Negative Proposals from Outside Government/Sources

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Suggestions (not from the Government) that would damage the health service.
  • Tory health spokesman Phillip Hammond was accused yesterday of being out of touch for suggesting that women doctors were less productive than their male counterparts during a career in the NHS. Women doctors expressed disbelief at Mr Hammond's statement, at a private meeting during the Tory party conference in Bournemouth, that the NHS would get about 20% less work out of a female doctor than a man over a lifetime. Men, they pointed out, are increasingly looking to more flexible working hours, either to spend more time with their families or to pursue other interests. Guardian 5 October 2000.
  • Secret talks have been held at the highest levels of the Tory party to carry out the biggest restructuring of the National Health Service since its creation, with all people earning more than £35,000 banned from treatment. Observer 25 February 2001.
  • Why the NHS is bad for us.  Observer health editor Anthony Browne, once a passionate believer in the NHS, tells why he now feels it can never work and is only kept alive by wrong-headed idealism The Observer NHS debate.  Anthony Browne Observer Sunday October 7, 2001
  • The health service you want.  Anthony Browne Observer Sunday October 14, 2001
  • What next for the NHS? The Observer debate.  What should happen to the NHS? Practioners, policymakers and thinkers respond to Anthony Browne's diagnosis and prescribe their own cures for the nation's health. The Observer NHS debate Observer Sunday October 14, 2001
  • Pay-as-you-go health.  Call for higher rate taxpayers to fund own treatment.  An NHS historian and former senior principal medical officer at the Department of Health is calling for higher rate taxpayers to be "encouraged" to pay for their own basic treatment. David Brindle Guardian Wednesday October 24, 2001
  • Why charges won't work here.  Malcolm Dean Guardian Wednesday October 31, 2001
  • The Conservatives yesterday sought to exploit a Labour review of the future of NHS funding to claim the public no longer believed extra spending would solve the demands on the service. Michael Howard, the shadow chancellor, argued the future lay in private funding, possibly including social insurance schemes.  Guardian Unlimited Friday November 23, 2001
  • Top surgeon issues dire warning on NHS. David Pallister Guardian Friday December 7, 2001
  • Patients ready to pay to see GP, says Tory leader.  Duncan Smith says barrier to charges already crossed.   Guardian Society Monday December 17, 2001
  • Plan to cut out politicians. Guardian Thursday January 24, 2002
  • The making of a new disease.  Michael Fitzpatrick on why the medical profession's latest ruling on ME (or chronic fatigue syndrome) is nothing short of disastrous.  Guardian Thursday February 7, 2002
  • Doctors would no longer be the first port of call for sick patients in an innovative plan proposed today by the British Medical Association. It suggests nurse practitioners should initially assess patients and guide them to the relevant services.  Guardian Thursday February 28, 2002
  • Tories claim NHS is beyond rescue.  Shadow health secretary to tell conference the service is doomed, but keeps Conservative alternative under wraps.  Michael White and Nicholas Watt Guardian Friday March 22, 2002
  • NHS Reform - Towards Consensus? The summary and introduction of the NHS reform report by The Observer's health editor, to be published this week by the Adam Smith Institute.  Anthony Browne and Matthew Young  Observer Sunday April 7, 2002
  • The treatment: how to fix the NHS.  The conclusion of the NHS reform report by The Observer's health editor, to be published this week by the Adam Smith Institute. What would it take for Britain's health-care to match the standards that other Europeans enjoy? And what are the practical steps towards a health-care revolution?  Anthony Browne and Matthew Young Observer.co.uk Sunday April 7, 2002
  • 'We take out health insurance when travelling, yet freely treat visitors able to pay' The writer, whose name is withheld, has been a GP practice secretary in Primrose Hill and Hendon, north London.  Guardian Society Thursday April 11, 2002
  • Tories 'should break NHS funding'.  Taped remarks by health spokesman stir controversy.  Patrick Wintour Guardian Thursday April 11, 2002
  • Bitter NHS medicine.  A Tory plan which is devious and unfair.  Leader Guardian Saturday April 13, 2002
  • Tories confirm plan for more private cash in NHS.  Duncan Smith insists on 'fairer way' to revive ailing health service.  Michael White Society Monday April 15, 2002
  • Chancellor's £105bn pledge to NHS by 2008 likely to be derailed by economic problems, warns new president.  John Carvel, social affairs editor The Guardian Thursday July 4, 2002 
  • Out of this world.  BMA leader talks nonsense on the NHS.  Leader The Guardian Friday July 5, 2002.  Letters in response The Guardian Saturday July 6, 2002 
  • Comment: Brown must stop throwing money at state monopolies.  The private sector has shown how to improve education and health.  Stephen Pollard Guardian Tuesday July 16, 2002
  • A Tory government would heavily subsidise the cost of private operations for patients who choose to opt out of NHS care in an attempt to ease hospital waiting lists, under radical Conservative plans unveiled yesterday.  Lucy Ward, political correspondent  Tuesday October 8, 2002 The Guardian
  • Following yesterday's surprise 'no' vote in the BMA ballot on proposed new contracts for senior hospital doctors, Dr Penny Dash speculates that this plays into the hands of Messers Blair and Milburn. Friday November 1, 2002
  • Competition is healthy  Letters Monday December 30, 2002 The Guardian
  • Parties edge closer on health as Tories unveil Blairite plan.  John Carvel, social affairs editor Wednesday March 12, 2003 The Guardian
  • About 60% of family doctors would like to charge patients for home visits and fine those who miss appointments, according to research out today. Tuesday April 29, 2003
  • Taxpayers would subsidise private health treatment for affluent patients under a future Tory government, Iain Duncan Smith will announce today. Nicholas Watt Thursday June 5, 2003 The Guardian
  • The Conservatives launched their new healthcare plan today with a threat to sack up to 30% of NHS administrative staff. Thursday June 5, 2003
  • More than two-thirds of family doctors want to charge NHS patients who fail to turn up for an appointment, according to a survey by healthcare managers. John Carvel Thursday August 28, 2003
  • The announcement of plans to make fertility treatment uniformly available on the NHS prompted Christa Ackroyd in the Sunday Express to consider whether a one-size-fits-all policy was the best solution. "Of course, it is wrong that the so-called postcode lottery of IVF determines whether the treatment is free or charged for," she conceded, but argued that there simply isn't enough money to go around. "Would it not be fairer for those who can afford IVF to pay for it and those who can't to be given it for free?" Edward Gibbes Monday September 1, 2003 The Guardian
  • The shadow health secretary, Liam Fox, today received a standing ovation after he pledged to give real choice to British patients by handing out health passports, while denying real passports to people with infectious or chronic diseases who may drain NHS resources, under a proposed public health law. Helene Mulholland in Blackpool Monday October 6, 2003
  • The Conservatives yesterday unveiled a sweeping extension of arms-length management and patient rights within the NHS which would take power away from future health secretaries and give people up to 60% of the cost - paid from NHS funds - of operations performed in the private sector. Michael White, political editor Tuesday October 7, 2003 The Guardian
  • A radical change in medical law to allow the NHS to buy organs from live donors in Britain and Europe will be debated in closed session today by the British Medical Association, the powerful organisation representing doctors throughout the UK. John Carvel, social affairs editor Wednesday December 3, 2003 The Guardian
  • A simple solution to transplant tourism.  Letters Thursday December 4, 2003 The Guardian
  • Short of cash and in possession of two kidneys? Philosopher John Harris thinks you should be able to sell one of them to the NHS - and the medical establishment is taking him seriously. Thursday December 4, 2003 The Guardian
  • Human organs. Not for sale. Leader Thursday December 4, 2003 The Guardian
  • Why does the rightwing media hate nurses so? A banner headline in the Daily Telegraph earlier this month declared: "I would not trust my dog, let alone my mother, to many nurses." David Crouch Wednesday December 17, 2003 The Guardian
  • A ginger group of 500 hospital consultants yesterday launched a campaign to overturn the principle of a tax-funded NHS with a poll suggesting massive public support for change. John Carvel, social affairs editor Thursday February 26, 2004 The Guardian
  • Last week, 500 doctors made a public call for the NHS to be scrapped and replaced with a system of social insurance, similar to those used in parts of Europe. But such thinking, writes Peter Davies, is both intellectually misguided and quaintly out-of-date. Thursday March 4, 2004
  • NHS and school passports will be Tory flagship. Nicholas Watt, political correspondent Saturday March 6, 2004 The Guardian
  • A three-point plan to speed up medical treatment and abolish NHS waiting lists was outlined by the Tories yesterday as the party pledged to introduce the most wide-ranging reforms to the health service since its foundation in 1948. The Conservatives pledged to give patients greater freedom by allowing them to choose where they are treated. The Tories would offer: Nicholas Watt, political correspondent Thursday June 24, 2004 The Guardian
  • Waiting lists will be "completely" abolished within five years by a future Tory government, Michael Howard declared yesterday as he hit back at Labour taunts by attempting to cast himself as the saviour of the NHS. Nicholas Watt, political correspondent Thursday June 24, 2004 The Guardian
  • What Labour and Tories are offering on health. Patrick Wintour Thursday June 24, 2004 The Guardian
  • 'A state-run NHS is an anachronism' . The Tories need to rethink their NHS proposals. Extracts from other newspapers Monday June 28, 2004 The Guardian
  • The government is facing grassroots pressure from GPs for the right to charge NHS patients who miss appointments, after evidence that non-attendance is costing the health service £162m a year. Research from Developing Patient Partnerships, a health education charity, found there were 8.8m missed GP appointments in Britain last year and 3.9m missed appointments with practice nurses. John Carvel, social affairs editor Tuesday August 24, 2004 The Guardian
  • Imposing fees for more convenient GP appointments and removing prescription charge exemptions for well-off pensioners could help boost NHS coffers, a thinktank said today. The Social Market Foundation's health commission investigation into changing the existing system of NHS charges to generate extra revenue concludes that the health service should steer clear of charging for clinical services. Hélène Mulholland Thursday September 16, 2004
  • David Cameron will spell out how the Conservatives plan to run the NHS today by going further than Tony Blair in promising greater freedom for hospitals and more opportunities for private companies to provide state health services. The new Tory leader aims to revive plans dropped by Labour to give the most efficient hospitals in England much more freedom to borrow money to expand popular services and end a 15% limit on services which can be provided by private companies. David Hencke, Westminster correspondent Wednesday January 4, 2006 The Guardian
  • Hotel charges for hospital stays and GP consultations by video phone are among the possibilities predicted by experts to become reality by 2015. Friday January 6, 2006 8:19 AM
  • It's enough to make you sick. In an opinion piece, Daniel Finkelstein points to the flaws of a social insurance model for health. He says: "All this sage nodding over the privatisation of the National Health Service is driving me to distraction…The reason to stick with it is that it is better than the proposed replacement." Social insurance systems "are simply tax by another name. This is one of the reasons why the systems in France and Germany, often referred to by reformers, are not pure social insurance schemes, they are complicated hybrids involving general tax, private insurance and user payments…The availability of new treatments does provide a financial challenge, but it is hard to understand why this challenge should be either increased or diminished by the way healthcare funding is organised…Perhaps an insurance scheme would buy everything more cheaply, leaving more money available for the new drugs. Yet this cannot be the case, since most people accept that the NHS is better at controlling costs than most systems in other countries." Summary by Keep our NHS Public of  The Times 11 January 2006
  • Tories told to adopt positive attitude on public services. Stephen Dorrell, co-chair of a review of Tory policies on public services, has said the party needs to see them as a good, not a burden. The group said it would look at whether charges for eye and dental treatment should be abolished to make the NHS genuinely free at the point of use. But they will also investigate whether more private money could help improve public services. Its report noted that people were prepared to spend more of their own money on private health and education as their incomes rose but that the public was reaching its tolerance limit on the level of taxation. Summary by Keep our NHS Public of  Independent 2 March 2006
  • An open letter from 900 NHS doctors to be delivered to Tony Blair today warns that the health service cannot survive in its present form and that individuals should expect to pay for treatment in the future. The doctors said a healthcare system funded only from taxes was bound to fail to meet patients' rising expectations. Rationing of services and bigger financial deficits were the inevitable result of preserving the status quo, they said. John Carvel, social affairs editor Monday April 3, 2006 The Guardian
    • Health rationing will lead to inequity. Follow up letter, Tuesday April 11, 2006 The Guardian
    • A reply to 900 doctors. In a letter to the BMJ Julain Tudor Hart writes: "Why is anyone still giving space to proposals for insurance-based care ? The Treasury has rejected it under every government, so has the Wanless report, so does the BMA, simply because it is the most costly and least efficient way to deliver. If everyone is included at all levels of risk, and we all agree to help our fellow citizens when they need it, why waste from a quarter to a half of the cost on administration and (if private sector insurance is involved) profit for shareholders ?" Summary by Keep our NHS Public of  British Medical Journal 21 April 2006
    • Patricia Hewitt: 'The stakes are high. If we fail to reform the NHS, the privatisation agenda will take over'. In an interview with the Independent Patricia Hewitt said: "Already we are seeing a clamour from the right building up in the media, think-tanks and organisations like Doctors for Reform to abandon the NHS as a tax-funded service and move to some combination of social insurance, private insurance or charges. That is the not-very- hidden agenda of the right. So the political stakes could hardly be higher, because if we fail to make the improvements and the reforms we set out to make in the NHS then that agenda - which is essentially an agenda of privatisation - is waiting to take over." Summary by Keep our NHS Public of  Independent 24 April 2006
    • Another way to fund the NHS. Doctors for Reform and the think tank behind them, Reform, have been calling for the tax-funded healthcare system to be abolished. But what is Reform ? Reform was originally set up by two Conservative MPs and has an advisory council and an advisory board. Membership of the advisory board includes the chief executive of a major pharmaceutical company, chairmen of global investment banks, MPs, former civil servants and former Government advisers. Andrew Haldenby is a director and co-founder of the organisation. He was previously communications director at Business for Sterling and head of the political section in the Conservative research department. Rupert Darwall, a consultant director, was previously special advisor to Chancellor of the Exchequer Norman Lamont. Another consultant director Nick Bosanquet is professor of health policy at Imperial College London. On the Advisory Board is Sir Christopher Gent (chairman), also chairman of GlaxoSmithKIine plc and a non-executive director of Lehman Brothers Holdings Inc; Meg Allen, director of DRAMLA SA consultancy, Geneva, Switzerland; Frank Field, Labour MP and former Minister for Welfare Reform; Nick Herbert, Conservative MP and co-founder of Reform; Jonathan Hill, a director of Quiller Consultants, the UK communications group and former political secretary to Prime Minister John Major; Oliver Pawle, vice-chairman of UBS Investment Bank; Derek Scott, economic consultant to KPMG and former economic adviser to the Prime Minister until the end of 2003; Sir Steve Robson, Second Permanent Secretary and managing director of the Finance, Regulation and Industry Directorate at HM Treasury until 2001 (which included advising on the Private Finance Initiative); Jeremy Sillem, former chairman of Bear Stearns International Limited, the European arm of the New York-based investment bank; Sir Richard Sykes, former chairman of GlaxoSmithKline plc until May 2002.

      Prof Allyson Pollock says DfR is re-igniting an old debate which has long been quashed by the evidence. "They don't seem to understand that every review of funding and financing of healthcare and all the evidence shows that a progressive tax-funded system such as the one we have in the UK is the fairest and only way of doing it. Their report has no data and no evidence. I don't know why they're revisiting this old chestnut on funding." She says the real issues are where all the money being invested in the NHS is going and why trusts are in deficit. Money is leaching out of the NHS through expensive contracts with the private sector, "astronomical" Private Finance Initiative payments and the bureaucratic costs of running the new financial market system. "The question is why is this group getting all this publicity ? They are just 900 or so out of 60,000 doctors. Many of these doctors have some of the largest private practices in the country or have left to join the pharmaceutical industry. They are not representative of the NHS workforce." Dr Peter Fisher, president of the NHS Consultants' Association says people should ask how DfR group is funded - by the think-tank Reform. Dr Fisher says: "If you have any sort of health insurance, it would have to be universal because, otherwise, people will fall through the net like they do in the US. There is no real difference between an insurance system like that and a tax-funded system except that the money is more expensive to collect. If money was raised through insurance, it would still be mis-spent. 'This debate is diverting real attention from the real question which is - why is the extra money the Government has put into the NHS being wasted ?"
      Summary by Keep our NHS Public of  Hospital Doctor 5 May 2006
  • Jack and Jill and the NHS. In a letter to the Times, Alex Nunns of Keep Our NHS Public writes: "Jamie Whyte suggests that healthcare should be privatised because "Jack smokes, drinks and overeats. Jill does not. Jack's behaviour means he consumes more healthcare than Jill. It would be unfair if healthcare cost Jack and Jill the same" ("You want fairness, you pay up", May 5). What happens when Jill gets breast cancer ? Is it fair that she should die if she can't afford the radiotherapy ? There is already a privatised healthcare system - it has had a perfectly fair test in the richest country in the world. Americans spend 16 per cent of their GDP on healthcare - twice what Britons spend. Yet 45 million Americans have no health insurance at all, whereas the NHS covers everybody. The inefficiency of a market system is shown by the astronomical cost of management and administration in the US - 30 per cent of total health spending. Perhaps this explains why Jack and Jill consistently say that the NHS is their most valued institution. Summary by Keep our NHS Public of  Times 9 May 2006
  • Private management "should run NHS". A leading public health consultant has called for the NHS to be run by an independent cross party organisation, free from government control. Dr Layla Jader, member of the British Medical Association's Public Health Committee Wales said that "the NHS is too complex and too vital…to be governed by the self interest of a specific party." Her suggestion is designed to remove the largely political pressures upon those in charge of the NHS that have led to a swathe of "short term solutions", and the NHS being used as "a theatre for experimentation in management." Dr Jader also recommended a separate NHS board to advise those in charge and likened the whole suggestion to the handing over the setting of interest rates to the Bank of England. Summary by Keep our NHS Public of  Liverpool Daily Post 23 June 2006
  • Health service changes would give patients freedom to shop around. Plans being considered by the Conservatives would offer full freedom to shop around the health service. The reforms would give patients denied a treatment by their health service the chance to register elsewhere to receive it. The plans are designed to remove the "postcode lottery" over which there has been much recent outcry. The plans, to be adopted by the party's Public Service Improvement Group, would introduce US-style health maintenance organisations or European-style social insurance schemes. The plans, originally published by the Kings Fund health think-tank in a pamphlet called Designing the New NHS, are almost certain to be adopted by the party following its conference. The plans would allow patients to choose their PCT and shop around for a new one if desired, funding would follow the patient, forcing PCTs to compete for patients in a similar way to the US or parts of Europe. The proposals would require radical changes to financial management in the NHS and would require safeguards to avoid potential abuse. The King's Fund study that produced the proposals stated: "It would in effect provide a form of competing, publicly funded health maintenance organisation in the UK." Summary by Keep our NHS Public of Times 3 October 2006
  • The former health secretary Alan Milburn, a close ally of Tony Blair, yesterday proposed a new wave of health reforms based on giving patients NHS credits to choose some of their own healthcare. He said the scheme would empower patients, cut costs and radically redistribute power in society. He said the NHS credit or personal budget would eventually be offered to patients suffering long-term conditions. But he said "the initial focus should be on those with complex long-term care needs, including patients requiring palliative care in the most disadvantaged areas where health needs are greatest and where services tend to be poorest". Patrick Wintour Tuesday October 24, 2006 The Guardian [This is likely to leave people with insufficient and with less than if the NHS were to provide.  It is much easier to cut a contribution than to withdraw a service.  A budget in an area with few services is of little value in any case.]
  • Report calls for NHS 'new start'. The NHS should be given a "new start" by writing off all its financial deficits and allowing patients to choose which primary care trust buys their healthcare for them, pro-market think-tank Reform has said. key reform programmes, such as an increase in the number of foundation trusts, have been delayed or slowed down, the redesign of hospital services has become hopelessly entangled with deficits and the service is weaker than it was two years ago, Nick Bosanquet, professor of health policy at Imperial College, London, claimed in Reform's annual report on the NHS. He said primary care trusts should be required to get rid of direct provision of services and should then be turned into US-style health maintenance organisations, concentrating solely on buying best-value care on their patients' behalf. Patients should be given a voucher, signing up for a three-year period but then able to change between what in effect would be competing insurers. Meanwhile it has emerged that NHS waiting times and -numbers have stopped falling, and in some specialities have become worse, as the service struggles to deal with the consequences of last year's £500m-plus overspend. Summary by Keep our NHS Public of Financial Times 2 January 2007
  • Inefficient hospitals have too many beds, claims think-tank. The government's favourite think-tank, the Institute for Public Policy Research (IPPR), has released a report suggesting that thousands of beds could be axed if the NHS were more efficient. The IPPR's analysis argues that the government policies of closing A& E units and making people travel further for specialist treatment could save hundreds of lives. It gives the use of life saving angioplasty for heart-attack patients offered by specialist hospitals, as opposed to the clot-busting drugs on offer in smaller hospitals, as one example of possible improvements. The report claims that 13,000 beds are being unnecessarily used because of overlong hospital stays and that London and the north-west have too many hospitals. Richard Brooks, co-author of the report, said that much of the controversy over reconfiguration came from confusion with short-term deficit busting cuts. "One of the real problems is that the public now thinks this is all about a short-term financial crisis, and that is incredibly corrosive of public trust," he said. However the British Medical Association said that releasing people earlier could only be justified if there were the community services in place to care for them. Summary by Keep our NHS Public of Observer 7 January 2007
  • Fewer hospital beds 'will make the NHS better'. Bed-blocking is costing the NHS almost £1 billion-a-year, a new report claims. Some 13,000 beds are wasted every year because patients are kept in hospital for longer than necessary, says the study by the Institute for Public Policy Research (IPPR). Richard Brooks, an associate director at IPPR, said: "A better NHS will be one with fewer hospital beds overall. At the moment there is a high-intensity debate on proposed changes to hospitals but people should be aware that it is not always the best idea to keep everything as it is. Not all of these beds are necessary." But Geoff Martin, the director of campaigns for Health Emergency, a pressure group that has co-ordinated protests against proposed cuts to hospital services, described the report as "patronising nonsense". He said: "This is an attempt to construct an intellectual argument for a government policy that is about cuts and saving money. I don't think anybody will believe it, apart from IPPR, Patricia Hewitt [the Health Secretary] and some of the officials at the Department of Health. I haven't seen people on the streets of Worthing, Guildford, Huddersfield, Rochdale and Airdrie campaigning in support of closing hospital beds." Summary by Keep our NHS Public of Telegraph 7 January 2007
  • Tories pledge to scrap NHS targets. David Cameron vowed to put GPs "in the driving seat" today as he unveiled plans to scrap most national health service targets and put doctors in charge of their own budgets.  Deborah Summers and agencies Monday January 22, 2007 Guardian Unlimited [Much of the detail in the proposals is sensible.  The fundamental flaw is to retain the discredited split between commissioning and providing secondary and tertiary services]
  • Tories 'to carry on Blair reform'. The Conservatives are best placed to carry on Tony Blair's public service reforms, the shadow chancellor says. George Osborne claimed Gordon Brown, the next prime minister, had "abandoned the centre ground of public service reform to the Conservative Party". But at a hustings event later Mr Brown said there would be "no retreat" from the centre ground of British politics. Mr Blair has called for personalised services which allow people to choose schools and hospitals. Mr Osborne said that Mr Blair's ideas on choice were right, but said he had been wrong to impose them from Whitehall. Mr Osborne said that while the Tories and Mr Blair agreed on "the essentials of the way forward", Mr Brown was not part of the "growing consensus". He said the deputy leadership debates had shown that Labour was poised to move to the left, abandoning the centre ground. But Labour chairwoman Hazel Blears said she "completely and utterly rejected" Mr Osborne's accusation that the party was "lurching to the left". Mr Brown said there would be "no retreat" to "soft options" or the failed policies of the past. While Mr Osborne rejected "alternative funding mechanisms like social insurance", Conservative MP Peter Bone wrote an article on his website calling for a system of private health insurance to be brought in. Mr Bone said that radical reform of the NHS was needed, and "the solution which would provide immediate, quality health care at no large cost to the patient at the point of treatment is compulsory insurance". Summary by Keep our NHS Public of BBC 30 May 2007
  • Calls for 'NHS tax' to finance health care. Senior doctors are to propose that health care should be paid for through a compulsory NHS income tax. Hospital consultants will next week argue that the present centralised system funded through general taxation is "unsustainable and dysfunctional". A motion to be debated at a British Medical Association conference will suggest a means-tested system similar to those used in France and Germany. It would see health care paid for by insurance companies, with contributions paid either by employers or taken directly from wages. Anyone with earnings below a certain level would have their contributions paid for by the state. Contributions would vary according to income, meaning high earners would pay more. The call for reform comes as a growing number of economists are arguing for a fundamental change to the way health care is funded in Britain. Summary by Keep our NHS Public of Telegraph 2 June 2007
  • Tory right-wingers step up pressure on Cameron over NHS. David Cameron's authority as leader of the Conservative Party faces a fresh challenge by Tory right wingers with some MPs now calling for the NHS to be abolished as a tax-funded system. The 40-strong Cornerstone group of right wing Tory MPs have a radical plan for all patients to be required to take out compulsory private health insurance. The group, which is led by senior Tory backbencher Edward Leigh and has the support of a number of front bench spokesmen, said in a report that scrapping the NHS as a tax-based system could enable the Tories to offer "massive" tax cuts at the next election. The report by Tory MP Peter Bone will embarrass the Tory leadership, which has ruled out compulsory private health insurance for all and, so far, resisted demands by traditional Tory supporters for big tax cuts. Mr Cameron's Shadow Chancellor, George Osborne, a key ally in the modernisation of the Tory Party, last week ruled out private health insurance as a Tory option, saying: "We are having no truck with ideas for some alternative funding mechanism like social insurance. Nor are we looking to help fund escape routes from public services for the few who can afford it, which is why we have moved away from the idea of the patients' passport." Summary by Keep our NHS Public of Independent 4 June 2007
  • Health of patients will set GP pay - Tory plan. David Cameron's long-awaited blueprint for NHS reform will be set out today in a Tory white paper that seeks to abolish government targets for reducing waiting times, the Guardian can reveal. The Tory leader, who has declared the NHS to be his top political priority, will aim to use the document to prove he is committed to a universal health service, free at the point of need and funded by taxes. The paper, NHS Autonomy and Accountability, is the product of an 18-month policy review. ... But other sections open other stretches of clear blue water, differentiating the Tories from Labour. The government has rejected proposals to provide the long-term sick with individual budgets to buy healthcare services, although it encourages local authorities to provide older people with money to buy social care services, such as home helps. Patricia Hewitt, the health secretary, has insisted that the government has not turned the NHS into a competitive market because hospitals are barred from competing on price. Mr Cameron's proposals would allow NHS and private hospitals to undercut the national tariff as long as they could maintain an acceptable quality standard. John Carvel, Social affairs editor Wednesday June 20, 2007 Guardian  [Two problems are that individual budgets may not be sufficient for adequate services, even if the patient is able to order such services, and that competition on price may require patients to go to a hospital that is not the most convenient].
  • NHS Patients Should Have Individual Budgets to Spend on Healthcare. Patients should be a given a personal budget to pay for their healthcare directly, according to a new report from the University of Birmingham’s Health Services Management Centre. Care & Health 17 August 2007 [This is a bad idea.  It sets out to meet a need that patients have not identified. It is no guarantee that the services that patients might choose to purchase are available - problem also found with direct payments for social care.  It imposes responsibilities on people just when they are ill and least likely to want responsibilities.  It equates health care with marketable services when often the problems are connected with reaching the correct diagnosis and choosing an appropriate treatment plan.  The value of an individual budget may be hopelessly inadequate for the best treatment plan for the individual patient.  This would lead to the slippery slope of co-payments, possibly in the tens of thousands of pounds.]
  • Abolish NHS, says Brown's 'wise man'. An influential former Bank of England executive has called on Prime Minister Gordon Brown to abolish the National Health Service. Willem Buiter, who was appointed by Mr Brown as one of the founder members of the Bank's Monetary Policy Committee, has urged politicians to consider disbanding the current system. He suggests a system of mandatory private health insurance, with the Government paying for those who cannot afford it. Prof Buiter was one of the "wise men" selected by Mr Brown to decide on interest rates when he became Chancellor. Summary by Keep our NHS Public of Telegraph 4 September 2007
  • Cameron calls for funding cuts at superbug hospitals. David Cameron pledged to dock payments to NHS trusts for every patient who is infected with MRSA or other hospital-acquired superbugs. He said the party would go further than the government to reward success and penalise failure. It was not enough to give health inspectors the power to fine trusts for persistently poor infection control; the regulator should order a percentage cut in the hospital's income if patients become infected while under its care, Cameron said. His intervention came as the NHS managers' leader sparked a row about the consequences of devolving health policy to administrations in Scotland, Wales and Northern Ireland. Dame Gill Morgan, chief executive of the NHS Confederation, said there were now four different health services operating in the UK. Summary by Keep our NHS Public of Guardian 3 January 2008
  • Tory plans to victimize old and sick. Doctors have warned that Tory plans to fine hospitals whose patients contract MRSA or hospital acquired infections would hit the weak, old and ill. The British Medical Association said the plan, unveiled this week by David Cameron, would put hospitals off treating the most vulnerable patients. Dr Laurence Buckman, chairman of the BMA's GP committee, told the BBC: "Patients will be selected. Hospitals won't admit people who look like they might get a complication afterwards - that means people who are chronic sick, people who have cancer. How are you going to manage people on chemotherapy, who often get infections during the course of their treatment ?". However Mr Cameron said "payment by results" was the best way to ensure the prioritisation of infection control. Summary by Keep our NHS Public of Mirror 4 January 2008
  • Lib Dems' Nick Clegg plans radical departure. Patients would be able to opt out of the NHS and under plans being drawn up by the Lib Dems. David Laws, the party's new head of public service reform, said that the new Liberal Democrat leader Nick Clegg was determined to take his party in a radical and daring direction. Mr Laws said he wanted to extend private provision to allow parents and patients more power and choice where the state sector was failing them. The party was looking at plans to fund private treatment if the NHS kept patients waiting too long. "If a hospital doesn't deliver the treatment within a reasonable period of time, say six months, the penalty they face is that the patient has the power to say 'I'm taking that money' and exit into the private sector, and the NHS will have an obligation to fund the whole private sector cost." Other plans include an expansion of the use of private treatment centres to perform minor surgery when NHS hospitals cannot cope. Mr Laws, a former investment banker, once advocated a system of social insurance for healthcare but he said that was not currently on the cards. Summary by Keep our NHS Public of Telegraph 9 January 2008
  • Keep politics out of the NHS. GP Dr Margaret McCartney writes in the Financial Times: A new year brings the traditional political punch-up over the National Health Service. In the red corner, Gordon Brown is organising an "NHS constitution", which will tell prospective patients that they must make various health commitments before they are allowed NHS treatment, and a new "screening programme", which he says will save thousands of lives. In the blue corner, David Cameron has decided that hospitals should be financially penalised for infecting patients with MRSA or for procedures that bring poor results. Each of these proposals illustrates just how little politicians understand about health and just how well-insulated they are from the sweaty frontline that delivers medical care. Let me explain. First, there is the notion that people who are perceived to be responsible for their ill health should somehow be penalised for it. The usual suspects are smokers and the overweight but would we, therefore, also have to scold those who heed the Department of Health's recommendations on exercise, yet call on the NHS to fix strained ankles or stressed knees. Or what of people with skin tumours from sunbathing too often, have they been "responsible" with their health ? Do they deserve treatment ? And what of the very important idea - medically and economically - that there should be clinical evidence guiding clinical actions ? This also seems to have escaped Brown, as the screening tests he proposes are almost all nonsense. In order to be effective, and not harmful, screening tests on people with no symptoms of a condition have to show that screening is cost-effective, safe, and can lead to effective interventions. Screening that is not already being done is either not useful or unproven. Performing this kind of screening only leaves patients and doctors with dilemmas about whether to intervene when the prospective benefits are marginal, or even non-existent. All this toying with clinical priorities to win votes is tiresome. If you let politicians influence clinical decisions, you end up in a moral mess. Let's take, for example, the overweight pensioner who lives up four flights of stairs in her tenement flat and can no longer get the shopping for the invalid husband she cares for. She smokes, too, and has tried to cut down but the addiction is hard to break and cigarettes are one of her few pleasures. She would be helped by a knee replacement and if she could walk better, then she would be able to get to the shops and exercise more. She accepts that her risk from an operation is higher than it might be but wants to proceed - and who really can deny her ? She has paid her taxes, saves the state money by caring for her husband. How much more "entitled" would the prime minister like her to be ? Similarly, Cameron's announcements fail to grasp what it is that results in high MRSA rates and complications from operations. If I were a hospital looking to balance my books and make money, I would take easy cases and perform uncomplicated surgery on relatively fit patients - just like the private sector. If I wanted to reduce the chances of patients contracting MRSA, the evidence suggests I should invest in expensive measures such as reducing bed occupancy, adding extra staff and increasing cleaning time. So how exactly is reducing funding to that hospital going to help reduce MRSA ? In fact, the resulting deficit might even exaggerate all the problems that contributed towards MRSA in the first place. Both Brown and Cameron have considered the idea of allowing the NHS more freedom from politics, governed instead by an independent body. But now each seems to have backtracked. The NHS should always be accountable. But so should politicians. Evidence-based clinical decisions are what doctors aspire to, because they know these have more chance of working than do random opinions plucked out of the air. This year is the 60th anniversary of the NHS. It would be wonderful to think that our politicians might mark the occasion by creating some compassionate, real world- and evidence-based policy. And if they can't manage that, they could do us a favour by keeping quiet. Summary by Keep our NHS Public of Financial Times 12 January 2008
 

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Sheila Porter-Williams
Campaign for Health Service Democracy
Green Haven, Halfway Lane
Dunchurch
Rugby, Warwickshire CV22 6RD
sheilaCHSD@porter-williams.freeserve.co.uk