back to work'.  The two together are toxic to the poorest in society. Those least able to cope are the most affected by the cuts in benefits and the loss of services. It is the coupling of these two strategic aims that make their policies ethically questionable. For, by combining the two, slashing the value of benefits to make budget savings while also changing the benefits system, the highest burden falls on a specific group, those dependent on benefits. For the greater good of the majority, a minority group, those on benefits, are being sacrificed; sacrificed on the altar of austerity. And they are being sacrificed in part so that others may be spared. Utilitarian ethics considers the ba

Prioritising people in nursing care.

There has been in recent years concern that care in the NHS has not been sufficiently 'patient centred', or responsive to the needs of the patient on a case basis. It has been felt in care that it as been the patient who has had to adapt to the regime of care, rather than the other way around. Putting patients at the centre of care means being responsive to their needs and supporting them through the process of health care delivery.  Patients should not become identikit sausages in a production line. The nurses body, the Nursing and Midwifery Council has responded to this challenge with a revised code of practice reflection get changes in health and social care since the previous code was published in 2008. The Code describes the professional standards of practice and behaviour for nurses and midwives. Four themes describe what nurses and midwives are expected to do: prioritise people practise effectively preserve safety, and promote professionalism and trust. The

When Finance Drives Destruction

Tackling climate change means stopping the funding of rainforest destruction, says a significant study commissioned by the World Wildlife Fund.  The UK's financial services have provided directly over £8.7 billion to 167 different traders, processors, and buyers of forest-risk commodities (cocoa, rubber, timber, soy, beef, palm oil, pulp & paper) from 2013 to 2021.   With direct and indirect investment,  the figure rises to a staggering £200 bn.  Whilst not all that investment is in destructive projects,  the study concludes there is little transparency on the risk.  Finance is the oil in the economic machine.  But it also drives decisions. We all know the importance of money. We borrow to invest. So much depends on it, such as company pensions.  Do we really know what our pension pots are doing? We invest for the future. But what kind of future? Is all investment good?  Much investment is bad. Investment drives the nature of our economy. It drives our decisions as individuals,