This issue does complicate matters though. Patients’ risk-aversion disappears. Doctors’ risk-aversion might not, but they’re not the ones with the pain. The patients might feel that they’ve got little to lose.
But this is exactly what the core Rightist dogma dictates: the poor must be punished for their poverty; the sick must be punished for their illness; and profits must be made from suffering.
Where this is all going to blow-up, is when the fucking stupid idiot Sun/Mail/Telegraph-reading working classes who have got on-board the Fascism-Lite/Tory bandwagon discover that they may have purchased a German car, but they are not, in fact middle-class, much less upper, and they suddenly can’t afford all the things they once took for granted - like heat, light, shelter, food and health…
Already too late, and even if the Labour Clownshow somehow miraculously don’t fumble the next election - they will do as Bliar’s ‘New Labour’ did, and crack right the fuck on with piecemeal privatisation.
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CUNTS!!!
FUCKING CUNTING CUNTY CUNTS!!!
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I don’t think the traditional “NHS” will exist within the next 10 years, there’s no stopping the change now. It will start as a mixture of private sector providing GP and frontline services and the NHS providing surgical, cancer and complex treatments.
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Deliberate and managed/ mismanaged decline (whilst the insurance and private providers sit waiting like vultures).
In lots of cases where I’ve had to go into a hospital and sort the clusterfuck of an elective backlog, the only recourse has been to do some limited remedial stuff with internal capacity and then contract in the local independent capacity. The utter shambles of waiting has grown now to such a colossal scale that even if all private capacity was given over to NHS waiting lists we would not get back to <18wk elective performance within the next 4-5 years…
I’ll be totally frank -the NHS makes little to no attempt to manage their contracted surgical/ medical capacity, and so pretty much every employing NHS hospital has no idea how much of the consultant job plan is being delivered as per, and also no clue as to what private work they might be doing on ‘NHS time’. I’ve uncovered fraud at every single hospital I’ve looked at elective lists (over 30).
Private work is delivered by using NHS surgical/ medical capacity, end of story. So private work is almost certainly at the expense of NHS delivery, and effectively a paid/ insured method of getting to the front of the queue more quickly.
All of this is obviously completely avoidable, but then you would a. have to be competent in managing; and b. actually want to make things better; and c. not financially conflicted to want to drive more activity into the private sector).
@kevin made some very good points above that I would have repeated here about the cherry picking of procedures by private companies,. Very few Dept of Health Mandarins I’ve met grasp that the full range of procedures cross subsidises the more difficult, complex and risky aspects of care (esp emergency care, and in particular care of the elderly). Instead all they want to do is act like a supermarket and set prices which mean ultimately that all hopsitals are now in debt, and of course then have no funds with which to invest in improving care and expanding into beneficial new procedures and services.
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Spot on.
The vast majority of people have chosen to ingnore the evidence of their own eyes and ears which has allowed the well-oiled Tory propaganda machine to kick in and blame the NHS.
When you have Tory MP’s being able to pose for photo ops in foodbanks without being lynched you know the game is up.
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100% agreement. The NHS will become the PDSA For Humans, what few services are available will be entirely charity-funded, and euthanasia will have been quietly legalised in the UK.
Futile though it is to note it, this has been very much the case for the 40 years that I can account for, and presumably for the entire history of private medical services in the UK. Every consultant I worked with in the early 1980s was rarely seen in the NHS units unless there were rare tutorial cases through which he wished to guide his Registrar. All the rest of his time was spent at the private hospital he part-owned, and they all had part ownership of them.
It is right to blame the tories for the privatisation of the NHS, but it has been very much aided-and-abetted by the medical profession, who have looked with envious eyes upon the secession of dentistry from the NHS, and desired the same.
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Very few want to pay more Tax. Blame will be placed on ‘People live longer’ or ‘the baby boomers’ an argument which misses the fact there would have been more tax going into the pot. Perhaps Cruella will blame ‘healthcare tourists’ or they will trot out the fearful notion of the 70’s and the ‘brain drain’ as examples of why higher taxes will not work (Negating other countries that do) Military spending is good tho.
Vote Stronzetto
Only a few need to pay more taxes: Amazon, Paypal, Shell, Exxon, &c, &c…
Just in case there’s not enough to be FUCKING ANGRY about:
The NHS will never be able to compete with the private sector, however, it should certainly not subsidise it. Time to bring the medical profession onto full time contracts, tie their training into return of service, deny the private sector any use of NHS facilities etc.
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The reason medics have got away with it for so long is that they will leave the NHS wholesale if binding contracts become a thing - even the worst of them can earn more in the private sector or abroad.
Very very few exceptions can get by solely privately - they need their NHS outpatient/ clinic time to prime their pipeline of work.
No NHS, no problem…
There will always be some element of public healthcare. Private companies depend upon the NHS to do all the difficult and expensive work that they almost certainly want absolutely nothing to do with.
How is the management relationship between each consultant and the hospital trust structured here ? If neglect/malpractice happens and a patient comes to harm as a consequence, and someone chooses to sue, then it’ll be the trust that they sue, right ? But the neglect will have been a decision made by an individual consultant or perhaps an MDT of them. So the trust must be being held liable for the behaviour of the consultants. Surely the trust will need to have some authority over them if it’s going to be held liable for their shortcomings ?
If a consultant refuses to see a patient and the patient looks like coming to harm then can the trust step in and insist that the patient is seen ? Or are they just relying on post-disaster disciplinary threats (the GMC striking the consultant off ?) to keep the consultants’ behaviour in order ?
A ‘job plan’ is agreed, usually between the specialty clinical lead (another consultant) and then should (but rarely is) signed off by the Medical Director.
A consultant job plan is made up of 4 hour ‘sessions’ (or 3.5 hrs, it varies between Trusts and age of contract etc).
These sessions will then be allocated to different activities -
- Direct patient care (clinics, theatre, ward rounds etc); and also 1B, supervision and clinical cover, out of hours etc
- Admin (patient and internal correspondence; meetings etc)
- Professional development (research, reading literature, training, attending symposia etc)
So what you might think is that if a clinical incident occurs, that this would be straightforward to establish what the contracted activity was - ie where was the consultant supposed to be, was he/she attending etc.
However, enter the loose concept of ‘clinical supervision’ whereby it might say on the job plan that the consultant is spending 4 hrs on Friday afternoon (as if) in outpatients, but in actual fact his registrar is actually the one seeing the patients face to face. The consultant is ‘available’ to supervise and consult with on any issue that might arise. He is accountable in theory, but more often that not it would be the actual doctor who would be responsible. In these cases the consultant wanders off to do what he has planned and as he leaves says ‘don’t fuck it up’ to the doctor and that is that.
In the event of a serious clinical inicident, the hospital will not want to lose their scarcest and most valuable clinical resource, and ranks will close and investigations will ensure that lessons are learned whilst retaining the consultant. Very serious incidents will involve the lawyers making complex judgement calls which if they think they’ll lose big and can put it absolutely squarely on the consultant then the 180 will be head spinningly quick!
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This is exactly how my nan died.
She went into hospital with stomach pains and was diagnosed with a twisted bowel or lower intestine. Her operations were cancelled and rescheduled 4 times over a period of three weeks because the consultant was also running a private practice out of the local Spire hospital. She eventually succumbed to pneumonia but the nurses and ward doctor were pretty damning in their description to me that the consultant had form for it.
I wanted to make a complaint but didn’t push my dad as he was upset and said that “going after the consultant wouldn’t bring her back or make it any less painful”
I did a bit of detective work and found he’d had a wrongful death case against him previously for prioritising private work over NHS. The GMC just filed an outcome that he was advised via a formal letter to not ignore NHS cases but there was no case to answer for wrongful death or negligence. He also had an active enquiry ongoing with the GMC but I couldn’t access any of the info for it.
I wanted him to be held to account as it was clear he was being negligent and it needed stopping but dropped it as it would upset my dad too much.
Don’t even get me started on when the hospital gave my mum the wrong dose of chemo that wiped out her white blood count and resulted in her spending 10 days in the cancer ICU with bacterial pneumonia 
Fucking disgusting, but I fear very far from unprecedented…
Doesn’t seem to load for me. Was it bad enough that it might have been pulled ?