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NHS continued

 
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On 4 Sep 2011 at 1:21pm Paul Newman wrote:
Cancer Survival -Southover Queen is confused both about the supposed rate of improvement and underlying cause
Dr. Franko Berrino, who lead the 2007 study published in the Lancet noted that " Survival rates in England have only improved at a similar rate to other countries and not caught up in absolute terms ". He additionally concluded ( from the maturing data ) was that the 2000 NHS Cancer plan was not working .This was based on diagnosed cases 200-2002 .
Interestingly, in 2007 Hospital Doctor ran a Poll in which 43% said they would vote Conservative as opposed to 7% Labour and 15% Lib Dem reflecting their poor opinion of New Labour`s stewardship
 
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On 4 Sep 2011 at 1:26pm Paul Newman wrote:
The interest in Cancer is that it is relatively measurable between countries whereas general health may be affected by any number of factors, diet notably. The claim that the NHS provides good value is not backed up with the facts. We spend more per head on cancer than France Italy and Germany all of whom have significantly better results .
The inescapable conclusion is that both patient and tax payer get a poor deal . From £20 billion IT fiascos , clown show finances an average of 12 days off sick a year vast lottery pay outs for Consultants the idea that we can continue with our Cuban system is , in my view, a fantasy .
 
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On 4 Sep 2011 at 1:40pm Paul Newman wrote:
The 2007 survey of 127,000 NHS staff revealed that only 2 in 5 would be happy to be treated at their own hospital ....
Btw although I do not propose we adopt the US system ( which we cannot afford anyway) it is another of Southover Queen`s inventions that those with no insurance do not have access to health care. They can get the same care at one of the nation`s non profit hospitals (90% of them) The US spends more per cap via the state on health than we do and vast deal more than Cuba the only comparable system to ours.
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On 4 Sep 2011 at 4:28pm Observer wrote:
Obviously a terribly interesting discussion between yourselves Mr Newman (yawn).
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On 4 Sep 2011 at 4:32pm Old Cynic wrote:
Damn lies and statistics, smoke and mirrors! All I can say is the NHS saved my life, and my mothers and dear friends - and I will do ALL I can to protect it from greedy private companies and greedy government - and I'm not alone in this. Call me sentimental and irrational (and I'm sure I'm going to get some of the typical forum abuse and be shouted down) but its how I andy many thousands feel and any government who tries to sell it off to the highest bidder is in for a fight.
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On 4 Sep 2011 at 4:56pm Decent Citizen wrote:
With you there Old Cynic.
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On 4 Sep 2011 at 5:01pm bastian wrote:
I was about to start a thread on theNHS myself but with a newman ban on it because there is no time left for idle bickering about this topic.I wish to alert you all to a bill that is going through parliment that will make the discussion about the NHS null and void.Did you know that the minister for health will, if this bill goes through,no longer be obliged to provide a free at the point of need service to the public,it will be an end to cradle to the grave.The only politician who has been vocal so far is Dame Shirley Williams,if you want your National Health Service to remain National fight now.
 
 
On 4 Sep 2011 at 5:08pm bastian wrote:
If this is a democracey then surely something of such importance should go to a ballot referendom and I do not mean an online mock version open to abuse, when the tories were elected they said they would protect the NHS,so what changed them? orwho is acting as a renegade party member? and coersed by who with how much money?
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On 4 Sep 2011 at 6:22pm Paul Newman wrote:
I have no doubt you would prefer to disseminate your ludicrous scaremongering undisturbed Bastian. Health Secretary Andrew Lansley said "We have made it crystal clear, time and again, that we will never, ever, privatise the NHS.."
Back up your preposterous allegation or back down. I shan`t hold my breath waiting for an informed reply.
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On 4 Sep 2011 at 7:57pm huw wrote:
My family have has their fair share (and some) from the NHS over the past few years and I think they do a fantastic job.
I can't really be bothered to go back and read the previous thread but I think this link may suggest that the "facts" that are being quoted are not quite up to scratch.
Also, I would never quote a politician's promise to back up my argument. They are quite able to u-turn, lie and be economical with the truth.

Check it out here »
 
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On 4 Sep 2011 at 8:54pm Paul Newman wrote:
You will have to explain why you think that Huw it does not contradict anything I have said and we may have our own opinions as to the impartiality of the Guardian.
On the older data there is no disagreement that we under perform but it goes beyond the raw numbers. Survival rates can be correlated with spending and in Europe there is a rough proportionality. That does not hold true for the UK which, for example , spent three times as much as Poland with similar results on lung cancer.
This is a quote from Karol Sikora Professor of Cancer Medicine at Imperial College " Britain is one of the leaders in cancer research ....The tragedy is that , because of the inadequacy of the NHS British patients are not accessing the benefits"
.. but what would he know eh ... probably just some nasty old Tory.
 
 
On 4 Sep 2011 at 9:25pm Yawn.... wrote:
He probably is but no-one thinks our health service is perfect. It is still a lot better than many countries', the US to name one easy target.
 
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On 4 Sep 2011 at 9:31pm Old Cynic wrote:
Who trusts Andrew Lansley hed sell his grandmother for profit and lie about it
 
 
On 4 Sep 2011 at 11:30pm Southover Queen wrote:
It's interesting that those who are willing to quote their actual experience of the NHS, as opposed to those who quote the Daily Mail/Telegraph portrayal thereof, speak warmly of the care they've received. I'm in a slightly different position: I have worked in a media capacity in a good many hospitals and other care environments covering all kinds of areas from trauma care right through to oncology. I haven't just dropped in either; I've spent months in different institutions and systems as a professional observer.

Now I'm quite willing to accept that it's likely that by virtue of the fact that these institutions agreed to have cameras following their work they are probably among the better ones, but I have been amazed and deeply impressed by the standard of care the vast majority receives. Where there were frustrations these were often caused by absurdly poor buildings which were not designed for 20th century care let alone 21st, by systems which weren't properly linked up and by a lack of resources. Interestingly in most cases these weren't felt at the acute/intensive end - so those who needed an MRI scan or an operation right now would get it - but they did cause delays further down the line. The personnel delivering the care were, on the whole, quite exceptional, and, on the whole, so was the care they delivered.

If you do spend any time at all as an observer in a hospital or a GP's practice you realise that most of the systems are operating with absolutely no slack in them. They're also being forced to tick a lot of boxes and meet a lot of targets which have been imposed by politicians frightened of what the press will say about them, so they tinker at the edges without the reform that is needed. The NHS's biggest problem, in my humble opinion, is the fact that it's a pioneer institution which is now long in the tooth, but there's nothing at all wrong with the idea. What it needs is to be taken out of the political realm so that it's no longer a political football, and it needs to be left alone by ideological grandstanders whose understanding of its value and its weaknesses is negligible.

 
 
On 5 Sep 2011 at 12:45am Paul Newman wrote:
No slack in them eh; an intriguing description of an organisation where the average sick days per year is 12.. Did you spend much time amongst the IT consultants, or the endless managerial staff who, from 2000 to2006 increased 66% ?( Reform). The numbers were still rocketing in 2009 at a time when every other organisation was losing costs .
I think we shall take the question of poor cancer results as a decided and I hope you will forgive me if I do not take seriously ,your suggestion that neither political or democratic pressure should in the future be applied .We`ll just sign the cheque and shut up shall we ? I think not Doctor Croesus ( nice new yacht! )
 
 
On 5 Sep 2011 at 12:46am Paul Newman wrote:
The problem is that those who are good at articulating their experience are also good at negotiating the treatment kommisars. Despite the fact that 85p in the pound of investment went on Labour areas in their period health results grew wider apart with some areas of the UK having shocking life expectancies.
Its amusing that sentimentally doctrinal socialists, so attached to their little USSR, do not notice that the NHS redistributes from young to old from poor to rich and from ill educated to educated. As you presumably well know, privatisation is not ?? Be like the US?. It might be , adopt French, or Danish models. Your silly caricature of the reforming case is one you might usefully reconsider.
 
 
On 5 Sep 2011 at 10:28am jrsussex wrote:
I believe I am correct in stating that the NHS is among the largest employers in the UK. As such I think that overall they perform very well, inevitably there will be areas that can be improved and, like any company, mistakes will occasionally occur. It is unfortunate that due to the very nature of the business their "mistakes" can lead to the death of a patient, which is catastrophic for the relatives and friends of the deceased but also for the staff involved.
There are areas within the NHS that can undoubtably be improved, certainly I believe some levels of both senior and middle management could be removed, but overall they perform well. I have had 2 major operations in the last 4 years, which unquestionably are the reason for my still being here so perhaps I am biased but I do honestly feel that the UK can be proud of its health service. Arbitrary comments degrading the whole of the NHS are pointless and stupid. They offer nothing to the debate.
 
 
On 5 Sep 2011 at 12:06pm Southover Queen wrote:
Paul, I make no such concession about cancer results. These are improving but there are no quick fixes: what is needed to achieve continuing success is a lack of interference and an absence of arbitrary and ideologically-driven reforms.

My reference to there being no slack in the system is to actually to bed spaces and resources. I invite you to cast your mind back to the Thatcher years when there was a moral panic about there being too many hospital beds, representing "inefficiencies". Instead of something like 80% occupation, the results of those reforms were that occupancy rocketed to something close to 100%. All it takes for chaos to result in those circumstances is a flu epidemic. That is what I mean about decisions being taken as a result of political pressure rather than in consultation with people who actually plan and use the system. It also means that very seriously ill people end up being treated in completely inappropriate wards and receive poor quality care - because the right ward was full on admission.

The closer to capacity you operate the system the more administrators you need to manage scarce resources, and same goes for the never-ending arbitrary reforms imposed by governments of all political colours.

Since you've given up holding up the US "system" as the model to aspire to, I'm amused to see France cited instead. The admin's a nightmare, you can get state sponsored treatment in a spa* and it is not free at the point of use. The per capita spend is at the top of the European table and it is often discussed as unaffordable. The same is true for many of our European cousins. Do you actually have any experience of these systems? I do. The facilities are very shiny. The quality of care is very comparable and cheaper here by something like 3.5 percentage points of per capita costs.

*Just imagine the headlines in the Daily Mail "Scroungers in luxury spa holiday for free"
 
 
On 5 Sep 2011 at 1:07pm Paul Newman wrote:
If you have any evidence that Cancer results are improving ( from its dreadful base) ,above the norm, you have kept it a dear and precious secret. I on the other hand have produced reputably sourced evidence that you are incorrect.
The French health system including its Insurance top ups, internal market multiple and non National providers ( including private ) ...is rated b y the World Health Organisation as the best system in the world. I shall take it upon myself to inform them of their error on the basis that someone calling herself Southover Queen 'reckons' pronto tonto. Happy ?
You want to retain the most centralised system in the world outside Cuba and you call attempts to secure reform"ideologically driven" ?
I rather admire good old swivel eyed political commitment and
if there was a prize you would probably have won it with that remark . Well done
 
 
On 5 Sep 2011 at 1:28pm Oolon Colluphid wrote:
I am amused how Mr Newman cherry-picks his facts and stats to get the results he want. Here he is now having switched horses and praising the French healthcare system. Is Mr Newman aware that the France spends %18 more per-capita on healthcare than we do in the UK (h**p://www.globalhealthfacts.org/data/topic/map.aspx?ind=66#table), and that in France, health care spending is 16.7 percent of the French government's budget, where as it is 16.3 percent?

 
 
On 5 Sep 2011 at 1:29pm Oolon Colluphid wrote:
Sorry I mean to say where as it is 16.3 percent, in the UK h**p://www.visualeconomics.com/how-countries-spend-their-money/

 
 
On 5 Sep 2011 at 1:42pm Paul Newman wrote:
I only picked the French system as the WHO said it was the best . I have never suggested that we import the US here I used their cancer survival rates as a point of comparison but admitted that it was probably not a very illuminating one . It was Southover Queen who decided the only options were at each end of the spectrum for the usual reasons.
 
 
On 5 Sep 2011 at 1:53pm Southover Queen wrote:
You seem to be missing the point - here made again by OC - that the French system may deliver the best outcomes in the world but it's unaffordable and as such is the subject of much discussion. I'm sure the NHS could be wonderful as well if we decided to increase spending by nearly 20%, and spend some of that on reforms which actually address the problems rather than on what politicians prefer to believe are the problems. I am not objecting to reform, merely reform which is driven by ignorant ideologues whose changes are damaging.

Lastly, cancer statistics. Take your nose out of the Daily Mail mouth-foaming copy, and get your head round this article from The Economist. Is that sufficiently non-left wing to satisfy your reds-under-the-bed sensor? Survival rates for most of the common cancers have improved over the last 20 years because of better screening and faster diagnosis mostly because of increased funding.

In your second point you are putting words into my mouth. I have said nothing about retaining a centralised system; I merely advocate what would be objectively best for the NHS, not what your "swivel eyed" politicians wish to impose. Why is that a problem exactly? Could it be that the outcry from every informed institution and research organisation in the country insisting that this government is driven by ideology and is wrong is thoroughly inconvenient to your apparently very extreme view?

Check it out here »
 
 
On 5 Sep 2011 at 2:05pm Oolon Colluphid wrote:
There's little doubt that Mr Newman's take on this issue is clouded by ideology.
His argument is basically that there are certain failing in the UK Healthcare system, and he sources stats to prove this - fair enough- but he then goes on to infer that the system is rotten to the core and we should adopt some other quasi-privatised system. Not, he insists - as Miss Edmunds would have it - an entirely profit driven system, and not, he insists like out US cousins, but more like er.. the French or the Germans.

But when we draw comparisons and examine these other systems in detail what we find is that these systems are no more cost-efficient and only perhaps only marginally more effective in certain cherry-picked areas (like Cancer survival rates) than the UK system.

In this sort of argument we often hear the right beating the drum about trimming the fat from the system, getting rid of administrators and making the system more efficient. We've already hears how this affect front-line services with wards at near capacity levels more of the time. What I cannot understand is how anyone can believe that adding a whole new layer of bureaucracy into the system by requiring health professionals to negotiate costs and chase payment with health insurance companies can in any way lead to an increase in efficiency? Surely the opposite is true.
 
 
On 5 Sep 2011 at 2:16pm Oolon Colluphid wrote:
That's a great link Southover Queen, something Miss Edmunds should look at! It explains really well the problem with cherry-picking stats like cancer survival. I wanted to say something about the context of the cancer stats but that link does a much better job of it than I could have ever done.
 
 
On 5 Sep 2011 at 2:29pm Southover Queen wrote:
The "usual reasons"? Aha: that red-under-the-bed sensor again.

The reason I assumed that you were citing the US "system" as a model was because it's the only developed country in the world which has no insurance system and is, as such, the only privatised one. France (like all the other EU members) is funded by national insurance schemes of one kind or another so just doesn't fit your privatised model. It's just a very expensive nationalised one.

Oh, and by the way, Cuba has a brilliant healthcare system if you're measuring them on results and value for money - way above the mean on any graph you look at.
 
 
On 5 Sep 2011 at 2:35pm bastian wrote:
as usual the everyone loves to side track away from my point possibly because it is actually a raelly big issue that has somehow passed you by but it is a FACT that this bill will take away the right of this and other governments to provide care to the general public free at the point of use,the observer front page is not the only reference I have seen to this subject but I can see that none of you give a damn about such an important issue and would rather bicker about cancer survival rates.If this bill is quietly passed then more people will die of cancer and you won't know because the private institutions may not have to tell you.
 
 
On 5 Sep 2011 at 2:45pm bastian wrote:
By the way Germany has taken an interest in buying up our hospitals...our taxes going to Germany...not bolstering our own economy.
 
 
On 5 Sep 2011 at 2:48pm bastian wrote:
paul you may need to read a few more news articles from yesterday and today before you post rather than spewing the party line..which is the opposite of scare mongering,it's keeping it quiet until the bill is passed.
 
 
On 5 Sep 2011 at 2:49pm Pau, Newman wrote:
Sigh.....I appreciate that our notional per capita spend (excluding the vast pensions black hole ..ha ha ) is lower than France although year on year productivity losses for the last ten years do not encourage me to agree its a matter of throwing money at it.
Comparing global results however is impossible given the randoms involved and spending on (relatively comparable) cancer on this country is high .In fact , as I specifically mentioned, we are , apparently , outside a proportional spend/ result curve on the wrong side .You are missing the point
By informed bodies who do you mean? Not I hope the BMA and Public Sector Unions whose resistance to change is hardly mysterious. Informed bodies have also retained high military spending by extensive lobbying . Fancy that !!
I am not an extremist , I am a Conservative .I support moderate reform in the direction of multiple providers, choice and decentralisation I do not however anticipate utopia .
You call this ideologically driven but if that is so it is the ideology embraced by the Western World rather than that embraced by the Soviet Union and old East Germany ; controversial maybe but there it is.
 
 
On 5 Sep 2011 at 3:08pm Southover Queen wrote:
I do give a damn, bastian, but then I'd like to see the whole ill-conceived ideological nightmare that is the Health and Social Care bill consigned to the rubbish bin. The health services need sympathetic reform, not yet another ideological earthquake.
Paul, by informed bodies I'm mostly referring to the Kings Fund but I'd certainly consider the point of view of those who actually work in the system. If the BMA and the RCN, for instance, have opinions and contributions to the debate, then it's perverse in the extreme to exclude them. if, just because they're all membership bodies representing the interests of their members, you believe they should be excluded then I'd suggest you're missing absolutely crucial input for ideological reasons.

I've never heard anyone accept a label of "extremist", but you certainly give a pretty good impression of it. Along with Ms Edmunds, it has to be said.
 
 
On 5 Sep 2011 at 3:30pm bastian wrote:
SQ, the unions have been excluded...also in the observer yesterday..the tories want this to be a fait du complete..you wake up and it's all happened,today security of health, tomorrow nothing.And I disagree that reform is what it needs..this constant movement is exhausting if you work under it and I do..just let us all get on with our jobs like the experts we are,for the benefit of all who require it,if you can pay for yourself go ahead,but don't force the rest of us to pay when we cannot.
 
 
On 5 Sep 2011 at 4:20pm bastian wrote:
paul,your sophistry is clouding the real point again,try talking from the heart rather than from a stats sheet folded inside the conservative manifesto(that is now scrawled all over in purple crayon)So we can get the measure of you...the man,not his party.
 
 
On 5 Sep 2011 at 4:25pm Southover Queen wrote:
bastian, I know the unions have been excluded and I would be keen to hear their views. That was what I meant by membership organisations, and of course the RCN and the BMA fall into those categories as well. I just wanted to see whether Paul would discount them as quickly as "trade unions", as I imagine he would the input from Unison or Unite.

I understand completely what you mean by constant reforms being exhausting. I don't agree that reform isn't needed, but it must not be imposed by politicians with no real understanding of how the system works at the moment, and that's what I can see is happening. That's why I've been at pains to emphasise sympathetic change, by which I mean consultative and research based change which listens both to the service users and to the service providers.
 
 
On 5 Sep 2011 at 6:04pm Paul Newman wrote:
Its hardly ideological to be aware that Unions exist to represent their members whose interests are not identical with tax payers and patients.
As to my spot on the political spectrum I feel the world would have an identical amount of useful information without your opinion but if you feel the need to vent ; go for it . Its healthy ..and free at the point of use
 
 
On 5 Sep 2011 at 9:45pm Southover Quewn wrote:
Ah, the soft thud of the towel thrown in. By the by, you didn't clarify whether membership of a union disqualifies you from having a valid opinion. If I were an NHS worker I'd be insulted that you think I'd be too partisan to put wider interests first just because I belong to a union. And if course they're a great source of expert informed opinion from the shop floor - but maybe the shop floor's too close to the people who really know what's what for you. I'm sorry you think I should take my opinions somewhere else, not least because your trite undigested views need challenging. So I'll stick around if you don't mind.
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On 6 Sep 2011 at 7:08am Zebedee wrote:
Well said Southover Queen and Oolon Colluphid (where did you get that moniker?). An illuminating thread.
 
 
On 6 Sep 2011 at 10:55am Deelite wrote:
Hitchhikers guide
 
 
On 6 Sep 2011 at 2:03pm bastian wrote:
strange to imagine but union members are also tax payers and patients...so log paul and thanks for all the fish.
 
 
On 6 Sep 2011 at 2:39pm Paul Newman wrote:
Oh alright alright good goading. I think the question of whether think tanks or Unions having a formal role in legislation is an interesting one for another time .
The Kings Fund seems a good conduit for professional expertise and such bodies may well have a useful consultative role as they have had in the 'listening process'
On the subject of England's Poor Rates of Cancer Survival " I recommend the Kings Fund Publication " How to Improve Cancer Survival " which deals with the methodological problems identified on this thread and widens the comparison outside Europe .
On their critically supportive stance on Coalition reform you might read the latest briefing on the Health and Social Care Bill. It seems reasonable to me although it is the job of elected representatives to decide having listened.( IMHO)
So there we are boringly sensible really. Sorry
 
 
On 6 Sep 2011 at 3:12pm bastian wrote:
I think you will find that the kings fund is only one side of the story and being a private finance initiative leaning company will back the tories all the way,hardly unbiased as that would mean talking to,on an equal level,with other organisations that have a vested(not invested)interest,like unison ,the BMA and the royal college of nusing,these people know that if the right to treatment at the point of contact ends then that is the end of thNHS as we know it.
 
 
On 6 Sep 2011 at 4:10pm Southover Queen wrote:
I've found the Kings Fund to be a generally very helpful and objective voice in the ongoing debate surrounding the future of the NHS. As a charity I think they're actually obliged NOT to take a party political POV, but I agree if you find the prospect of any change of any kind discomfiting then you'll be suspicious of them too. I don't because I do believe that the NHS, as an statutorily funded institution, must adapt as the society it is part of changes, and the Kings Fund is a powerful and very positive advocate for that. I particularly disagree that they "back the tories all the way" - have a look at some of the briefings and reports they've produced over the last few months for evidence of that.

Check it out here »
 
 
On 6 Sep 2011 at 4:41pm bastian wrote:
I have looked already and though seemingly ok,I am still wondering at thier impartiality as they co run the "impact" awards with glaxo smith kline drug company,and that would suggest little untainted contact with a giant company who have an interest in free trade of its product.Now paul would argue that the unions are impartial but they make no money out of the NHS,so their interest is in the public good and the continuing level playing field under which people work and recieve care.


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