# Worrying move for NHS



## Northerner (Mar 9, 2011)

Just been reading about the potential outsourcing of entire care pathways to private providers. Particularly worrying was the following:



> NHS Oldham is also looking to split care pathways among competing providers, starting in May. The PCT is to launch tenders for ophthalmology, sexual health and *diabetes* services in the next three months, and has awarded a contract to take on the entire budget for elective orthopaedic and rheumatology services to a private firm, Pennine Musculoskeletal Partnership.



Full article at:

http://www.pulsetoday.co.uk/story.a...71009&sp_rid=NjU3NzMyNzAyOQS2&sp_mid=36362612

(registration required, but free - definitely worth signing up to in order to read the medical profession's reactions to the changes)

I am totally against the back-door privatisation of the NHS that is clearly the current governnment's aim


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## AlisonM (Mar 9, 2011)

I don't suppose the level of care will improve at all?


Why haven't we got a tongue in cheek smilie?


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## chrismbee (Mar 9, 2011)

Private healthcare companies require profit.

Diabetes care (in common with other conditions) does not necessarily attract profit, unless it is at (vast) expense to the NHS ie. us tax-payers 

A sinister move, however you dress it up!


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## everydayupsanddowns (Mar 9, 2011)

I completely agree. Effective diabetes care is expensive, and the potential benefits to patients (and savings to overall NHS budgets of non-development of complications) won't really be felt by the [privatised] diabetes care provider.

And we think it's tough for T2s to get test strips now. Pump funding...? What are the chances of a full time CGMS for intensively managed Type 1's under that arrangement.

Scary.


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## Twitchy (Mar 9, 2011)

I feel another letter to my MP coming on... she's going to think I'm stalking her at this rate!!


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## shiv (Mar 9, 2011)

I had heard that type 1 care at a minimum was going to be ringfenced due to the complexity of it. I am keeping my fingers crossed for that


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## HartHen61 (Mar 9, 2011)

Does it mean if diabetes is privatized outside of the NHS all diabetics will have to pay them for medications, needles, strips, etc and will we have to contact them instead of our gp's, and what will happen to all the dsn's in the NHS will they loose their jobs, most diabetics rely on their expertise as some people do'nt have consultants or nurses to talk to and get free advice, frightening thoughts !!!!


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## Twitchy (Mar 9, 2011)

I don't think it will mean you'll have to pay, it should all still be 'free at the point of care', but I guess it sounds like the budget will be given over to a private company outside the nhs to manage (theory being they will be cleverer with using it, probable reality being they will cut corners to make profits, me cynical, moi??!) I'd suggest we all get contacting our MPs as this sounds a bit dodgy = at least ask for 'clarification' which will get questions raised and maybe head off the most extreme options at the pass as it were...


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## Ergates (Mar 9, 2011)

Totally agree, Northener!!


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## Freddie99 (Mar 9, 2011)

Abandon all hope all ye who enter. I think I'll get my nursing training out of the way and escape the country. This is effectively cutting the NHS but by other means. I'm sure there will be corners cut by the private companies. Waste in the NHS is bad enough at the moment but I'm sure that there will be too many corners cut and patient care will be put at risk.


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## Northerner (Mar 9, 2011)

I can already foresee crackdowns on strip provision, and possibly even a 'preferred supplier' where a private healthcare provider has an arrangement with one particular meter company.


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## grahams mum (Mar 9, 2011)

how worse it can get here (conquest hospital)?????


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## shiv (Mar 9, 2011)

Northerner said:


> I can already foresee crackdowns on strip provision, and possibly even a 'preferred supplier' where a private healthcare provider has an arrangement with one particular meter company.



It actually makes me feel a bit sick when I think about it. I'm hoping my new team in London will be very proactive and supportive when it comes to cutbacks. I wish we had an adult equivalent of the standards children get at Leeds or UCLH!


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## mcdonagh47 (Mar 9, 2011)

Northerner said:


> Just been reading about the potential outsourcing of entire care pathways to private providers. Particularly worrying was the following:
> 
> 
> 
> ...



Oldham comes under a group of hospitals called the Pennine Acute Hospital Trust. The Pennine Muscular Thingy looks like it is the Consultants of the Pennine Hospital group going private with a captive, guaranteed clientele.


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## mcdonagh47 (Mar 9, 2011)

Northerner said:


> I can already foresee crackdowns on strip provision, .



..and Pumps. "You don't need a pump, the clinical advantage over basal/bolus is not sufficient to justify the cost", they will say.


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## shiv (Mar 9, 2011)

^ to be honest, that's the situation as it is now. So many of us are having to PROVE to consultants that injections aren't working.

There are some PCTs which will give them to lots of adults - York is one I believe - so there is some hope out there.


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## Robster65 (Mar 9, 2011)

I agree totally with whats been said and especially the preferred suppliers to gain discounts from the cheapest and most basic of meters, pens, etc.

BUT. In the US, a much higher % of patients (clients?) use pumps and CGMs because, presumably, they are more cost effective over the lifetime of a patient. Plus, they may get bonuses on lower HbA1cs, etc or less complications maybe.

I am totally against it but it may not be as bleak for the patient in all aspects.

Rob


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## Northerner (Mar 9, 2011)

Robster65 said:


> I agree totally with whats been said and especially the preferred suppliers to gain discounts from the cheapest and most basic of meters, pens, etc.
> 
> BUT. In the US, a much higher % of patients (clients?) use pumps and CGMs because, presumably, they are more cost effective over the lifetime of a patient. Plus, they may get bonuses on lower HbA1cs, etc or less complications maybe.
> 
> ...



But the US healthcare system is funded by massive amounts of money from insurance companies. Also, they have co-pay where you have to contribute a large proportion yourself, unless you are in a particularly good ins. scheme at work. Many people are tied to their jobs because they can't afford to lose the health insurance, especially if they developed chronic conditions like diabetes whilst in employment. Equipment, such as pumps, pens, needles etc. are priced much higher in the US, again because it's all paid for through hge premiums. If you don't have good insurance you can even end up with no insulin  I've heard of people having to wait for their pump to fail completely before they can get a replacement etc. Not good


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## Robster65 (Mar 9, 2011)

Hmmm. Didn't realise it was that bad. In which case, scratch what I said and we'll have to hope they put some controls in place for minimum service standards and targets, etc.

A bit like they did for the cleaning contracts. Just before MRSA took hold.

Rob


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## Northerner (Mar 9, 2011)

Robster65 said:


> Hmmm. Didn't realise it was that bad. In which case, scratch what I said and we'll have to hope they put some controls in place for minimum service standards and targets, etc.
> 
> A bit like they did for the cleaning contracts. Just before MRSA took hold.
> 
> Rob



I expect there will be standards and rules, but the thing that bothers me most is the breakneck speed of everything - just how ell considered will everything be? It's like the government have been so long out of power that they are trying to change everything as quickly as they can before someone realises what they are doing! The NHS is enormous. At the same time as all these massive changes they are losing (highly qualified) staff as well as the whole infrastructure supporting it. I think what they are doing would be highly risky even if the economy was strong.


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## mcdonagh47 (Mar 9, 2011)

Northerner said:


> But the US healthcare system is funded by massive amounts of money from insurance companies. Also, they have co-pay where you have to contribute a large proportion yourself, unless you are in a particularly good ins. scheme at work. Many people are tied to their jobs because they can't afford to lose the health insurance, especially if they developed chronic conditions like diabetes whilst in employment. Equipment, such as pumps, pens, needles etc. are priced much higher in the US, again because it's all paid for through hge premiums. If you don't have good insurance you can even end up with no insulin  I've heard of people having to wait for their pump to fail completely before they can get a replacement etc. Not good



I've even seen American posters on other groups saying things like, I know I have got Type 2 diabetes but I don't want  be officially dxed yet because I haven't got insurance, what do I do ?


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## mcdonagh47 (Mar 9, 2011)

Northerner said:


> I can already foresee crackdowns on strip provision, and possibly even a 'preferred supplier' where a private healthcare provider has an arrangement with one particular meter company.



Preferred suppliers seem to exist already at least on the quiet e.g.  Danish Novorapid from NovoNordisk seems to be No1 in Britain even though American Humalog from Eli Lilly is known to be more effective and the insulin most like our own. Suppose Humalog is more expensive. Although Lilly and NovoNordisk might have carved up the world between them in an unwritten Gentleman's Agreement cartel.

Again Simvastatin is now the statin of first choice in the NHS though Atorvastatin is generally reckoned to be superior on pure medical grounds.

If it means cheaper, more widely available test strips and pumps etc then preferred suppliers with a couple of options available might be an improvement ?


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## Northerner (Mar 9, 2011)

mcdonagh47 said:


> ...If it means cheaper, more widely available test strips and pumps etc then preferred suppliers with a couple of options available might be an improvement ?



I agree, I'm just not confident that that is what will happen! I hope I'm proven wrong though, since the juggernaut appears to be set in motion...


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## mcdonagh47 (Mar 9, 2011)

Northerner said:


> I agree, I'm just not confident that that is what will happen! I hope I'm proven wrong though, since the juggernaut appears to be set in motion...



Remember - its not a "Top Down" reorganisation of the NHS, its just that the Man at the Top has ordered it out of nowhere.

The Govt - Gove, Cameron, Hague etc - are actually beginning to look quite incompetent.


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## Cate (Mar 9, 2011)

So writing to our MPs...what do we need to say?

Anyone got a draft letter I can copy and send to mine?  Do DUK have any official position on this yet?

Would like to harrass my MP about it, but have no time to read the details and write a letter myself...

(I think it's a terrible idea FWIW!)


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## Twitchy (Mar 9, 2011)

this is more or less the email I sent a while ago (some personnal details cut)

Dear -------

I hope all's going well for you.  I have a quick query I hope you can help me with, please? It's to do with funding policy re the NHS.  As you might remember, I am a type 1 diabetic - I remember you saying ----------, so you might be interested in this subject.  I am a member of both a local diabetic mums group and an online diabetic support forum (see below). On the latter, increasingly there are instances where diabetics are finding that their access to consultant led care, or equally critically, access to test strips, lancets and needles (etc!) is being challenged and in fact rationed.  I don't know what you might remember from ---------, but trying to live life as a diabetic without being able to test (& so control) as required is like being asked to drive with your eyes closed!  Long term implications include so many complications such as loss of sight, amputations etc - all surely with hefty, long term benefits & societal cost implications. It appears to me that a short term (in year?) savings program is being led by PCTs/GPs at the detriment of patient care. The damage caused by short term savings may not emerge for many years, but from any rational view point surely this is a bad approach?!  Please can you confirm if the government is aware of any such savings drive (specifically against diabetic's consumables including access to insulin pumps & their supplies) and if not, is it possible that the health minister could for example remind the nhs that asking patients to not test often, or to reuse sterile single use consumables poses a health threat? (ie a patient on multiple daily injections (mdi) being asked to make one 'single use' needle last 4 days, or another patient again on mdi being asked to test just once per day!)

Please don't take just my word for this (although personally I have already had to argue the case with my surgery's 'diabetic specialist nurse' & then GP for a sensible number of test strips).  If you want to see how diabetics all over the UK are experiencing this, please have a look at diabetessupport.co.uk. We all know cost savings have to be found & the pain has to be shared by all. But surely the quality of care we were assured would be sustained should be there?

I'm really sorry if this comes across as a rant (it's not aimed at you personally!) - I'm speaking as someone currently undergoing laser eye surgery for diabetic retinopathy, who desperately wants to retain their job, continue paying taxes & being a useful member of society! I just need the support of the NHS to be able to do this. )  Please let me know if there is anything I can do to assist you at all on this issue.

With best wishes,

*********************
From memory, the MP submitted a  written parliamentary question to the Department of Health and a letter to the Chief Executive of the PCT. Both of these came back with 'comforting words' and I've not been nagged about test strips since! 

For the current situation I think I would be using words to the effect of being concerned at hearing of the prospect of my healthcare being contracted out to the lowest bidder ('best value'?!) etc- basically looking for an explanation of what safe guards & balances will be in place to ensure the best possible patient care with regard to long term (ie not political term!) outcomes.  (ie not short term savings at the cost of future expense treating complications, funding benefits etc...

(Sorry if this is a bit confused, hubby rabbiting on in my ear in raptures about the hairy bikers cooking on tv - MEN!! )


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## Robster65 (Mar 9, 2011)

That reads very well Twitchy.

I think we do tend to focus on the cost now vs. the cost in future in purely financial terms, because that's how the GPs/DSNs are justifying their rationing.

There's also the point that whatever the cost in financial terms, it is unnacceptable to put any of us in a position where we have an fairly hefty chance of complications because we are denied a relatively cheap and effective consumable. And if they ration them on teh grounds of innefective testing, then they should take responsibility for educating us to make the best use of them. Which they're not prepared to do even if they have the level of knowledge.

Rob


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## ThunderBolt (Mar 10, 2011)

You'll have to forgive my ignorance of political clap trap, but it seems to me to be yet another quick fix that's bound to go nips up. There's a berk OK 2 berks at the helm now, Noddy and Big Ears and there'll be another berk in after them. As much as many would blame Labour, in particular TB, it's been going downhill for a longer time than his reign of terror. Or weakness as the case may be. Privatising firms like British Steel for one was great until the money it was sold for ran out and your knives and forks put nothing back into the tax pagers pocket. 

I forgot what I was going to say now after that rant... It was a good point though. You'll just have to take my word for it now I'm afraid. Sorry!


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## FM001 (Mar 10, 2011)

Privatisation of the NHS has been a long time coming, previous Conservative governments have secretly talked about it but never dared to take the first steps, here we have a ruthless Prime Minister who disregards expert and public opinion and presses ahead with his plans regardless, as we have seen lately the victims of his cuts have been the sick, vulnerable and least well off in society.

John Major in his time in government was the first to fully propose private funding of the NHS, his PFI plans were laid down to help build new hospitals with private money instead of using government funds. Private Finance Initiative (PFI) didn't take off under Major but was later carried on by the Blair Government who borrowed money from the private sector in return for a part-privatisation of the hospitals built, in return for their investment the government would pay a lease to the private sector which would last 40-50 years.  This on paper might sound good, but many local health authorities are struggling to pay the lease and have had to make cuts to compensate.

To my mind the present proposals are the beginning of the end for the NHS, it was reported a few weeks back in the Guardian that GP's and government ministers have shares in these private companies, it would be very lucrative for them to refer patients to these private companies regardless of their ability to cater for the patients needs.  As per usual the least well off in society will be the ones to suffer here, patient care will be a byword and the top 10% of earners in society will see little change as they have the ability to pick and choose their health care provision.

R.I.P NHS


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## ypauly (Mar 10, 2011)

toby said:


> Privatisation of the NHS has been a long time coming, previous Conservative governments have secretly talked about it but never dared to take the first steps, here we have a ruthless Prime Minister who disregards expert and public opinion and presses ahead with his plans regardless, as we have seen lately the victims of his cuts have been the sick, vulnerable and least well off in society.
> 
> John Major in his time in government was the first to fully propose private funding of the NHS, his PFI plans were laid down to help build new hospitals with private money instead of using government funds. Private Finance Initiative (PFI) didn't take off under Major but was later carried on by the Blair Government who borrowed money from the private sector in return for a part-privatisation of the hospitals built, in return for their investment the government would pay a lease to the private sector which would last 40-50 years.  This on paper might sound good, but many local health authorities are struggling to pay the lease and have had to make cuts to compensate.
> 
> ...



I think it's all about removing years and years of unwanted/un-needed layers of management the NHS has accrued over the years.

But remember the budget is protected and will rise with inflation so care should not be affected in any negative way.

What gets me is that quite a few times recently I have heard "this is a result of goverment NHS cuts" Which simply isn't true.

wether the changes turn out to be good or bad I think they are being made for the right reasons, as there are far too many managers earning far too much money that should be being spent on care.


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## Copepod (Mar 10, 2011)

mcdonagh47 said:


> Preferred suppliers seem to exist already at least on the quiet e.g.  Danish Novorapid from NovoNordisk seems to be No1 in Britain even though American Humalog from Eli Lilly is known to be more effective and the insulin most like our own. Suppose Humalog is more expensive. Although Lilly and NovoNordisk might have carved up the world between them in an unwritten Gentleman's Agreement cartel.
> 
> Again Simvastatin is now the statin of first choice in the NHS though Atorvastatin is generally reckoned to be superior on pure medical grounds.
> 
> If it means cheaper, more widely available test strips and pumps etc then preferred suppliers with a couple of options available might be an improvement ?



You've prompted me to check relative costs in BNF online:
Humalog 5 x 3ml cartridges = ?28.31
Novorapid 5 x 3ml cartridges = ?28.84.


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## Northerner (Mar 10, 2011)

ypauly said:


> I think it's all about removing years and years of unwanted/un-needed layers of management the NHS has accrued over the years.
> 
> But remember the budget is protected and will rise with inflation so care should not be affected in any negative way.
> 
> ...



Paul, do you honestly believe that one bureaucracy will not be replaced by another? Or that there are no 'cuts' in reality? The need for care is increasing all the time as the population ages, new treatments become available, etc. If you don't keep pace with that then you are spreading an ever-declining amount of money amongst and ever-increasing number of people. And if there are no cuts, why are wards closing, hospitals closing, young doctors being let go, nurses being made redundant...etc., etc.... 

And it was the Tories that introduced the management structure you are happy to see go, my Mum worked for 25 years in hospitals and I remember the changes well when they were brought in.


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## ypauly (Mar 10, 2011)

Northerner said:


> Paul, do you honestly believe that one bureaucracy will not be replaced by another? Or that there are no 'cuts' in reality? The need for care is increasing all the time as the population ages, new treatments become available, etc. If you don't keep pace with that then you are spreading an ever-declining amount of money amongst and ever-increasing number of people. And if there are no cuts, why are wards closing, hospitals closing, young doctors being let go, nurses being made redundant...etc., etc....
> 
> And it was the Tories that introduced the management structure you are happy to see go, my Mum worked for 25 years in hospitals and I remember the changes well when they were brought in.


Hospitals need manager and admin staff, the old days of the matron doing it were silly. Clinical staff should be doing clinical work but can you say truthfully that the NHS needs more managers than nurses?


People have also complained for years about the "postcode lottery" we see it here all the time with the differing standards of care. Under the proposed changes your GP will be able to decide whats best and do what he feels is right. If that means a clinic in the next town that have a good record as opposed to a local one that has a bad record you will be able to go there, and visa versa.

Examples of excessive waste.

From 2003 
http://www.independent.co.uk/opinio...hs-need-more-managers-than-nurses-599416.html

From 2009
http://www.telegraph.co.uk/health/h...S-but-managers-rising-faster-than-nurses.html

From 2010
http://www.independent.co.uk/opinio...hs-need-more-managers-than-nurses-599416.html

http://www.guardian.co.uk/society/2010/mar/25/nhs-management-numbers-frontline-staff

http://news.bbc.co.uk/1/hi/8614684.stm


Most interestingly of all (though I havn't verified the figure mentioned) ?7 billion spent on general practice ?12.6 Billion spent on admin.
http://community.healthcarerepublic...15/could-the-nhs-manage-without-managers.aspx

Something has got to change, it really has. We don't have a bottomless pit of money due to the last goverment wasting it (see I got a dig a gordo the great in too) lol


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## ypauly (Mar 10, 2011)

I would add I agree it's worrying to change something we all care so much about, I really do care and also worry it will go wrong as it has before. I just prefer to think positive.


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## Northerner (Mar 10, 2011)

My worry isn't that things are changing, it's the pace and scale of the changes of such a massive organisation - changes which have very little support from GPs themselves (read Pulse for their stance on the whole business). This isn't like steel or coal, it affects people's health directly and I can only see it as a massive gamble. There is no time for pilot schemes to uncover any flaws. I've worked on some pretty big projects in my time and am fully aware of the way that the 'big ideas' men don't actually think things through, as they are too convinced by their own infallibility.


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## fruitloaf (Mar 10, 2011)

ypauly said:


> Under the proposed changes your GP will be able to decide whats best and do what he feels is right. If that means a clinic in the next town that have a good record as opposed to a local one that has a bad record you will be able to go there, and visa versa.



Sadly I think that is very different from the way it will be. 
GP's don't want this role. They don't have the experience to do it or the time. It will be out sourced to private companies that will act like the current PCT's. It will be fundamentally ruled by cost.

The health service is being crippled and patient care is going to suffer. The running costs of the NHS increase year on year due to more patients, more treatments etc. This is far more than inflation. The NHS cannot be run like a business because you can't just cut out the bits that are expensive. Private companies will bid to do the cheap easy work (as is already happening) and the NHS will be left to pick up the rest.

more test strips? not a chance


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## ypauly (Mar 10, 2011)

Northerner said:


> My worry isn't that things are changing, it's the pace and scale of the changes of such a massive organisation - changes which have very little support from GPs themselves (read Pulse for their stance on the whole business). This isn't like steel or coal, it affects people's health directly and I can only see it as a massive gamble. There is no time for pilot schemes to uncover any flaws. I've worked on some pretty big projects in my time and am fully aware of the way that the 'big ideas' men don't actually think things through, as they are too convinced by their own infallibility.


I would have liked to see some regional trial carried out, especially as the NHS budget has been protected so they can't argue its money. But I am sure of one thing, that is the NHS will continue and try to improve. But as I said before does it need 50,000 managers? and 4 times that amount of other admin staff, I really dont believe it does.

A good example is my local hospitals out patient department that used to have 3/4 receptionist/admin type staff. It was recently re-developed (and filled with nice artwork but that's a different thread) now there are 2/3 admin that tell you what desk to go to then at each of the desks/waiting area there is a receptionist there, staffing has visably trebled.
Yet at the same time it was taken over by another hospital trust and all the appointments are made via the appointment centre in the other hospital. That centre maybe more efficient or better in some way but the outpatients centre I go to had enough people to do this. If you read back through some of my initial posts on this site appointments are hard to get/arrange because of this, I have had nothing but trouble in this area but no matter who I speak to at my hospital they can't do anything about it.

Some things just need sorting. I would love the authority to hire and fire in the NHS the first people I would sack is anybody that ordered a painting, sculpture or other stupid thing that now litter the entrance halls and foyers of our hospitals. Millions and millions were wasted on this crap, when all I want to be able to do is book an appointment.


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## ypauly (Mar 10, 2011)

fruitloaf said:


> It will be fundamentally ruled by cost.



It allready is, ask anybody that has needed specialist cancer drugs or many type 2 diabetics who want testing kits.

Costs in the NHS has been a deciding factor of care for years, yet this was done while paying an army of managers to spend fortunes on artwork. I simplify it I know but it is the truth.


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## fruitloaf (Mar 10, 2011)

ypauly said:


> It allready is, ask anybody that has needed specialist cancer drugs or many type 2 diabetics who want testing kits.
> 
> Costs in the NHS has been a deciding factor of care for years, yet this was done while paying an army of managers to spend fortunes on artwork. I simplify it I know but it is the truth.



oh yes I know it already is but it's only going to get worse, a lot worse. I simply cannot understand how patients, ie anyone who uses the NHS or may need to in the future can be in favour of these changes. It isn't going to benefit them!


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## Northerner (Mar 10, 2011)

ypauly said:


> It allready is, ask anybody that has needed specialist cancer drugs or many type 2 diabetics who want testing kits.
> 
> Costs in the NHS has been a deciding factor of care for years, yet this was done while paying an army of managers to spend fortunes on artwork. I simplify it I know but it is the truth.



I'm with you on the management thing Paul, I just don't think you can sweep them all aside and expect that things can function without them overnight, or that GPs can suddenly take on the task (a task they mostly don't want).


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## plantarian (Mar 10, 2011)

*Out to Tender*

When they tendered out the cleaning we got MRSA

I wonder what will happen when they tender out the care?

Apart from Profit?

Hospitals don't have to make profit only break even.

Directors of companies are legally bound to make profit for the shareholders.

Only the shareholders will benefit.

If you want to benefit as a patient you'll have to become a shareholder


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## plantarian (Mar 10, 2011)

*If I was*

If I was a director of Pfizer I'd be tendering for sexual health services

Then I'd standardise the service

Set up a vending machine with condoms, Viagra and antibiotics

I bet someone has already thought of that!


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## ypauly (Mar 10, 2011)

Northerner said:


> I'm with you on the management thing Paul, I just don't think you can sweep them all aside and expect that things can function without them overnight, or that GPs can suddenly take on the task (a task they mostly don't want).



The GP's always say that though, everytime any changes are mentioned the GP's get together to see what's in it for them. The last changes were made 6 years ago and in order to get the GP's on board thier pay was nearly doubled.

This.
http://www.telegraph.co.uk/news/uknews/1582271/Pay-for-GPs-has-doubled-to-110000.html


To achieve this.
http://www.gpcontract.info/


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## ypauly (Mar 10, 2011)

plantarian said:


> When they tendered out the cleaning we got MRSA



Had nothing to do with cleaning contracts, some of the best hospitals in the world have been affected by new anti-biotic resisted viruses.

This was a report from america. It clearly states that most of the infections are as a result of poor sterilisation techniques during surgery. Yet poor old Mrs mop got the blame from the sun and dailly mail.


http://www.naturalnews.com/028441_superbugs_infections.html


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## Twitchy (Mar 10, 2011)

Right guys, I think we can worry ourselves silly about these changes, but can I gently suggest we try something to make a positive influence on what's happening?... 

I suggest we all write to / email our local MP, with something along the following lines:

1. Bit of personal intro - type of diabetes, hopes for a productive life (ie whether tax paying wage earner, or family raising, or being a positive volunteer part of the 'big society' or whatever best applies to you)

2. Concerns re current proposals: ie what you are concerned might happen, how it could / would impact on 'diabetics like myself' and why this is not a good idea for society in both the short term or longer term (ie try & point out how expensive mistakes could be!)

3. What you would like your MP to do - ask a question of the health secretary / answer an immediate local concern you have, etc. 

And of course finishing nicely thanking them for their time / trouble! 

You can find your local MP's contact details by going to the house of common website:

http://www.parliament.uk/mps-lords-and-offices/mps/

Hopefully if they get badgered by enough of us, they'll realise diabetes care at least needs to be carefully protected! (Squeaky wheel etc etc...!)


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## ypauly (Mar 10, 2011)

fruitloaf said:


> oh yes I know it already is but it's only going to get worse, a lot worse. I simply cannot understand how patients, ie anyone who uses the NHS or may need to in the future can be in favour of these changes. It isn't going to benefit them!



It's quite simply the fact that if the NHS is to survive long term it needs to be radically different. There needs to be a focus on clinical care and not pushing paper around to satify some politicians ego.

I would like to see the NHS there forever, I would like to think that it will be there for my grandchildren and thier grandchildren. If it is allowed to continue with costs out of control and it's budgets rising way way in excess of inflation or indeed population growth as it has been for many years now, it will not survive long term without it being means tested or contributed to in some other way.

Total NHS spending rose from ?32 Billion in 1995 to 90.2 Billion in 2007/8

Here are the facts.
http://www.dh.gov.uk/en/Managingyourorganisation/NHScostingmanual/index.htm

This is interesting to read although I warn it's more of a  political rant lol.
http://www.civitas.org.uk/pdf/nhsHowMuch.pdf


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## ypauly (Mar 10, 2011)

Twitchy said:


> Right guys, I think we can worry ourselves silly about these changes, but can I gently suggest we try something to make a positive influence on what's happening?...
> 
> I suggest we all write to / email our local MP, with something along the following lines:
> 
> ...



This is a good idea considering the huge cost in treating diabetes. It will at some point (due to it's rapid growth) become a political football. Say what you expect to get and what the NHS is required to do for you in order for you to be/remain productive.


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## mcdonagh47 (Mar 10, 2011)

Twitchy said:


> Right guys, I think we can worry ourselves silly about these changes, but can I gently suggest we try something to make a positive influence on what's happening?...
> 
> I suggest we all write to / email our local MP, with something along the following lines:



This site, "Find your MP", gives name and Westminster address of MPs plus website/email.

http://findyourmp.parliament.uk/


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## Northerner (Mar 10, 2011)

mcdonagh47 said:


> This site, "Find your MP", gives name and Westminster address of MPs plus website/email.
> 
> http://findyourmp.parliament.uk/



Thanks mcdonagh


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## FM001 (Mar 11, 2011)

Twitchy makes a good point and we need to pressurise our local Tory and Lib Dem MPs and remind them that we will not tolerate the destruction of our NHS.  When I said this was the beginning of the end for the NHS I truly meant it, this ConDem Government will tear apart piece by piece every fragment of our precious National Health Service and sell it off to the highest bidders, patient care will account for nothing and profit and return will be at the forefront of any decision making. 

Its such a shame really as the NHS was once a role model to the world where medical provision was provided regardless of your income or status, David Cameron and his Etonian chums will suffer none from these changes and will no doubt profit somewhere along the line.


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## Phil65 (Mar 11, 2011)

shiv said:


> ^ to be honest, that's the situation as it is now. So many of us are having to PROVE to consultants that injections aren't working.
> 
> There are some PCTs which will give them to lots of adults - York is one I believe - so there is some hope out there.




I've had a pump ordered, not because injections were not working for me, but because I strove to get one! My control is good on MDI.  My DSN and consultant recommended me for a pump and the PCT approved the application. Lucky me.


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## ypauly (Mar 11, 2011)

toby said:


> Twitchy makes a good point and we need to pressurise our local Tory and Lib Dem MPs and remind them that we will not tolerate the destruction of our NHS.  When I said this was the beginning of the end for the NHS I truly meant it, this ConDem Government will tear apart piece by piece every fragment of our precious National Health Service and sell it off to the highest bidders, patient care will account for nothing and profit and return will be at the forefront of any decision making.
> 
> Its such a shame really as the NHS was once a role model to the world where medical provision was provided regardless of your income or status, David Cameron and his Etonian chums will suffer none from these changes and will no doubt profit somewhere along the line.



They do not want to destroy the NHS, that is Labour spin and lies. They want to improve it, but without having a massive pot of money the last goverment had it means change and a different type of thinking.

GP's are only against it because there is nothing in it for them. Also remeber that if GP's were listened to there wouldn't be an NHS as they didn't want it at the very start.


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## FM001 (Mar 11, 2011)

ypauly said:


> They do not want to destroy the NHS, that is Labour spin and lies. They want to improve it




Sorry ypauly but I did have to laugh at the above!  Are they also not wanting to improve the armed forces  with the predicted 12,000 losses, ships and aircraft put on hold or scrapped altogether and fighter pilots who have nearly completed their training being shown the door?

The local elections in May will show you what the general public think of Cameron and his cronies, a huge embarrassment will be when the good people of Sheffield show Nick Clegg and the Lib Dems what they think of the savage cuts to public services and the betrayal of the youth who voted for them in the last election.


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## ypauly (Mar 11, 2011)

toby said:


> Sorry ypauly but I did have to laugh at the above!  Are they also not wanting to improve the armed forces  with the predicted 12,000 losses, ships and aircraft put on hold or scrapped altogether and fighter pilots who have nearly completed their training being shown the door?



No that is a different matter. There are cuts in those areas due to the massive financial mess labour has got this country in. There are NO CUTS to NHS budgets.


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## am64 (Mar 11, 2011)

ypauly said:


> No that is a different matter. There are cuts in those areas due to the massive financial mess labour has got this country in. There are NO CUTS to NHS budgets.



sorry i thought the financial mess had something to over jealous hedge funds and iceland    which if you all remember is where a lot of public money was invested so public services could supplement their income with the interest...most of them lost all the money ....apart from those 'gamblers'  who arranged all the transactions and took their 'commission'


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## ypauly (Mar 11, 2011)

am64 said:


> sorry i thought the financial mess had something to over jealous hedge funds and iceland    which if you all remember is where a lot of public money was invested so public services could supplement their income with the interest...most of them lost all the money ....apart from those 'gamblers'  who arranged all the transactions and took their 'commission'


Firstly
Labour changed the rules and banking regulations that made this sort of trading possible.

Secondly
We have spent a total so far of ?112 Billion directly supporting the banks much of that in return for a stake or shares. We have also guaranteed loans and securities but unless they fail they will cost nothing.

The stakes and shares that we hold are worth alot more by many times than the amount we paid out.

Thirdly
Our national debt 2006/07 BEFORE the banking crisis stood at a whopping ?494 Billion and was rising by an extra ?30 Billion every year due to massive over spending by Labour.

Finally
Our debt now stands at a whopping ?1 Trillion due to labour (mostly gordon brown) doing NOTHING for two years after the bank problem and subsequent recession which increased the deficit to ?170 Billion, because he didn't want to look the baddie and lose the election. He just left that to the conservatives, now they look bad.


But another thought.
we are collecting roughly (I will admit to not knowing the latest figures) ?140 Billion in taxes. We are spending more than ?92 Billion on the NHS alone.
Doesn't leave alot for everything else does it?

Should we keep on borrowing?

How are we ever going to repay this debt?

Are people happy that we are currently spending ?120 Million a DAY on just the interest? Imaging what the NHS, Education system including universaries or the justice system could do with that massive sum that we are wasting.


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## Northerner (Mar 11, 2011)

I think this is wandering away (in a sort of James Burke 'Connections' sort of way) from the original post, which was about the backdoor privatisation of the NHS, in particular diabetes care. I will just add, since Paul seems to think that GB was responsible for the global banking crisis, that it started in the US and has affected countries throughout Europe, not just us. Has anyone here ever studied derivatives? Fiendishly complicated, to the point where even those dealing in them didn't understand them, just saw that it was making them money and ignoring the obvious pitfalls.

To be honest, I don't think any government has done a good job, whatever their political persuasion, since I was old enough to realise there were supposed to be people running the country. That would be Wilson, Heath, Foot, Callaghan, Thatcher, Major, Blair and Brown - and now this shower.


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## mcdonagh47 (Mar 11, 2011)

Northerner said:


> To be honest, I don't think any government has done a good job, whatever their political persuasion, since I was old enough to realise there were supposed to be people running the country. That would be Wilson, Heath, Foot, Callaghan, Thatcher, Major, Blair and Brown - and now this shower.



Foot ??? He was never PM.


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## Northerner (Mar 11, 2011)

mcdonagh47 said:


> Foot ??? He was never PM.



You spotted my deliberate mistake!


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## mcdonagh47 (Mar 11, 2011)

Northerner said:


> You spotted my deliberate mistake!



At least you spelt it right


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## Ellie Jones (Mar 11, 2011)

It does seem that it's a very much back door into privatisation for the NHS, Bevan must be rolling in his grave..

Whats needed is restructuring of the NHS to make it more viable and cost effective...

As it stands within the NHS management is basically top heavy, with it's managment structure no business can survivie...  Pull the management structure of the NSH into line with corparate businesses, job done saved a fortune front line services not only remain uneffected but could be increased to provide a much better service!

But it seems that PCT's are jumping guns here, as why are they putting services out to private tender!  As what is going to happen when GP's take over the fund pot to commission services for their patients?


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## am64 (Mar 11, 2011)

soz for going off thread folks ...i just like winding up Ypauly


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## ypauly (Mar 12, 2011)

Northerner said:


> To be honest, I don't think any government has done a good job, whatever their political persuasion, since I was old enough to realise there were supposed to be people running the country. That would be Wilson, Heath, Foot, Callaghan, Thatcher, Major, Blair and Brown - and now this shower.



If we take maggie and obviously foot off that list we could agree lol

And a small effort to keep on topic. It may be back door privatisation I dont know, but I do know we can't afford to not make any changes.


P.S  I understand how the banks got into the position they did, it started with Clinton creating legislation that meant everyone could buy thier home and had to be offered a mortgage.

I understand that the initial de-regulation started in the eighties with Maggie.

I also understand that when america was having a banking boom due to clintons efforts, Gordon wanted his slice of the cake and further de-regulated so that Britain could compete in the same markets.


P.P.S I am under no illusions as to the responsability our goverments hold, which ever ones they are. The sad fact is Gordon could have been saving when he was doubling taxation, he could have been saving instaead of selling the gold and he could have been saving instead of robbing our pensions.


I dont think you are the only one that likes winding me up am64

P.P.P.S Keep smiling


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## ypauly (Mar 12, 2011)

I keep saying i'm going to put my soap box away lol 
	

	
	
		
		

		
		
	


	











 *expletive deleted*


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## Northerner (Mar 12, 2011)

ypauly said:


> I keep saying i'm going to put my soap box away lol
> 
> 
> 
> ...



Paul you're too nice a chap to get mad at! I do hope that, somewhere, there is a charitable institution that is searching for a cure for your malady, or at least some safe place for you to hide out come the next election...


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## FM001 (Mar 12, 2011)

Nice to see the Lib Dems getting a warm welcome in Sheffield.


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## ypauly (Mar 12, 2011)

Northerner said:


> or at least some safe place for you to hide out come the next election...



Eton maybe lol?









^^^^^^ I just wanted to use that smiley lol


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## Northerner (Mar 12, 2011)

ypauly said:


> Eton maybe lol?
> 
> 
> 
> ...



Haha! Love it!


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## Northerner (Mar 14, 2011)

Looks like Lansley is starting to backpedal on his plans, given the huge opposition from all sides:

http://www.telegraph.co.uk/news/pol...Lansley-signals-retreat-over-NHS-reforms.html


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## FM001 (Mar 14, 2011)

Northerner said:


> Looks like Lansley is starting to backpedal on his plans, given the huge opposition from all sides:
> 
> http://www.telegraph.co.uk/news/pol...Lansley-signals-retreat-over-NHS-reforms.html





I seen this in the Guardian this morning.  Nick Clegg has had a rough ride over the weekend at his conference in Sheffield and under duress has promised to confront Cameron on his plans to tear apart the NHS and flog it off.  It could be the start of the 'good ship coalition' hitting stormy waters, or perhaps this is wishful thinking!


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## Northerner (Mar 14, 2011)

toby said:


> I seen this in the Guardian this morning.  Nick Clegg has had a rough ride over the weekend at his conference in Sheffield and under duress has promised to confront Cameron on his plans to tear apart the NHS and flog it off.  It could be the start of the 'good ship coalition' hitting stormy waters, or perhaps this is wishful thinking!



The Telegraph does make a point of how a lot of the Coalition's 'bold' policies are running into trouble. I think this must have a lot to do with their detachment from the reality of how people will react, possibly due to the fact that they haven't been in government before (or if they have it was so long ago that the world has moved on).


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## AlisonM (Mar 14, 2011)

I've always thought this coalition is a classic case of 'the devil makes stange bedfellows'. Liberals and Tories are not natural chums and I have to say I despise Clegg et al for selling out their principles for the sake of some spurious power (it's very clear who's really in charge). I don't think any of the two main parties are worth an "expletive deleted" and the rest are cranks and racists. It would be a good idea to send anyone who wants to stand for election to see a shrink immediately as they have to be insane.

I would love to see *real* proportional representation which would put an end to the party system as we know it and, I reckon, lead to a far more stable government that might actually work for the people of our islands. I don't count this nonsense we've been saddled with up here, it's a just a variation on a theme of 'first past the post' and clearly doesn't work.

I'm glad Nick Clegg has been given a hard time over this and other policies. I really hope they'll have a major rethink and not just over the NHS sell off either, the whole coalition business is sick.


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## ypauly (Mar 14, 2011)

Northerner said:


> Looks like Lansley is starting to backpedal on his plans, given the huge opposition from all sides:
> 
> http://www.telegraph.co.uk/news/pol...Lansley-signals-retreat-over-NHS-reforms.html



The only problem is, nobody seems to be coming up with any better ideas. In fact nobody seems to be coming up with any alternative ideas. These proposals maybe watered down or made softer in some way but unless a better idea turns up I can't see them being scrapped as even labour were keen on private finance iinitiatives, they even positively encouraged more private sector envolvment.


I agree with the overall sentiment that the Lib dems are well and truely out of thier depth though.

This made an interesting read too http://www.pulsetoday.co.uk/story.asp?sectioncode=35&storycode=4128808&c=2


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## FM001 (Mar 14, 2011)

Northerner said:


> The Telegraph does make a point of how a lot of the Coalition's 'bold' policies are running into trouble. I think this must have a lot to do with their detachment from the reality of how people will react, possibly due to the fact that they haven't been in government before (or if they have it was so long ago that the world has moved on).




Well put, ''detachment of reality'' is certainly relevant with this shower, not because they lack ministerial knowledge but the fact that they were born with a silver spoon in their mouths and have never wanted for anything in their lives.  Old dinosaurs like Kenneth Clark were next to useless in government back in the terrible days of Thatcher in the 80's, what could he ever bring to politics in the 21st century?


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## Northerner (Mar 14, 2011)

Looking forward to hearing what happens at the BMA's Special Representative Meeting tomorrow.


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## FM001 (Mar 14, 2011)

Northerner said:


> Looking forward to hearing what happens at the BMA's Special Representative Meeting tomorrow.





Me too, it should be interesting.


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## ypauly (Mar 14, 2011)

toby said:


> Me too, it should be interesting.






I do believe the last time they got this upset was back in 1943 when they voted against the formation of the NHS.

It will indeed be interesting, I still believe that 90% of doctors are like 90% of politicians and arn't interested in anything that doesn't make them rich. Most are in it for what they can get and not what they can give.


Cynical I know, but I do wonder that if these changes came with a 20% payrise they wouldn't say a word.


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## margie (Mar 14, 2011)

toby said:


> Well put, ''detachment of reality'' is certainly relevant with this shower, not because they lack ministerial knowledge but the fact that they were born with a silver spoon in their mouths and have never wanted for anything in their lives.  Old dinosaurs like Kenneth Clark were next to useless in government back in the terrible days of Thatcher in the 80's, what could he ever bring to politics in the 21st century?



A lot of the shadow cabinet are millionaires as well - i think that often gets forgotten.

Did I read somewhere that David Cameron's brother is a Dr and was unhappy about the proposals - or did I dream that.


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## Northerner (Mar 15, 2011)

I've been following  Pulse's live blog of the BMA's meeting. To say there is little support for the Bill would be a huge understatement!

http://www.pulsetoday.co.uk/story.asp?sectioncode=19&storycode=4128818&c=2


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## ypauly (Mar 17, 2011)

I may be considering taking back every word! 



Having had my internet installed instead of using a crappy dongle, I took the chance to catch up on what I have been missing. I wish I hadn't.


Anybody watch PMQ's?

Anybody care to explain what the efects of having to follow european competition laws will be, because I can't find any previous examples of countries that have had to change. They all seemed to have that competition anyway.


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## ypauly (Mar 17, 2011)

I can't be the only one that watched it


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## Northerner (Mar 17, 2011)

ypauly said:


> I may be considering taking back every word!
> 
> 
> 
> ...



This is worth a read: 
http://www.nhsconfed.org/Publications/Documents/Euro_Briefing_4_final.pdf

I remember reading when the Coalition first put forward their proposals that it could mean that the NHS can lose control over things like 'preferred suppliers' etc. Basically, it would mean the end of the NHS as we know and love it


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## ypauly (Mar 17, 2011)

Northerner said:


> This is worth a read:
> http://www.nhsconfed.org/Publications/Documents/Euro_Briefing_4_final.pdf
> 
> I remember reading when the Coalition first put forward their proposals that it could mean that the NHS can lose control over things like 'preferred suppliers' etc. Basically, it would mean the end of the NHS as we know and love it



It amazed me to hear cameron say it was in labours manifesto.

Which proves that people that say they are all the same are right.


I will have a read of that later thanks alan.


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## Northerner (Mar 17, 2011)

ypauly said:


> It amazed me to hear cameron say it was in labours manifesto.
> 
> Which proves that people that say they are all the same are right.
> 
> ...



There's this too Paul, a bit more succinct! 

http://blogs.channel4.com/factcheck/bringing-competition-and-the-eu-into-the-nhs/6019


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## am64 (Mar 17, 2011)

ypauly said:


> I may be considering taking back every word!



Result !!!


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## ypauly (Mar 19, 2011)

Northerner said:


> This is worth a read:
> http://www.nhsconfed.org/Publications/Documents/Euro_Briefing_4_final.pdf
> 
> I remember reading when the Coalition first put forward their proposals that it could mean that the NHS can lose control over things like 'preferred suppliers' etc. Basically, it would mean the end of the NHS as we know and love it



Just read that, I havn't fully digested it yet but it doesn't look too promising.

I was shocked and amazed at the date though, this has obviously been planned/on the cards for a long long time.


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## Northerner (Mar 23, 2011)

Some more interesting stuff from Pulse online:

*GP reforms? leaders on boards of private firms*

Exclusive: One GP in 10 on the boards of new commissioning consortia also holds an executive-level position with a private provider, exposing the serious potential for conflict of interest in the Government?s NHS reforms, Pulse can reveal.

Our investigation, based on data released by PCTs under the Freedom of Information Act, finds almost a quarter of consortium board members have some kind of interest in private providers, with others either shareholders or advisers.

http://www.pulsetoday.co.uk/story.a...30311&sp_rid=NjU3NzMyNzAyOQS2&sp_mid=36410525

*GPs forced to cut staff*

Exclusive: GPs will be forced to take a series of undesirable measures to control costs after last week?s tough pay deal for the coming financial year, including cutting hours or even making redundancies.

More than a third of GPs told a Pulse survey they planned to pursue ?lower-grade recruitment?, following warnings from accountants last week that the deal would amount to a pay cut of 1-4%. A quarter of GPs will be forced to consider reducing staff hours while 14% said they were prepared to make redundancies.

http://www.pulsetoday.co.uk/story.a...30311&sp_rid=NjU3NzMyNzAyOQS2&sp_mid=36410525


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