Positive proposals from outside government/Sources

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  • Handle with care.  Finally, a charter is set to give Britain's six million carers the support they deserve. But why has it taken so long?  Jane Feinman Observer Sunday November 25, 2001
  • Every government department should base its policy on public health - just like they do in London, argues Anna Coote.  Guardian Society Thursday December 6, 2001
  • Patients 'should not have right to sue'. Guardian Society Sunday January 13, 2002
  • The answer to problems of ownership may lie in mutuals, as some football clubs have found.  Felicity Lawrence Guardian Society Monday February 18, 2002
  • Free personal care for elderly backed in poll.  Pensioners forced to sell homes to pay for basic needs.  Guardian Society Friday February 22, 2002
  • Why should young working families pay more income tax so that relatively well-off middle-aged people can inherit substantial sums when their parents die (NHS debate, February 22). The point of saving for old age is that, if necessary, you can be cared for in a comfortable nursing home - a significant improvement on the geriatric care wards of the not so distant past. Deborah Reavell, Basingstoke, Hants.  Guardian, Saturday February 23, 2002.  
  • Fund care for elderly or face backlash, Government told.  Gaby Hinsliff, chief political correspondent Observer Sunday February 24, 2002
  • Observer Comment Extra: the NHS debate.  Public ethos, private delivery?.  The debate between 'public' and 'private' provision of health is simplistic and wrong. A new mutualism can deliver the public service ethos better than the monolithic NHS. Is Alan Milburn ready to take on misguided critics?  David Green Observer.co.uk  Sunday February 24, 2002
  • The government must make long-term care free to all pensioners or suffer a massive backlash from the baby boomer generation, according to a controversial report from a Blairite think-tank. Guardian Unlimited Sunday February 24, 2002
  • Councils 'should be charged' over bedblocking.  David Batty Guardian Society Thursday March 14, 2002
  • NHS 'should spend more on health promotion'.  John Carvel Society Tuesday May 14, 2002
  • Good views. Simon Parker rightly points to the wider use of referendums by local authorities in allowing people a greater say (Vote now, pay later, June 25). It is wrong to limit referendums to the running and funding of services. If the biggest issue is the health service or transport, then councils should be able to elicit local views via a referendum on issues such as these too. If such a referendum was linked to the local election, it might attract a greater number of voters. Dennis Reed - Commission on local governance.  Letter Wednesday June 26, 2002 The Guardian
  • The Liberal Democrat leader, Charles Kennedy, today said that he was considering plans to give local councillors control of the NHS and fund the health service through a special dedicated tax.  Society Thursday July 4, 2002
  • The Liberal Democrat leader, Charles Kennedy, yesterday moved to reposition his party as the one most committed to delivery of public services, through decentralisation, mutualism, and earmarked taxes for health.  The Guardian Friday July 12, 2002 
    The full text of Charles Kennedy's speech
  • A new battleground in British politics is set to be opened when the Liberal Democrats propose a big programme of decentralisation, shifting power from Whitehall and handing tax-raising powers to local and regional government.  Patrick Wintour, chief political correspondent Guardian Wednesday July 31, 2002
  • Two interlocking policy issues will dominate the run-up to the next general election. Issue number one is familiar: improved provision of education, health and other services. Issue number two is moving rapidly into the frame: the extent to which services should be controlled at local level.  Leader Guardian Wednesday July 31, 2002
  • Laws to deal with cancer.  Guardian letters Friday August 9, 2002
  • What breast cancer patients expect.  The Observer's campaign partners, Breakthrough Breast Cancer, have produced a draft pledge for the care which the NHS should promise to every woman diagnosed with breast cancer and are currently consulting the public on the campaign.  Observer campaign Sunday November 10, 2002
  • 'We need standardised team investigations of sudden infant deaths, to protect parents along with children,'  Joyce Epstein is director of the Foundation for the Study of Infant Deaths, Britain's main campaign group on cot death.  Friday December 13, 2002
  • Don't bar the sick  - ...but we need to know who is ill  Leader Sunday December 15, 2002 The Observer
  • A cancer survivor who rejected orthodox treatment argues for change in the NHS.  Michael Gearin-Tosh Saturday January 4, 2003 The Guardian
  • Call to define NHS care. Prioritise specific entitlement over reform, says thinktank. David Brindle Wednesday January 15, 2003 The Guardian
  • Researchers claimed yesterday to have uncovered powerful evidence that reducing the age at which routine screening of women for breast cancer was introduced from 50 to 40 could save many more lives. James Meikle, health correspondent Friday April 25, 2003 The Guardian
  • Chronic care in need of a voice. Malcolm Dean Wednesday June 25, 2003 The Guardian
  • Sarah Middleton-Lee on a pilot project offering patients citizens advice bureau services while visiting their doctor. Wednesday August 6, 2003 The Guardian
  • The NHS needs further devolution in decision making, says Malcolm Dean. Wednesday October 1, 2003 The Guardian
  • Scientists yesterday called for an extra £100m a year to reverse the collapse of clinical research in the National Health Service and to test new and sophisticated ways of treating a growing range of diseases. Tim Radford, science editor Friday October 31, 2003 The Guardian
  • Our beloved general hospitals will soon be a thing of the past, says Nigel Edwards. Wednesday June 16, 2004 The Guardian
  • One in 10 hospital patients does not need to be there and could be cared for at home, health chiefs say. The NHS Confederation, which represents hospital managers, will use its conference this week to call for a major rethink of the NHS which could see hospitals pared back to the essentials. The number of beds could be cut, many diagnostic tests could be carried out in the community instead of in hospital and hi-tech methods used to monitor the chronically ill in their homes. Gaby Hinsliff, chief political correspondent Sunday June 20, 2004 The Observer
  • The NHS and successive Labour governments have failed dismally to recognise the distinct needs of black and ethnic minority patients. John Reid and Trevor Phillips propose a way forward .John Reid and Trevor Phillips Wednesday July 14, 2004 The Guardian
  • A coalition of 20 charities and patient groups today launched a manifesto of proposals to provide better care for the 17 million people living with long-term chronic conditions. The 17 Million Reasons manifesto calls on politicians to shift their focus away from emergency care and waiting lists towards the care and support of those with long-term conditions - more than a quarter of the population. Tash Shifrin Wednesday September 8, 2004
  • Doctors enter pre-election debate with health manifesto. Debbie Andalo Wednesday March 9, 2005
  • As Patricia Hewitt digests the results of her 'citizens' summit' consultation exercise, key figures in the health sector suggest where she should go from here. (Feature: out of favour) - Wednesday November 9, 2005
  • A clean bill for health Sixty years after the national health service bill, a new white paper is needed to make good recent damage. Allyson Pollock  on http://commentisfree.guardian.co.uk/allyson_pollock/2006/03/regaining_the_values_of_the_nh.html March 24 2006
  • Long live the NHS. A coalition of groups have sent a joint letter to the Times defending a tax funded healthcare system against attacks from groups like Reform. The letter is signed by the British Medical Association, the Chartered Society of Physiotherapy, Diabetes UK, the Family Planning Association, Macmillan Cancer Support, the New Health Network, the NHS Confederation, the Royal College of Midwives, the Royal College of Nursing, Unison, the Sainsbury's Centre for Mental Health, and Turning Point. It says: "In the week of the 60th anniversary of the second reading of the NHS Bill, we would like to take the opportunity to state our belief that the United Kingdom is fortunate to have one of the fairest health systems in the world where no one need fear becoming bankrupt because of their need to fund their healthcare. It has dedicated staff who are driven by a passion for patient care and has been transforming itself into a 21st-century healthcare system of which we can all be proud. The continued commitment of funding through tax ensures equity for patients but also makes economic sense because it is the cheapest way of collecting money. If a system is unaffordable through tax it is not affordable through any other funding system. International experience shows there is no necessary link between how systems perform and how they are funded. Any move to a health insurance system to charge patients for their care would increase bureaucracy and would leave those who need the most care with the greatest financial burden. We are not complacent. The NHS will need to respond to the tide of rising expectations and need by improving efficiency and responsiveness. With the dedication and commitment of staff we believe that the NHS can continue its transformation and be a model for other countries." Summary by Keep our NHS Public of  Times 27 April 2006
  • How to improve the government's NHS reform plans while avoiding any hint of a U-turn was the challenge to readers set by John Carvel. Your suggestions should give the health secretary much food for thought. Join the debate here. Wednesday August 23, 2006 The Guardian
  • In the drive to save the NHS, I'm choosing a Toyota. ... Which is where the second remedy comes in. More modest, but also more encouraging, was Peter Day's In Business programme on Radio 4, which looked at the application of Toyota's production principles to healthcare. Some people's hearts will sink, or swell with indignation, at the very idea. But the difficulties with the approach are not what people think they are, and they are far outweighed by the potential benefits. The beauty of the Toyota system is that it concentrates rigorously on doing only what the customer (internal or external) wants, when they want it. Compared with Western systems, it's tortoise versus hare: rather than seeking efficiency by speeding up individual activities, it focuses on improving the flow through the entire system by keeping those activities to the absolute minimum. Result: a race-winning combination of higher quality and lower cost. As Malcolm Jones of the consultancy Productivity Europe points out, Toyota hasn't made a loss, or closed a factory, for 40 years. It sounds simple, and in one sense it is. You start with the demand and design a system to satisfy it. In A&E, for example, most of the workload is minor complaints or, increasingly, referrals from NHS Direct that aren't really emergencies at all. Often even serious incidents are predictable, like drink-fuelled injuries on Saturday night. A system designed to handle predictable demand dispenses with the need for complicated scheduling and automatically increases capacity to cope with truly urgent cases. It takes time, but whole hospitals are gradually being converted to these principles. And as they convert, miracle of miracles, capacity increases. Firms organised along these lines habitually find that they start insourcing activities they can do better and more cheaply than others, so little headcount reduction is involved. There's no reason why the same should not be true of the NHS. But hang on a minute. If, as one consultant interviewed on Day's programme put it, gaining these benefits for the NHS is 'about putting together the broken processes', why is government policy so intent on fragmenting them? Isn't separating out activities and hiving them off to the private sector (what the Keep our NHS Public campaign calls 'patchwork privatisation') the very antithesis of Toyota-like flow? Simon Caulkin Sunday January 14, 2007 The Observer
  • Health tops public priorities for next election. A YouGov survey for the Royal College of Nursing has found that the public believe health should be the top spending priority for the next government. The survey of over 2,000 people also found overwhelming support for the NHS with 93% saying they valued it as an essential free public service. Summary by Keep our NHS Public of Health Service Journal 12 April 2007
  • Meldrum unconvinced by BMA's 'cosy' reform plans. The new chairman of the British Medical Association, Dr Hamish Meldrum, has outlined reservations over the union's proposal for the introduction of health economy foundation trusts (HEFTs) to tackle problems with the purchaser-provider split. The union came up with idea in May to deal with places where the purchaser-provider split was causing "stubborn divisions". The proposal was one of 24 recommendations from A Rational Way Forward for the NHS in England paper, published by the union before Dr Meldrum took his post. At the time the move was described by its supporters as an "alternative approach for the reform of the NHS". But Dr Meldrum said last week: "I have some reservations about the HEFT model because there is a difference between involving primary and secondary care in discussions but actually lumping them into one trust could create problems. The move away from the market should be evolutionary. For some people everybody going into one organisation may be too cosy and comfortable. People may want to keep their separate identities," he said. "You're never going to get rid of competition, for example between GPs. A lot of competition comes from just wanting to do a better job, to see what your colleagues are doing and trying to do better." His view contrasts with the BMA's paper, which will undergo consultation until the 7th September, which says that HEFTs would supersede foundation trusts: "The HEFT model could revolutionise relationships between local health systems and communities." Summary by Keep our NHS Public of Health Service Journal 9 August 2007

    Julian Tudor Hart and Alex Scott-Samuel - What would we do instead? (from Keep our NHS Public)

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