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NHS listening exercise: Submission Resources

May 26th, 2011 by

There are just four days left of Andrew Lansley’s NHS listening exercise. That means we have 4 days left to flood it with our comments, concerns, and objections.

We can make sure that when the figures are released in a couple of weeks, the headlines are clear: the bulk of the submissions to Lansley’s listening exercise opposed his plans.

It’s easy and fast to make a personal submission to the listening exercise using the 38 Degrees website. It only takes a couple of minutes, and there are hints and suggestions for what to include.

You can send a message to the “listening exercise” right now here? It will take only a couple of minutes. You can be as brief or detailed as you like, and there are links below to useful facts & figures that you can include in your message.

Then let other 38 Degrees members know what you submitted in the comments section at the bottom of this page.

Here are some of the big issues 38 Degrees members are concerned about:

  • Decisions being taken behind closed doors
  • The threat to the Government’s duty to provide a comprehensive health service
  • Competition versus co-operation
  • “Cherry-picking” by private healthcare providers
  • The Government is not listening to experts and patients
  • Huge changes are being proposed without proper trials first

You might find some of the information on the 38 Degrees NHS Action Centre useful. The British Medical Association has lots of useful information at their campaign centre here.

There are lots more happening across the country. Here are a few links:
See what some 38 Degrees members have been saying to their local MPs as they’ve handed in Save the NHS petitions up and down the country.
Have you signed the Save the NHS petition? Over 400,000 people have, and many have left comments on the page.
For up to the minute news and opinion the Guardian’s NHS Reform blog is worth reading.
You can have a look and see what’s being said about the NHS right now on Twitter.
And don’t forget the 38 Degrees Facebook page. There has been a constant conversation about the NHS since Lansley announced his proposed changes.

 

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  • Sam Times2

    why is Nick Clegg sending NHS Bill back to committee when his MPs nodded it through the first time

  • Anonymous

    I’m looking forward to seeing what people are including in their submissions. I just put my own one in. I focused on:

    The role of the NHS regulator, “Monitor”: this shouldn’t be fudged, their priority focus needs to be on patient care, not forcing competition.

    Keeping the government’s duty to provide a comprehensive health service. I think it’s really sinister that this could be scrapped.

    Listening to the real experts: I’ve been lucky enough to meet/speak to dozens of 38 Degrees members across the country with real expertise in health care, and real concerns about the bill. And then there’s this huge number of patient groups, health charities, and professional associations like the British Medical Association who are raising concerns. It’s crucial that these concern to listen to, and no surprise that people aren’t trusting Andrew Lansley if he refuses to do so.

    What did you put in yours?

  • Caritia

    I have several fundamental concerns about proposed changes to the NHS. I think it is time to go back to the drawing board.For example, I have not so far been reassured by what I have heard from the government on the issue of “cherry picking” of NHS services by private companies. “Cherry picking” could be extremely destabilising to our health service, and there must be a clear plan and legal mechanism to rule it out.I work within in the NHS at a GP’s in Tottenham, my mother work within the care system for 30 years, she watch that go private and was not happy with the care that was given to those whom she had come to care about and respect. Privatised cherry picking is not the answer, because those that will suffer are those who are in the most need of care and those who are vulnerable. Having money should not be the key to good health and access to good health care. It has never been right to denine access to those who are in greatest need. Many of those people who are well and can afford to pay should, but a balance must be struck. Allowing any person who comes in to the UK access to free care is part of the issue as to why the services is so over stretched. In addition the miss management & lack lustre approach to managing the funds that are available. More concern for patient’s and patient care & less on who big a pay cheque the boss/doctor is going to get and things may start to impr ove. There is now such a high degree of patient who are diabetic, obsess and suffering from on going & chronic disease it is no wonder the system can not cope. Telling mother their weight will double during pregnancy – I mean come on, mum’s are positively being encouraged to eat as much as they can with no help to loose it after the pregnancy. Better care & to actually care would be a good start, private policies & back door deals will not achieve that and many will suffer in the process. Open up the forum, seek advice from those who live & breath the system everyday, let the floor be open be objective & think business like but not Scrooge, practical not every person for themselves. The NHS is a gift do not let it be destroyed for greed. Thank you Ms C Abell – NHS Worker

  • Anonymous

    thanks for sharing this Caritia.

  • Angela

     My letter:

    There can be few things more precious than our NHS and I agree with taking action to continously improve it; however, I am appalled by the poorly constructed plans this government has proposed. Virtually the whole of the medical profession has deep concerns as do the majority of those people who rely on you, our representatives, to make decisions for our good.
    Please truly listen and act in a way which reflects the professional and public views.
    Just imagine how you would have reacted when in opposition if Labour had acted in the way you have – you would have been in uproar!
    So amend the plans and preserve our NHS and don’t let it fall into the hands of the profiteers – if there is spare money to be had, then by all means make efficiencies and plough the money back to improve the service!
    Thank you for listening (I am trusting you on this one…..)Angela Steatham

  • Nicky Griffiths

    My letter:

    It is not necessary to bring in private companies to promote competition. Patient choice between NHS providers competing on equal terms brought about by integrated care pathways and a national charging system to commissioners means each trust competes not on price but on quality of service. Introducing private providers raises the issue of “cherry picking” of certain procedures which would destabilise the system. I don’t believe GPs are the best people to commission services. While they may have good knowledge of what is needed in their area, commissioning is a financial and logistical exercise of some complexity. Most GPs will require specialists to undertake this so those professionals that once worked for PCTs will be employed by Consortia which will simply be PCTs by another name. In other words, the whole unsettling reorgnisation will end up causing a great deal of uncertainty and cost simply to end up with something fairly similar.I feel it is incredibly important any commissioning body should have representatives from patients and other health professionals as well as GPs. My experience as a Community Health Councillor means I do not think all GPs automatically represent their patients’ wishes or best interests. Ironically, the GP practice in my area that is a leader in the new commissioning consortia is the subject of great patient dissatisfaction over waiting times for appointments and difficulties in seeing the GP of one’s choice. If they cannot organise these aspects of their practice to the satisfaction of patients, why should their commissioning be any better?I cannot see how the reorganisation will save money. I fear it will actually be less efficient and detrimental to quality of care. At least the proposals should be trialled before for several years before being implemented.

  • http://twitter.com/sushi_juggapah Susheila Juggapah

    My message:

    I have fundamental concerns about these proposed changes to the NHS. I think the Bill should be scrapped rather than ploughed through to save Andrew Lansley’s reputation. The NHS was set up to provide an essential safety net, and catch those who need health care; not just for those who can afford to pay for it. The social implications of further privatisation are being ignored in this legislation. The knock-on effect this will have on poorer communities, who are dependent on a comprehensive health system, will only help to increase economic inequality and further the gap between those who can pay for their health and those who can’t. Listening to the voice of the people would not only be politically astute; it would be the best way to ensure quality healthcare for future generations.

  • Michael Pantlin

    Nobody wants these reforms,. The patients never asked for it, neither did the staff and it wasn’t in your election manifesto. They smell of pure political opportunism to get public NHS money paid to your businessmen cronies.I depend on weekly urgent medical intervention by the hospital specialist service haematology to keep me alive. Any delay the doctors tell me can be fatal. I don’t want the finance for my care to be at the pleasure of a GP who does not have the training to look after me and cannot respond immediately.The private sector is already hugely integrated with the NHS in the provision of spectacles, dental serviceI depend on weekly urgent medical intervention by the hospital specialist service haematology to keep me alive. Any delay the doctors tell me can be fatal. I don’t want the finance for my care to be at the pleasure of a GP who does not have the training to look after me and cannot respond immediately.The private sector is already hugely integrated with the NHS in the provision of spectacles, dental services, all the supplies for the NHS, private consultancy services, agency nursing, hospital catering, cleaning and portering services and any further private provider services will destroy the heart of the NHS. I simply to not trust your reassurances any more than when we were told the Common Market would be a purely trading linkage and now find ourselves ruled from Brussels and described as an EU state.Force these unwanted changes through and you will alienate many voters who will not forget it and like myself who will never vote for the Conservative Party agains, all the supplies for the NHS, private consultancy services, agency nursing, hospital catering, cleaning and portering services and any further private provider services will destroy the heart of the NHS. I simply to not trust your reassurances any more than when we were told the Common Market would be a purely trading linkage and now find ourselves ruled from Brussels and described as an EU state.Force these unwanted changes through and you will alienate many voters who will not forget it and like myself who will never vote for the Conservative Party again. You will go down in history as the party that destroyed a much loved healthcare system,

  • Glyn Williams

    Hands off our NHS

  • http://www.prda.info Richard Surman

    The government is going to try and push this through in order to retain credibility with private enterprise and hard core Tory support – and it will go down in political history as one of the most disgraceful betrayals of the nation’s trust in recent history (together with Blair’s Iraq adventure). Millions of us love the NHS, even with its many shortcomings. I chair a patient group for the 1600 patients diagnosed annually with Pelvic Radiation Disease – a horrible, disabling and largely ignored condition affecting many people who have had cancer in the pelvic region. God knows what will happen to our modest efforts to obtain better resources and treatment if Lansley’s plans are allowed to go through lock stock and barrel.

  • Peter Singer

    It’s not clear what problem the reforms are intended to address – except the problem of providing comprehensive health care for an ageing population. In other words, it’s a rationing exercise, an attempt to control costs. Yet any involvement of the private sector will cost us more, not less: clearly no company is going to get involved unless it expects to make a profit, i.e. suck money out of the NHS to benefit its directors and shareholders. The money should be kept in the NHS and used to provide health care.

    How much is the government paying the big consultancies (PWC, KPMG, etc) to design the new structures of the NHS? This is another way that governments of all parties have wasted our money in the past on expensive and unnecessary reorganisations, impractical and overblown computer projects, etc. There must be full disclosure of any such involvement IN ADVANCE, not after the event, when it too late to stop the waste. If it doesn’t already exist, the NHS should set up its own management training college to ensure that its structures and methods are efficient and effective.

    My family’s experience of the NHS has been overwhelmingly positive. Any complaints are not about the medics, who have been uniformly excellent, but about the bureaucracy (losing files, duplicating letters, etc) or the sometimes dodgy nursing; and the terrible decline in hospital cleanliness after cleaning was contracted out. These problems need to be addressed by better trained and more vigilant managers listening to feedback from patients and acting on it. Major reorganisation will not solve these problems, just create a whole raft of new ones: it will throw the system into turmoil for years to come, cost billions, and divert funds from health care into private profit.

  • http://twitter.com/giociampa Gio Ciampa

    I’m of the opinion that the NHS should be run as a non-profit organisation. If potential providers could be asked if they would be willing to operate this way then it would quickly establish those who are more interested in caring for people than making money…

  • Catherine Belsey

    MessageI have fundamental concerns about proposed changes to the NHS.The introduction of competition from private companies is likely to drive down standards. (How else do private companies make a profit?) I remember when cleaning was contracted out: it got worse. Catering was turned over to private companies: hospital food got more unhealthy. We can’t afford to play such games with the nation’s health.

  • Cliff James

    Copy of submission to Mr Lansley ‘listening’ exercise:

    I want to make a contribution to the NHS
    listening exercise. I am deeply concerned that the changes that Andrew
    Lansley wants to make will end up damaging our health service.

    For example, I am concerned that new commissioning bodies will not be
    properly accountable and will not operate in a transparent way. GPs
    should not be able to take decisions behind closed doors, and other
    stakeholders including patient groups and other health professionals
    should also be involved.
    Most disturbing of all, the proposed Health and Social Care Bill would
    herald an increased marketisation of health care provision. There are serious ethical and utilitarian problems with the requirement that
    medical services will be auctioned off to the cheapest providers. It is
    fundamentally against the interests of the British people that ‘no
    frills’ private companies offering low-cost, low-quality private
    services will be preferred providers over public sector providers.

    The single bottom line for all private companies is profit – the
    economic value created by a company after deducting the costs of all
    inputs. It contrasts fundamentally with the ‘Triple Bottom Line’ of
    public sector organisations, which measure their success against a
    three-tiered standard: social and environmental success, in addition to
    profit. Within a sustainability framework, the ‘profit’ aspect of
    public sector organisations is also interpreted as the real economic
    benefit enjoyed by wider society, and should not to be confused with the
    internal profit of a private company.

    It is therefore in the national interests that People, Planet and Public
    Profit should be the guiding principles that underpin any organisation
    providing essential services to the public. As it stands, the proposed
    Health and Social Care Bill prioritises private companies that are only
    concerned with the revenue they provide to shareholders.

    Without the social and environmental bottom lines of the public sector,
    private companies will be commissioned to provide essential diagnoses,
    operations and treatments with one underlying and overriding concern:
    the economic value of the company after deducting the costs of all
    inputs. The Bill is a recipe for inferior service, and cost-cutting
    measures at the expense of health and safety.

    For example, in April 2011, the Tees, Wear and Esk Valley NHS Trust
    ended its healthcare provision at the local prison. The commissioning
    board admitted that it had chosen the private healthcare provider Care
    UK to replace the NHS because, although it would provide an ‘inferior’
    service, it was cheaper.

    Without the social, environmental and public profit standards, this Bill
    will sacrifice people and planet on the tracks of profit. Nine years
    after the 2002 train crash that killed seven people in Potter’s Bar, for
    example, the inquest determined that the accident was caused by health
    and safety failures. The two private companies responsible for the
    accident, Railtrack and Jarvis, were blamed for a catalogue of
    inadequacies and shoddy management systems, caused by cost-cutting
    measures that were aimed at increasing revenue.

    In response to the Potters Bar crash inquiry, Gerry Doherty, leader of
    the TSSA rail union, commented that: “The pursuit of profit was placed
    as a higher goal than passenger safety.”

    If Andrew Lansley’s Bill is passed, we can expect Potters Bar incidents
    in operating theatres across the country.

    Furthermore, there are serious public concerns over the impartiality and
    financial motivations of those who are promoting this Bill in
    parliament. To quote The Telegraph:

    “John Nash, the chairman of Care UK, gave £21,000 to fund Andrew
    Lansley’s personal office in November. Mr Nash, a private equity
    tycoon, also manages several other businesses providing services to the
    NHS and stands to be one of the biggest beneficiaries of Conservative
    policies to increase the use of private health providers.”

    There are significant doubts, therefore, regarding the legitimacy of
    this so-called ‘listening’ exercise. If the ears of those who are
    supposed to be listening are stuffed with Care UK cash, how can they
    hear the united opposition from doctors, patients, the NHS
    Confederation, the British Medical Association, the Royal College of
    Nursing and the Royal College of GPs?

    Finally, the most dramatic changes proposed by this Bill were not put
    before the general public at the time of the General Election in 2010,
    nor were they mentioned in the Coalition Agreement between the
    Conservative and Liberal Democrat parties. Without a legitimate mandate
    to enact a bill that is so fundamentally against the interests of the
    British people, this Health and Social Care Bill should be scrapped
    altogether.

  • Katy

    My copy of submission to the listening exercise:

    I’m making this submission to the NHS listening exercise because I have huge concerns about the proposed changes. 

    I am particularly opposed to the proposal to scrap the Secretary of State’s duty to provide a comprehensive health service. This duty is fundamental to the operation of the NHS and any changes to commissioning practice may be particularly vulnerable without it in place.

    Please consider the overwhelming public opinion and advice from our health care professionals (such as the BMA, GMC, RCN and trade unions) and halt these proposed changes to the NHS.

    I think it’s time to drop these proposed changes to the NHS and start again.

  • Steve Taylor

    Steve Taylor

    ToNHS listening exerciseSubjectDrop the NHS plansMessage

    …I’m making this submission to the NHS listening exercise because I have huge concerns about the proposed changes. I think it’s time to drop them and start again.
    The NHS and I are almost exactly the same age. I have benefited from – and contributed to – the NHS all my life, as have all my friends and family, and we won’t take kindly to you wrecking it for us in the name of some spurious reform. It isn’t yours to play about with, it belongs to everyone, so stop trying to interfere with it…

  • C. Humfress

    My copy of submission to listening exercise:

    Having carefully read numerous submissions from the BMI, from Nurses’ unions and patient consultation groups and as a user of the NHS myself, I am making this submission in order to voice my own objections to the proposed changes.

    As someone whose close relatives work within the NHS (as nurses and midwives) and having experienced NHS treatment myself I am, in particular, opposed to:

    (1) the proposal to scrap the Secretary of State’s duty to provide a comprehensive health service. This is a duty which has been fundamental to the operation of the NHS ever since its formation. It must be retained

    (2) the proposed framework allowing “cherry picking” by private companies. This must be fully ruled out, and the mechanism for preventing it must be clearly established.

    (3) the guiding ethos of the NHS being changed from ‘collaboration’ to ‘competition’. The NHS should focus on providing quality healthcare, not on competition. The role of the regulator, the “Monitor”, should reflect this and promote collaboration.

    As Rowan Williams once noted: “The point at which the activity of nursing the sick can be expressed in terms of a producer supplying a customer is the point at which the culture of nursing the sick begins to disappear.” It is this ‘culture of nursing the sick’ which the proposed NHS reforms will ultimately destroy. It is time to drop the current NHS reform plans and rethink: this time with proper attention paid to the ‘culture’ of NHS healthcare, rather than the rampant promotion of a competitive, capitalist ideology.

  • Gushbhumbra

    The previous government wasted vast billions on paying
    GPs and Consultants too much instead of using the money to pay for the nurses
    of which the NHS is very short. The coalitions seems to want to throw even more
    money at GPs. I’m sure they’ll say they need some incentive to do the extra
    work.

     

     The GPs have
    enough to do as it is and cannot see enough patients now.

     Where are they
    going to find the time to decide on funding issues? And if  they are going to hire people to make the
    decisions for them then what is  the
    difference from the current position? As I understand it the same  people who are currently employed by the NHS
    trusts will be employed by GP  consortia
    to manage the new system (since they are the ones with  experience in the management of such funds)
    so what is it all about? How  will the
    GPs escape from the suspicion that they are pocketing the savings  themselves? This measure will only erode
    their integrity.

     

    If you really want to do something radical with the NHS,
    cut the amount spent on acute care by more intervention BEFORE people get ill
    with prevention rather than belated patching up afterwards.

     

    My father has been in hospital many times in the last few
    years, and it very much appears that he’s been discharged when it is
    financially advantageous for the NHS trust rather than for his health. (Beyond
    4 days and less than 7 days.) When he returned to the hospital without really
    getting better on the previous visit the trust gets paid again for treating
    ‘another patient’. It situations like this where the money is wasted. If he
    were treated for longer/ properly in one visit then a repeat visit could be
    avoided but the trust doesn’t make so much money this way. Also the hospital
    staff won’t appear to be so productive/ busy in the apparent number of patients
    they treat.

     

    Additionally, the way investigative tests are carried out
    is another way that savings could be made. When patients go in for a difficult
    diagnosis, the tests are carried out sequentially. This means seeing
    Consultants one at a time, most of whom say ‘We can’t see anything wrong’ so
    back to your GP to order another test. Each Consultant has a waiting list which
    means it can take months or years to come to a diagnosis and this means the
    patients gets significantly more ill before treatment can begin and then it
    costs much much more to treat. This has happened to my wife. Of course this
    assumes the patient survives the diagnosis period, unlike my Aunt who was
    passed from one Consultant to the next for more than a year till it was too
    late to treat her cancer, which was found at the last moment.

     

    I agree that throwing money at the NHS is not the
    solution, intelligent use of resources is the answer, but the government needs
    to think again about the current proposal.

  • Tony Smith

    As an academic who specialises in studying international health policy, I have to protest most strongly about the proposed changes to the NHS by this government.

    There is a big lie here.  Lansley and Cameron claim that the changes are not ideologically based, but it is untrue.  The whole purpose of these changes are to set the NHS up so that private providers can come in and begin the process of NHS break up and privatisation.  It doesn’t make much sense overall.  The only fully private system in the world is the US system, which has some of the worst outcomes overall.  You can get the best service in the world if you are rich, but if you are poor you can’t get treatment.  Even if you have health insurance if you get really sick, eg with cancer, your insurance will only pay for so long and many families are made bankrupt trying to fund treatment.  About a 5th of the population of the worlds richest country do not health insurance at all as they can’t afford it.  Because of these inadequacies the US tries to patch up the system with Medicare and Medicaid, but these systems are inneffective.  The companies that compete for contracts, spend about 40% of the money they receive on marketing.  Deduct profits from the total and the result is a very inefficient way to spend public money.  That is why Obama and Clinton before him have fought so hard to move to a system more like ours!

    The point is that public funding of private healthcare does not and cannot work.  You introduce all the transaction costs of the marketplace into the mix, with none of the benefits for the patient of the public who are funding it.  If you spend 50% plus of the health budget on funding the transactions costs of competition (marketing, tendering, much higher management costs and ultimately higher costs) you will never provide a better service than we have now.  Lots of people will get rich(er) though, whilst most of us will receive poorer care (or no care) and pay lots more for it.  It also makes little sense for the economy as a whole.  A healthy population is essential.  Ill people cannot effectively contribute to wealth creation.

  • gemolo

    Here’s my rather rrushed attempt!I actually agree with some aspects of the Bill, like transferring services into asset locked social enterprises to allow room for innovation and to put front line staff at the helm.

    But the coalition government is moving way too fast. It’s cutting the cash needed to fund this innovation, ruining the small organisations, social enterprises and charities that can make a difference. This is risking sell off to the private sector, which is given a level playing field in your procurement processes.

    Give them cash, fund innovation, give the small guys a chance to make a difference on a local level. The Big Society Bank is not going to be enough and Payment by Results is impossible for small organisations.Plough money in to make sure you get a better service back. Break down silos and look at holisic health care – link it to prisons, education, child care.Look at Turning Point, Speak Out, Cool2Care, Kingston PCT and, most of all, listen to the service users.Also, GP commissioning – the GPs I know are terrified. Explain your idea more and ensure that all GPs, front line staff and community health workers can a say in how the policy is developed, not just the ones making £100k a year who only have 5 mins to see their patient. It’s this rush and out of touchness to patients that causes problems in the first place. Are GPs really going to ‘prescribe’ art classes, or will they stick with pill prescriptions?

  • Richardcraik

     The NHS isn’t and shouldn’t be a commercial organisation. These proposed changes, in spite of all the counter-spin from government sources and the fobbing-off replies which many MP’s are sending out to their constituents, are clearly the start of a privatisation process for the NHS which will ultimately result in a profit-driven commercial organisation concerned not with treating the sick but in making money out of them for private health care providers and insurance companies- yet another insurance miss-selling episode in the making??

    I’d like to see these proposals dumped ASAP.  Type your comment here.

  • Ellie

    I want to make a contribution to the NHS listening exercise. I am deeply concerned that the changes that Andrew Lansley wants to make will end up damaging our health service.Look back to the 70s in the USA. Massive reorganisation of the health service under Nixon. Why did he change things, because his pals would make more money. The driver for change was not people’s health or equity of care, but profit and efficiency above all else.Under private health care in the USA, people die uneccessarily and the poor more often than any other group. Your government will be judged on what it has done for the most vulnerable in society and the proposals do not adequately protect the poor or anyone else. “Cherry picking” by private companies has not been shown to lead to better healthcare for patients.If tax money is being spent on health care, then whoever spends it ought to be accountable. We have all seen the reaction when MPs spending of tax payers money was not transparent.I am concerned that new commissioning bodies will not be properly accountable and will not operate in a transparent way. GPs should not be able to take decisions behind closed doors, and other stakeholders including patient groups and other health professionals should also be involved. Who will be there to advocate for rare conditions that a GP consortia may only have 1 patient with and therefore consider a low priority? Who will maintain that there are specialist centres for specific procedures, e.g. heart transplants?Who will ensure that procedures have a long term benefit for health and cost with cuts to NICE that have already taken place?I am a massive supporter of change within the NHS and realise that this is a difficult task. Would it not be best to trial this plan first before rolling it out and facing a potential meltdown of healthcare in England?Where is the evidence that Lansley’s strategy will work?
    Thank you for taking this view into account.All the best,Ellie

  • Shirley May

    My copy of my submission to the listening exercise:

    I am writing to register my deep concerns about Andrew Lansley’s NHS proposals.

    For example, I am very concerned that the legislation proposes to remove the Secretary of State’s duty to provide a comprehensive health service. I think the duty to provide a comprehensive health service is crucial and should be retained.

    I cannot emphasise that enough.
    I have been a nurse for 10 years.

    The key points of the health service: free delivery at the point of access, care in response to need, applicable to all. As soon as commercial interests enter the equation, these objectives become distorted and destroyed. The NHS needs to be a well-regulated publicly-responsible independent organisation funded by taxpayers and answerable to taxpayers.

    Cherry picking by commercial companies would leave the truly important
    difficult areas of care exposed. 

    The doctors do need to be at the centre of prioritising decisions, but not then
    trapped in a forest of administration and unable to practice their skills.

    An NHS Monitoring Body could consult doctors and implement their decisions in a transparent way, answerable to taxpayers.

    The only role for competition would be in providing goods and services within such a structure.

    Shirley May

  • Jacqui

    I wrote: I and many
    others are EXTREMELY concerned that the changes that Andrew Lansley
    wants to make will end up damaging our health service.

    The NHS was hard fought for by our forbears – do not sell it off and create an elitist American system!

    Private competition does not work, it may make a quick buck for those at
    the top, but the consumer loses out. Look at the price of railway
    tickets, gas etc.

    Listen to the healthcare professionals, they know the system better than you.

    I am concerned that new commissioning bodies will not be properly
    accountable and will not operate in a transparent way. GPs should not be
    able to take decisions behind closed doors, and other stakeholders
    including patient groups and other health professionals should also be
    involved.

  • Jaqhuff

    My submission:

    I am writing to register my deep concerns about Andrew Lansley’s NHS proposals. The facts and opinions from doctors, health economists, managers and even a former Conservative health secretary describe the speed of Government reform plans as a “train crash”, and warn that the NHS could ‘implode’ if their plans are not revised. These are the people who know about health care and especially the NHS. Why are they being ignored? I was particularly taken with a comment from Robert Creighton, the head of Ealing PCT, who told a conference that no one was “thinking about patient care or anything else”. I believe this is the crux of the issue. You are thinking about the money but the people are being ignored. It’s sounding like a massive ideological experiment and we are all your guinea pigs! This is not a government listening or considering their citizens! There are many reasons to be concerned about the current reform plans. Fore example, that the legislation proposes to remove the Secretary of State’s duty to provide a comprehensive health service. I think the duty to provide a comprehensive health service is crucial and should be retained. There are also issues regarding accountability and transparency which have not been resolved. To remove patient and GP representation and turn things back into a consultant biased, money making service will mean a return to pre-Beveridge days for health in this country. There is a reason why the NHS was created and why, despite its faults, it is so loved and fought for today. It provides equality and an accountable service which offers a universal service to all and is not financed by business as it is in the USA. This is the reason most people overseas envy the UK system and Obama has been desperate to get universal healthcare in the USA. People die there of curable and preventable disease. What incentive is there in such places to prevent illness when the pharmaceutical companies and others get more money for performing surgery? I lived in the USA for 3 years and, regarding the health system, it was terrifying, unless you had a lot of money of course! Competition does not mean quality or good prices for consumers. The railways are proof of how privatisation pushes up prices but does not improve quality. Competition creates a desire for profit to please shareholders and often price fixing, as we have seen with telecoms companies who have been investigated for this. Competition with big business behind it also creates an increased desire for money. Doctors stop training due to a desire to be in a caring profession, they train to become rich and the increased competition for places to train (at full price regarding fees of course) means those with ambition to succeed in a profession guaranteed to make them wealthy outweigh those who want to work in a caring profession. In addition, competition in healthcare will simply mean that the wealthy go to the expensive clinics and the poor to the low performing clinics or nowhere at all! It is yet another way for the Conservative government to push a wedge between the rich and the poor and widen the gap. Health is the most important issue for people on a daily basis. To consider the implementation of your plans with no trials to gauge the overall impact on people’s health is at best short sighted and at worst the blinkered path of Conservative ideology to the cost of the people! Above all, there must be a duty to provide quality, comprehensive healthcare. If this is eroded due to an inability to consider the needs of everyday people long term, this will be a sorry place to live under your governmen

  • Neil Lumby

    I want to make a contribution to the NHS listening exercise. I am deeply concerned that the changes that Andrew Lansley wants to make will end up actually damaging our health service.

    Whilst I can understand that the NHS may need some change I am completely opposed to the idea that it should be used as an opportunity to PROFIT from as opposed to CARE for the people of Britain as proposed/suggested your by your ‘adviser’ in the US recently. I’m also completely against using our scarce resources (we’re constantly told) to go through another costly change.

    It seems to me that the NHS forms a fundamental basis of the culture and attitudes of the British people. If health care is made the preserve of those who can afford it what impact will that have on the tolerance and fabric of the UK? I haven’t heard anyone talk about this and it concerns me…

    My impression is that the UK (the people) is in already in a very low state of morale – how can this help? You give the impression of being a completely uncaring and amoral government who really only sees the people as a resource to suite it’s own needs, agendas and possibly its own pockets.

    I would like to see some more attention given to investigating the ‘consultants’ who dip in and out of public and private service, destabilising and profiting at the expense of the NHS and (let’s be clear) the public who essentially fund all public organisations in this country through taxes.

    I expected better from your party (yes, I can see how you’re using the Liberal Democrats to deflect and confuse) – in fact you’re no better than the ‘shower’ you replaced. The only difference is that they favoured lining the pockets of public servants and you favour lining the pockets of private (and rather exclusive) organisations. The point is that I gave you my vote because I felt a change was needed and now I regret that completely.

    It WON’T happen again…

    I would also like you to consider these points… but I won’t hold my breath…

    I am concerned that new commissioning bodies will not be properly accountable and will not operate in a transparent way. GPs should not be able to take decisions behind closed doors, and other stakeholders including patient groups and other health professionals should also be involved.

    The NHS should focus on providing quality healthcare, not on competition. The role of the regulator, ‘Monitor’, should reflect this and promote collaboration.

    The government’s ‘duty to provide’ a comprehensive health service must be kept. Dropping this duty would erode the foundations of the NHS.

    ‘Cherry picking’ by private companies must be fully ruled out, and the mechanism for preventing it must be clearly established.

    Any changes to the NHS of the scale currently proposed should be trialled in small areas for several years first.

  • Jaqhuff

    Sorry, there were paragraphs in my submission, I don’t know why this removed them when I copied and pasted. I hope it’s readable :-/

  • Royston Simmons

    I have fundamental concerns about these proposed changes to
    the NHS and I think Andrew Lansley needs to review his decision and listen to
    public opinion, as MP are representitives of thier constituentsFor
    example, I am concerned that proposals to make competition the priority within
    the NHS would undermine our health service. The NHS should focus on cooperating
    to provide quality patient care, not on competition. The role of the regulator
    should reflect this.The NHS should focus on providing quality healthcare
    as a service for patients, and not competing for the most profitable treatments
    or procedures with the private sector and corporations interested only in
    profits and shareholders. It is the Governments duty to provide a
    comprehensive health service, free at the point of use for all. Avoiding
    discharge of this duty would be a failure of Government and would erode the
    foundations of the NHS and the health of the nation.Any new
    commissioning bodies should be democratic, transparent and accountable. They
    must not be allowed to meet behind closed doors. Patients and other health
    professionals must be represented as well as GPs.

  • Dorothy Stein

    As far as I can tell, Andrew Lansley’s plans are simply to destroy the aspects of the NHS as they benefit the patients and shift the current funding into profit for private enterprise. Don’t do it!

  • Dorothy Stein

    As far as I can tell. Andrew Lansley’s plans are simply to destroy the NHS as it benefits the patients and shift the public funding into profit for prvate enterprise. It is a terrible idea!

  • Anonymous

    I am contacting you to express my concern about
    Andrew Lansley’s proposed changes to the NHS. I do not support these
    changes, I think they are seriously flawed and that a fundamental
    rethink is needed.

    The fundamental concept of increasing the role of Monitor to promoting
    competition in the NHS is completely contra any notion of equal and
    universal health care for all. Competition is what drives the outright
    disgraceful health service in America, in which Insurance companies get
    rich by refusing to provide cover for such crippling mental health
    illness, or multifactorial disease such as Chronic Fatigue Syndrome. We
    are a long way from this, but the looming interest of the US health
    companies, and the increasing involvement of private companies focused
    on the neoliberal ideal of competition is putting us in the right
    direction. As state by the BMA the role of Monitor should be one of
    protecting and promoting high quality, comprehensive integrated
    services, not competition. Competition does not work out in the people’s
    best interests, even if its based on “muscular liberalism”, a concept
    which is as quietly detrimental as paternal liberalism. The votes of no
    confidence from a
    ll the major health care providers such have made this point clear
    months ago. They are the one’s running the show, and they know best.

    The NHS was built at the time of large post-WWII debt, with the
    government understanding it had a duty to provide of its people. We are
    citizens with rights, not customers with mutual obligations to the
    state. Strong neoliberalism which promotes the governments hands-off
    approach and passing the buck to private companies is not acceptable,
    and nor is it necessary, it is only an ideological principle of the
    markets which has no place in our health care system. The focus on
    private providers and competition is set to destroy the noble paternal
    foundations of the NHS, and is the first step to a backwards,
    discriminating, destructive health care system we see in America. I am
    completely opposed to such ‘reforms’, do not destroy our NHS.

  • Mdjcol

    I have fundamental concerns about these proposed changes to the NHS and I think Andrew Lansley needs to go back to the drawing board.
    The previous government wasted billions on paying Managers, Consultants and GP’s much to much instead of using the money to pay for the front line nurses, of which the NHS is still very short, and auxillary staff, who are the backbone of the NHS. My own hospital is staffed by a very high proportion of South African nurses ‘poached’ from abroad. Why are we not making it attractive and financially viable for our own youngsters to enter nursing and make a difference? Also, since our latest ‘cuts’ to the NHS budget were announced, (and according to the government we have been given more funding in the NHS) the only staff that are being ‘got rid of’ are in the main front line staff. The use of ‘policies’ like capability, performance management and sickness are being wielded like sticks over low paid staff to avoid paying redundancy payments.
    Who decides who stays and who goes? Thats right.. Managers.
    The coalitions seems to want to throw even more money at Managers, Consultants and GPs. How much do these people really need to live on a year? More than our own Prime Minister? I’m sure they’ll say they need some incentive to do the extra work being proposed!
     The GPs have enough to do as it is and cannot see enough patients now. To see mt own GP I need to book an appointment at least 7 days in advance. The real world is not that you can be seen within 24 or 48hrs as some ministers seem to believe! Where are they going to find the time to decide on funding issues when already they cannot see patients in a timely and prompt manner?
    If  they are going to hire people to make the decisions for them then this no different from the current position? It appears that the same people who are currently employed by NHS trusts will be employed by GP groups to manage the new funding system (as they are supposedly the people with the experience in the management of such funds)?
    It smacks of ‘Jobs for the Boys’ yet again. If they can’t manage our NHS and its funding now, why will they be better placed to do so with GP’s? Or is it the bigger pay packets they will all award themselves that will suddenly make them super efficient?
    In turn GPs will come under suspicion that they are pocketing the savings for themselves? This will only serve to erode their integrity.
    The current plans should be shelved and funding should be placed into the cands of consortia headed by the people, advised by nurses and support by GP’s.
    Managers have made a big enough ‘botch’ of our NHS chasing purely financial targets and pay awards for themselves. Only those with direct experience of and clinical backgrounds and experience should decide on funding. Managers who used to manage supermakets, truck companies, banks and other none health and care related businesses etc have no place in the NHS and the duty of care towards the citizens of this country!

  • CW

    I want to make a contribution to the NHS listening exercise.

    While I agree that there is room for improvement in the NHS I do not agree with the reforms being proposed by the government and do not believe they have a mandate to carry them out since they did not appear in the Conservative or Liberal Democrat manifestos.

    On the issue of GP commisioning bodies:
    I cannot see why it would be beneficial to make GPs themselves spend more time on procurement work taking them away from patient care. They are not trained to carry out this work either, therefore presumably the new commissioning bodies would have to employ specialist staff, experienced in administering health procurement. These staff already exist in the PCTs. The proposals will clearly require more of these staff than already exist therefore the costs will rise as economies of scale would be removed. This makes no sense. I have read that early adopters have already started to engage private sector consultants to carry out this work, adding yet more expense to the process and lining the pockets of shareholders to deliver a core public service.
    There may be a strong argument for clinicians and other stakeholders such as GPs having more influence over the NHS budget, so why not improve the PCTs to make their processes more efficient, accountable and inclusive.

    Procurement of standard goods and services in the NHS should be carried out centrally so as to get maximum value from contracts through economies of scales and zero duplication.

    Patient choice is often touted as a key consideration, however most people in the country just want to know that their local GPs and local hospital provide a top quality service. They do not want to have to choose their hospital or have varying levels of service in different areas.

    On the subject of increasing competition in the health service:
    Why? Evidence from workld wide sources demonstrates that price based competition leads to lowering quality. In addition personally I feel core public services should all be delivered at zero profit.
    Look at the mess of utilities and railways privatisation has made.
    The Conservative party appears to have a blind ideology that the free market is best even when evidence shows the opposite.
    I have a strong suspicion that the real aim of the Conservative party is to increase private sector involvement in public sector healthcare simply as an means to increase the profitability of these businesses (and vested interests) rather than for the good of the health of the nation.

    The NHS, like other areas of the public sector could be vastly improved by higher quality management and administration and less waste. A strong hand should be taken on all areas of the service taking ownership and responsibility. This is certainly not delivered by bringing in private sector consultancies. The private sector does not have a monopoly on efficient organisation; there is abolutely no reason why health services cannot improve by re-establishing the core objectives, simplifying processes and remvoing wasteful activities while remaining wholy non profit making.

    Finally, I am disgusted by the governments approach to evidence and specialist advice in general, mainly the fact that it ignores it but at worse the fact that it deliberately has misrepresented it sometimes saying that there is evidence completely opposite to that which exists.

  • Chloe

    This is what I wrote to the alleged Listening Exercise…

    ‘The wholesale, untested changes you are proposing for the NHS are far toorisky.’Your insistence on ‘competition’ will lead to profiteering by commercialcompanies and horrible consequences for patients. The NHS is a service nota business. If you and this government muddle the two, you will beresponsible for ruining quality of life for people already suffering quiteenough, and you will cause conditions that lead to avoidable patientdeaths.’The NHS isn’t perfect.  Serious review is always useful PROVIDED YOUGENUINELY LISTEN to the people working at the sharp end – in this case,medical professionals across all roles.’I have little confidence in this government’s honesty in reforming anythingbased on people’s real needs. In your first year it is my perception thatthis government has shown only that it is hellbent on destroying what itsays it will protect.’Please prove my cynicism and increasing despair unfounded – by allowingyour reforms to be directed by a proper mix of GPs, other healthprofessionals and patients; and leave the process properly open to publicscrutiny.’

  • Davidwindle

    I have fundamental concerns about these proposed changes to the NHS and I think Andrew Lansley needs to go back to the drawing board.

    For example, I am concerned that proposals to make competition the priority within the NHS would undermine our health service.

    There are only 3 points I would like to make:

    1. Doctors should not be responsible for managing accounts withsuppliers, dealing with contracts, or any other essentially business management and admin tasks. Doctors are highly trained specialists in health care – this single skill and duty should retain unique value unsullied by having to spend time managing the local healthcare network.

    Doctors should work in conjunction with specialist managers – as they do now, I believe.

    2. I object entirely to the mantra ‘introducing competition into the NHS will raise standards’. For me, this is entirely ideological. Competition is not the only way to drive standards, and tends to produce a culture of cutting costs and undermining opponents etc.

    Competition skews the priority of the providers, engaging them in a market battle with competitor agencies, as opposed to focusing on the quality of the service ie providing healthcare to the best of their abilities without feeling threatened and stressed out by being in some kind of health care gold rush/rat race.

    Collaboration is the key. And the ‘state’or government is the facilitator of this collaboration. Healthcare should really have nothing to do with competing interests. It is in all our interests that it is good, and the governement should retain their duty and responsibility to provide this.

    It is Conservative mantra that the state is negative and should be reduced, but in fact the state can be positive if it is given such regard. If it is given value, if it takes on its duty to care for the citizens.

    I will only ever vote for a government which says ‘healthcare is essential and too important to open to market forces, profit motives or unnecessary competition.’

    3. Choice – the goverment talks of choice as a positive in healthcare,as if what any patient lacks and really desires is a choice of healthcare providers.

    Well, I totally disagree. All anyone wants is a trusted healthcare provider, not to be forced to evaluate different brands and select the best based on a series of reviews online! If you are seriously ill, all you want to know is that you will be taken care of, not to fear that by making the wrong choice of provider you could end up writing your bad review of them from beyond the grave!

    If construed effectively, if ‘spun’ appropriately, the NHS could be a highly valued, governement run trusted British institution which is admired throughout the world and marvelled at for its ability to retain central human values unsullied by the market place.

    Please do not introduce any more competition into the NHS. I cannot vote for it.

  • Charles

    NHS has always done me proud, can always be improved, but don’t sell off the profitable bits to your mates!!

  • Helengee2000

    I am very worried about Mr Andrew Lansley’s plans for the NHS. I think he is trying to change too much, too quickly,too costly. I feel the NHS will crack under the strain;that patients will suffer as a result.Personally as a patient I’m experiencing the impact of the coalition government preparations for health reforms are having on the NHS now.It total chaos. There’s very little integration.Much of the infrastructure that use to to link care from one unit to another has gone.The left hand does not know what the rights up to.How the coalition can sanction that when its the health reform bill not even be agreed is beyond me.This is leading to avoidable deterioration in patients health.Costly both in personal sense to patients but also ultimately to NHS in budget;that deterioration costing more to treatment.Thought this coalition was about saving money not wasting it.Want patients want is quality healthcare not competition.They want collaboration and integration the same as promise to cancer care.Its not appropriate for private companies to be taking any savings or “profit” out of NHS.If the coalition insist on that route that money,those savings or “profits” should stay with in the NHS budget and be use to treat more patients.Re GPs controling the majority of the health budget.GPs understandably don’t have the time nor the skills to commision appropriate health care;especially specialist healthcare.Patients health needs can not be covered by one size fit all approach.What happens if as a patient you got a poor GP.Transfer to another?Many small towns,etc only have access to one practice. Those practice tend to speak with one voice.Impossible to second opinion or hold someone accountable as is.Whose ever is commissioning care they should be transparent and accountable Their decisions are potential life changing .Patients,other heaslth professionals must be represented on commissioning bodies as well.

  • Bill Grigg

    How many members of the public, and for that matter member of the NHS, realise that GPs are NOT, repeat NOT employess of the NHS! Since 1948 they have been ‘independent contractors’. In effect Andrew Lansley wants to give the NHS budget to private contractors who are not under direct management control of the NHS no mater what ‘monitoring ‘ mechanisms are put in place.

    Also it is a gross missrepresentation to say tat as a lot of GPs have joined consortia they support the proposals. The majority do not want to  change but do not want to be forced to join a group they may not want to!

  • Lianne

    All I can do as an ‘ordinary’ member of society is echo the thoughts expressed by the BMA in their submission – extract below. The Government’s acknowledgement that NHS staff and many others have genuine and significant concerns about the Health and Social Care Bill is welcome. The listening exercise is an important first step in responding to these concerns but it is vital for the future success of the NHS that it results in major changes to, if not withdrawal of, the Bill. This briefing summarises the BMA’s response to the Future Forum, which is overseeing the listening exercise.1It is clear from the deep seated concerns, expressed by stakeholders across the health sector in recent months that the legislation is fundamentally flawed. Introducing radical reforms in a period of the mostchallenging financial constraints ever faced by the NHS is an enormous risk.2The disquiet among the health profession is being exacerbated by the speed at which change is already being implemented on the ground – before any legislation has been agreed and continuing even through the listening exercise. The BMA continues to believe that the best solution would be withdrawal of the Bill. Failing this, the Government should introduce significant changes to the Bill to mitigate the likely negative outcomes and maximise the potential of achieving its more positive aims. While we share the Government’s objectives of giving clinicians greater responsibility for commissioning and shaping local health services, increasing public and patient involvement, and putting a greater focus on improving public health, most, if not all, could be achieved without any legislation.Please will you finally hear our concerns and stop this now.

  • Rob Mac

     I.m sick of the relentless privatisation of public services
     The NHS  was once the envy of the world ; not anymore
    The UK’s  privatised public services have benefited only multi- millionaire comp. exec’s. & shareholders
    The rest seem to be unimportant .
    Private transport systems , train , buses & so on  do cherry pick the best profitable routes .
    Once again these companies have increased their fares  ( that’s twice in 6 months! )
    We copy the american system which only benefits the rich over there .
    Even though they have more competition ; cause of America’s size
    They’re system still doesn’t work too well for ordinary americans .
    Some US residents having worked all their life then find that their health care insurance does not cover them when they do take ill & a lot just crawl  away  in to a corner & die .
    Apparently at the last count —30 million  americans had no health care insurance at all.
    My own experience of insurance companies here in the UK is that when youmake a claim about anything ( health , house ins.,  life ins, car ins, buliding contents ins & so on)
     These companies desperately try to find a way to not pay out ( as they don’t care about people )
    Only about making a profit , sorry to say .
     There’s no such thing as a free market economy as  most comp. have to be given Govt. grants( handouts not loans).  Even when they’re making massive profits.
    I’m at an age now when I’ve watched these changes only make things worse for most people.
    Time to wake up people & find your voice .  For the sake of your kids, parents , bro’s sisters , whatever .
    This govt. wants even more failed privatisation to benefit themselves & their business associates.  
          Disgusting, Despicable , Dishonest & perverse.
                  RWJM

  • Paul Denham

    In any large organisation, there are inefficiencies and always ways of doing things better. The NHS is no exception.However, the best organisations are well-managed and it makes no sense to me to get rid of highly qualified, professional managers, and to hand control of enormous budgets to GPs. I want my doctor to spend all his time treating his patients and not commissioning services. The NHS has one of the lowest administrative costs of any health provision in the developed world and it is not helpful to denigrate PCT commissioning staff as “expensive bureaucrats”

  • Bill Grigg

    The problem of the NHS is that none of the changes over the past 20 years have been given a chance to work before yet another change has been forced upon us.

    Put simply, consider the NHS as a huge, ocean going tanker, changing direction is slow and must be done with care to avoid disaters. The politicians have been treating it like a speedboat on the local lake! We have so many bits of previous changes still in place but no longer effective.

    We need to be left alone to sort out the mess before yet another re-organisation  results in more experience being lost and more wasteful use of management consultants which will only make thing worse!

  • Jane

    The ethos of the NHS is dear to my and my family’s heart. We believe in it and do not want it fundamentally altered to make way for private firms to make a killing.These fundamental changes were not in the Conservative party’s election manifesto. You do not have the public mandate to do these radical changes. They are not wanted.Monitor should focus on quality not competition.I am very concerned that the legislation proposes to remove the Secretary of State’s duty to provide a comprehensive health service. I think the duty to provide a comprehensive health service is crucial and should be retained.I had thought that the health service was safe in David Cameron’s hands, clearly it is not.I had thought that the conservative party’s ethos was to conserve those things that are good…..well, the NHS is a good thing and needs to be conserved!

  • Jaynebloke

    I have fundamental concerns about these proposed changes to the NHS and I think Andrew Lansley needs to go back to the drawing board.I am a pharmacist , I have worked in the USA in the past and I can’t understand why we would want to model our health system on theirs, a system where competition rules. It is a system with very little regulation and standard treatment practices leading to poorer care and great influence by pharmaceutical companies whose only goal is money making, not patient care!Their standing in the WHO ranking of health systems is 20 places below ours. I don’t see how mimicking this system makes sense. I am concerned that proposals to make competition the priority within the NHS would undermine our health service. The NHS should focus on cooperating to provide quality patient care, not on competition. The role of the regulator, “Monitor”, should reflect this.

  • David

    I have seen FIRST HAND the extremely POOR QUALITY OF CARE provided by a “private healthcare company” which has been given “outsourced contracts” by a health authority.

    The “private healthcare company” worked from an office on an industrial estate and ran under a name like “QualityCare Limited”. It applied for contracts whereby it would be required to provide healthcare to sick people in their homes. The company was adept at winning contracts from the local health authority.

    The reality of this private “healthcare” company’s “service” was as follows:

    - Although its workers were scheduled to visit patients at set times, morning and evening, its workers were nearly always late, by twenty minutes or more, but, most perturbingly, sometimes they were late by several hours, when the purpose of their visits were partly to administer VITAL medications at set times each day, medications that MUST be administered at set times. The “private healthcare” provider thus caused patients (and their concerned relatives) constant anxiety, and, by not administering medicines at the prescribed times, it jeopardised and compromised patients’ health.

    - The majority of the “carers” that the “private healthcare” company employed to attend to the sick in their homes had not been born in Britain, were not fully able to interact in British cultural behaviour, and, most alarmingly, could not speak English fluently. Some of them could BARELY speak English to their patients. The “carers” therefore could not communicate expertly with their patients. The workers it employed were, in fact, cheap labour, and this was, of course, to the advantage of the employer.

    The “private healthcare” company, however, won the contracts it desired, and was able to pocket much of what it was paid by the local health authority.

    It is in the interests of “private healthcare” companies to fight for contracts, to give every IMPRESSION that they are capable of doing the required work to a very high standard, but it is in their profit-driven interests to then cut their own costs in order to maximise their profits. Private healthcare companies are NOT vocationally-driven.

    The “private healthcare company” is profit-driven, despite any declarations of holding, above all, a desire to selflessly assist others.

    Therefore we must ELIMINATE private healthcare companies from the entire NHS and return fully to the principles on which the NHS was founded.

    Mr. Lansley’s “reforms” are therefore fatally flawed and must be rejected.

    What is required regarding the NHS, is the slimming-down of management and driving the management that remains to be far more efficient and facilitative.

    We do not need to create a new form of health system.

    Destruction is easy and gives false impression of creating improvements.

    REALLY IMPROVING what HAS BEEN CAREFULLY BUILT-UP ALREADY is far more challenging. Mr. Lansley does not appear to be up to this task.

  • Gabrielle

    I am a child and adolescent psychotherapist working in the NHS in CAMHS. There has been, for some considerable time, a need in the NHS to provide an evidence base for the treatments provided. This is in spite of the fact that, other than drug companies, many therapeutic modalities do not the resources to gather evidence. Case histories are decried as not being scientific yet randomised controlled trials are enormously expensive and frequently do not show the reality of working with complex cases. Having said that we do need to know that our treatments are effective before we can h ope to be funded.On what basis are the proposed changes to the NHS evidence based? What RCTs have been done on clinical populations to demonstrate the effectiveness of the proposals? Which areas are going to trial current proposals before all the NHS has to undergo major change? How long are these trials to be in operation before sufficient comparative data is gathered to show that it would be a sensible use of resources to make the proposed major changes? What long term studies are proposed to follow up the impact of change on a wide population over time?You should not make changes to the NHS without evidence that you are making real improvements

  • Tim Cooke

    Copy of letter to Andrew Lansley

    I am writing to you because I think what you are planning to do to the
    NHS will ruin what is, for the money, even now without reform the
    world’s premiere health service. Obviously, Blair and Brown pumped in
    money (doubled the NHS budget) without bringing about significant reform
    and increased productivity and the result was a bloated management
    structure and endless amounts of money wasted on the kinds of things
    that managers like spending money on – pr, conferences, trips abroad,
    new logos, glossy magazines, more managers etc. But the system itself
    has been t
    ried and tested over 60 years and it works – it just needs reforming.
    If power should be in anybody’s hands, it should be those of nurses and
    consultants, not managers and certainly not GPs who are not specialised
    enough to know how money should properly be spent on the people who come
    to see them with conditions that they can’t treat. It should also be in
    the hands of the consumers of the service and this should
    counter-balance control exercised by hospital front-line workers.
    Managers should be kept to an absolute minimum, only exist when and
    where their job cannot be done by nurses, consultants and other trained
    healthcare professionals, and they should be paid on the same scale as
    other hospital workers, not on their own exorbitant scale. The NHS is
    and should be fundamentally based on a team approach with everybody who
    works within it valued equally and paid accordingly – it should not be
    structured according to ideas and models derived from business which may
    well be s
    uited to producing widgets on a production line (though if we look at
    the far east and Germany they use a team approach and are much more
    effective producers of goods than either us or the US), but which are
    not applicable to treating multi-factorial health conditions. Millions
    of people across the UK are opposed to the changes you are proposing to
    make – they are both the consumers and the workers within that industry
    and if you claim to be a democrat, I urge you not to ignore them.

  • Peter Cooke

    I am deeply concerned about the proposed changes to the National Health Service. I have read with great concern about the stance taken by the doctors own professional body. The apparent paucity of public accountability in the proposed scheme is also of great concern considering the vast amount of public money required to provide a comprehensive health service.For example, I am concerned that new commissioning bodies will not be properly accountable and will not operate in a transparent way. GPs should not be able to take decisions behind closed doors, and other stakeholders including patient groups and other health professionals should also be involved.“Cherry picking” by private companies must be fully ruled out, and the mechanism for preventing it must be clearly established.Placing competition at the heart of our health service is a recipe for disaster.I must ask you to defer this change until comprehensive pilot schemes have been undertaken (please not in my area).

  • http://www.facebook.com/tim.mullen1 Tim Mullen

    Dear NHS listening exercise,I am writing to register my deep concerns about Andrew Lansley’s NHSproposals.For example, I am very concerned that the legislation proposes to removethe Secretary of State’s duty to provide a comprehensive health service. Ithink the duty to provide a comprehensive health service is crucial andshould be retained.The NHS should focus on providing quality healthcare, not, under anycircumstances, on competition.  The role of the regulator, “Monitor”,should reflect this and promote collaboration.The government’s “duty to provide” a comprehensive health service MUST bekept.  Dropping this duty would erode the very foundations of the NHS thathave served this country so well since 1946.”Cherry picking” by private companies MUST be ruled out, and the mechanismfor preventing it must be clearly established.Any changes of this scale to the way in which the NHS operates should betrialled in small areas for several years before being rolled outnationwide.Any new commissioning bodies should be transparent and accountable.  Theymustn’t be allowed to meet behind closed doors.  Patients and other healthprofessionals must be represented as well as GPs.

  • Gill Greetham

    I have several fundamental concerns about proposed changes to the NHS. I think it is time to go back to the drawing board.For example, I have not so far been reassured by what I have heard from the government on the issue of “cherry picking” of NHS services by private companies. “Cherry picking” could be extremely destabilising to our health service, and there must be a clear plan and legal mechanism to rule it out.Please STOP spending OUR monies raised through OUR taxes on expensive management consultancy reports which in the end tell you nothing that senior management hasn’t. Install the matrons back into hospital and take away the expensive management tiers replacing with trained clinical staff. The total amount of money wasted in reorganisation is shameful and YOU should be ashamed of yourself for trying, as many previous health ministers have, of reinventing the wheel!!yours sincerelyMrs G Greetham

  • Vicky Seddon

    This is the submission I have made I believe the changes that Andrew Lansley is proposing will damage our health service. They have the clear intention of opening the NHS to the private sector, with public money then producing profits for companies, instead of being dedicated to patient care. There is no consensus that GPs are the only appropriate group of health care staff to be involved in commissioning. Other stakeholders including patient groups and other health professionals should also be involved.Another massive re-organisation on this scale is not needed by the NHS. It seems that Mr Lansley and his colleagues have no idea of the degree of disruption that a re-organisation causes, or how the attention of staff becomes distracted from the purpose of providing health care, with anxieties about job security or job change becoming widespread. Any redundancies then have to be paid for, and a re-organisation of the scale suggested means a lot of redundancies. This is not the best use of resources for NHS. In my opinion, the bill should be abandoned.

  • Elfie Muller

    I am writing to register my total opposition to Andrew Lansley’s NHS proposals.
    For example, I am apalled that the legislation proposes to remove the Secretary of State’s duty to provide a comprehensive health service. I think the duty to provide a comprehensive health service is crucial and should always be retained.
    Furthermore, letting private companies in to provide services as well as promoting internal competition must be ruled out. The NHS should concentrate on providing quality healthcare for everyone and I, as a contributor to the funds for the NHS, object to see my money used to generate fat profits for private companies and their shareholders.
    I wish you would scrap the whole exercise – enough money has been wasted on it already!

  • Adrienne Howard

    please do not take the British public as fools– it is private privatization through the back door. The National Health Service has been fought for over for many years by millions of people.  It is a national jewel in the UK Crown — the envy of the world.  It is working, don’t fix it!

  • Ruth Fishkin

    Message
    Although I live in Scotland, I am seriously concerned about
    proposals to change the ethos and practice of the NHS in England and Wales.I
    have realised that this issue is driving my thinking towards voting for Scottish
    independence in the promised referendum.I am very worried about Andrew
    Lansley’s plans for the NHS. I think he is trying to change too much, too
    quickly, and in the wrong ways.I am an immigrant to the UK; I spent the
    first half of my life in the USA and have first-hand experience of life with a
    privatised medical system. It is expensive, unfair, and it has cost me the
    lives of friends. The bottom line is, that when health care provision
    becomes a business run on market models rather than a service with the
    presumption of universal entitlement to decent care, people die who
    shouldn’t.People go without care.I believe that the changes proposed are
    taking UK health care in this direction; and it is a bad one that most of us
    will have cause to regret before we die.The NHS should focus on providing
    quality healthcare, not on competition. The role of the regulator, “Monitor”,
    should reflect this and promote collaboration.The government’s “duty to
    provide” a comprehensive health service must be kept. Dropping this duty would
    erode the foundations of the NHS.

  • Maryamcollard

    I have several fundamental concerns about proposed changes to the NHS. I think it is time to go back to the drawing board.

    For example, I have not so far been reassured by what I have heard from
    the government on the issue of “cherry picking” of NHS services by
    private companies. “Cherry picking” could be extremely destabilising to
    our health service, and there must be a clear plan and legal mechanism
    to rule it out.

    I have also recently had excellent service from Moorefields and would hate for their services to be affected.

    Also recently my son was admitted to Queens Hospital in Romford, and my
    daughter in law was admitted to the same for the birth of her third
    child, the service in both instances was appalling. Admission and
    release taking up to 12 hours, dirty floors and facilities, elderly
    people being left food they were unable to eat (despite the large notice
    on each bed saying to feed the patient), notes with private information
    left open at the nurses station, large numbers of staff on the ward but
    no one to answer the phone or the ward doors (which were locked). The
    general attitude of the staff from Doctors down was that they were doing
    you a favour, lets get the attitude and the basics right before we
    start throwing the baby out with the bathwater.

  • Jw

    The NHS provides a SERVICE it is not intended to make money, the internal
    marketplace you will create will encourage private, for-profit firms with
    diametrically opposed priorities to those of the National Health SERVICE to
    bleed the NHS dry.

    Your plans are fundamentally, ethically and finacially unsound.

    Your ‘listening plan” seems nothing more than a sham.

    Prove that you are not the mercenary, ‘I’m alright Jack’ party that supports
    the rich.

    Surprise us all and show that the conservatives are the party for everybody
    and amend your NHS reforms.

  • Pipeman

    I agree – it seems incredible that there should be no requirement for the Secretary of State to provide a comprehensive health service. If one is to extend that policy, imagine also a Secretary of Stae for Education with no duty to provide a proper educational service to the country, or a Defence Secretary who had no obligation to provide a system of defence if we were attacked (that would have worked well in 1939!). So are Cabinet members to just become ornaments? If I want ornaments, I prefer garden gnomes – they’re more useful than most Govt ministers anyway, whatever the party. 

  • http://twitter.com/Civilwords Paul Houldsworth

     The public heard “no top down changes to the NHS”
    Andrew Lansley have you heard and listened to the public no changes to the NHS the public service that we fund and love?

  • Anni

    My husband and I have had , in the past few years, excellent service from the NHS. We have nothing but praise for the care and treatment we have received. We object strongly to this Govts attempt to take us back to year zero. The present Cabinet was not ‘born to rule’, it is there for the will of the people who elected them and to listen to what we, the people of this country, want.

    As with all large organisations there are things about the NHS which may need attending. But to carve up this excellent and world envied service, which contrary to the view of this Govt is held in high esteem by those who use it, is doing a disservice to all who use the NHS and those who work so hard to deliver it.

    Please desist from destroying our NHS..

  • http://www.facebook.com/profile.php?id=725501535 Matthew Hardy

    I have fundamental concerns about these proposed changes to the NHS. I think
    Andrew Lansley and the Tory Party need to go back to the drawing board with this
    legislation. This may be a difficult step, but it would be a big and bold step
    that would have the confidence of the British people.

    I am particularly
    concerned that proposals to make competition the priority within the NHS would
    undermine our health service. The NHS should focus on cooperating to provide
    quality patient care, not on competition. The role of the regulator, “Monitor”,
    should reflect this.

    I do not wish the NHS – now enjoying record levels
    of popularity – to suffer the fate of so many other privatised or
    part-privatised government agencies. One only has to look at the series of
    disasters on the railways following years of neglect after privatisation, or the
    endless delays and vast cost of the London Tube upgrade, to see what the outcome
    of the NHS bill may be.

    I speak from personal experience, as I had
    life-saving care in the NHS twice in 2007, and was greatly impressed by the
    dedication and efficiency of the service.

  • Tom Heavey

    Drop the NHS plansMessageI’m making this submission to the NHS listening exercise because I have many concerns about the proposed changes. I think it’s time to drop them.For example, I am opposed to the proposal to scrap the Secretary of State’s duty to provide a comprehensive health service. This is a duty which has been fundamental to the operation of the NHS ever since its formation. It must be retained.An NHS nurse for 10 years puts succinctly, what I agree with one hundred per cent: “The key points of the health service: free delivery at the point of access, care in response to need, applicable to all.As soon as commercial interests enter the equation, these objectives become distorted and destroyed. The NHS needs to be a well-regulated publicly-responsible independent organisation funded by taxpayers and answerable to taxpayers.Cherry picking by commercial companies would leave the truly importantdifficult areas of care exposed. The doctors do need to be at the centre of prioritising decisions, but not thentrapped in a forest of administration and unable to practice their skills.An NHS Monitoring Body could consult doctors and implement their decisions in a transparent way, answerable to taxpayers.”(Health) CARE before competition.PEOPLE before profitsYours sincerelyTom Hea

  • Steve Steventon

    I want to tell the NHS listening exercise that I am disgusted by Mr Lansley’s proposals for the NHS.There is no evidence base for these changes therefore they are ideologically driven. The ideas are about what government should be and not what good health care is.

    Big changes in big organisations lead to big problems. This is a basic fact. At best this scheme is naive, however it looks more malicious than that.

    The changes proposed will not cut the cost to the tax payer or deliver better services. What they will do is deliver vast profits to private companies. There is no use pretending otherwise. The same people will have the same medical needs and will almost cetainly be provided byt the same staff but on lower pay in less secure employment so that managers and share holders can make profits. There is no merit in any of this.

  • Ianflockhart

    I firmly believe that the impetus behind these changes to the NHS is being
    provided by the profit motive. Big business is working through rich Tories to
    make a major killing over the next few years. We will have multi-nationals
    raking in a lot of money over the first years of the privatisation, which it is,
    and then simply moving on to find something else to destroy. They WILL cherry
    pick given the opportunity, and without a doubt, this government will give them
    that opportunity.

    The promised transparency in the new commissioning
    bodies will be a joke; appeals to an independent body, such as a PCT, will
    either not be possible, because they have been closed down, or will be
    meaningless because we will be appealing to the fox that is killing the
    chickens.

    GPs should not be able to take decisions behind closed doors,
    and other stakeholders including patient groups and other health professionals
    should also be involved.

    Additionally, the government’s duty to provide a
    comprehensive health service is a foundation stone of our health service; remove
    that and you collapse the whole system.

    How can anyone who has had the
    chance to look at the American health care system think that ours will end up
    any different in the hands of private industry!

  • Charliecox28

    My daughter’s recovery from her Brain Haemorrhage became possible because she had faith in the collaborative exercises and Care Plans which were devised especially for her. I was involved EVERY STEP OF THE WAY and this gave me the confidence to know that my daughter was getting the best, emotional and physical care possible. Some people describe her recovery as a miracle. I believe it is because my daughter felt so positive about the TEAM of collective interested parties, that she felt that anything was/is possible. Take this away, take the decision making totally away from the ‘client’ and the people at ground level, then you will be seriously liable for the deaths of our precious future generations! WHOSE LISTENING NOW?!!!!!!

  • Jaybeepip

    The NHS should not be about competition but caring for the ill and vulnerable people placed in its care. Is Mr Lansley a doctor or connected with the medical profession? Does he know what is going on behind the scenes – I mean in the wards, the concern of the patients and their needs?

  • Trevor bushell

    this is a very angry letter from an NHS worker who has been apalled so far by the lack of care for our vulnerable since the lib/con have started running the country (pushing cuts thro public sector, housing benefits, university fees, stopping ema and it goes on).

    it is in my opinion this nhs bill that you intend to rush through is rather similar to the way you have dealt with the bankers crisis . That is, to look after your rich beneficiaries!! can you writie to me explaining why this is not true, because to me and many others this is how it seems!?

    My opinion-
    THE BANKS-
    you managed to save the rick bankers from becoming personally liable financially for the crash that they caused through their greed and competition. they were not penailised for their errors and you did not make any noise when we heard they were still going to hold onto their fat bonuses!!! Why? to priotect your beneficiaries. who suffered? the poor and vulnerable!!

    THE NHS??
    the same- You have links with private enterprises who fund you (ie- John Nash who manages several other businesses providing services to the
    NHS recently gave Mr landsleys personal office money)! who will suffer? the poor and vulnerable!!

    it is my opinion that this conservative liberal alliance has no regard for the poor and vulnerable. it is in my opinion that your motivation is flawed, slefish, greedy and immoral

    the NHs has suffered from bringing in private cleaning and catering services which have failed. that compettition has not helped but hindered the NHS!!! it will be the same if you do this to hospitals and services. only fully private system in the world is the US system, which has some of the worst outcomes overall

    leave our health service alone…. and more than that have a heart for the poor and vulnerable instead of focussing making policies that create greed and line the pockets of the wealthy and successful.

    i would like a reply to this letter from you explaining the evidence and research that you have got that shows this change in the NHS will be good for us? i believe that you have no evidence and are trying to rush this thro before people realise. even the listening exercise was not properly advertised, many of us did not hear about it till almost too late.

    Yours sincerely,

  • http://www.facebook.com/people/Martin-Seager/100001782635305 Martin Seager

    These proposals break a pre-election promise not to reorganise the NHS yet again and so are another major breach of trust with the public. They create further cynicism about the quality of democracy in our political system. These proposals will also further turn the NHS into a commercialised and fragmented culture run on market principles rather than humanitarian ones. Staff, instead of being valued in their professional expertise and vocational commitment to public service will become demoralised, disempowered workers in a series of unaccountable corporations. There is no evidence for these proposals and most of the experts are against them. The listening exercise should have happened earlier and now looks like a cynical attempt to buy time, save face and create a false impression consultation. There has been no pilot. Why not? What is there to like about these proposals? The best GPs will not want to get into commissioning and those that do will just rehire all the old PCT people. This will cost more money to create an essentially similar commissioning system but the introduction of private competition will turn the NHS into a mass of commercial dealings and contracts based on profits and bottom lines that have no bearing on the sufferings and personal health needs of our citizens. Health care is all about trust. These proposals threaten to kill what trust there is left in the NHS for beleaguered staff and taxpaying patients alike.

  • Ken Ulrich

    The utterly ill thought out ideas, nay irresponsible, of Mr Lansley, backed by David Cameron, will tear our wonderful NHS. apart.
    They say they are listening to the public but with so very many, including doctors and nursing staff opposed to the outrageous plans, if they still go ahead, the ‘listening’ exercise will have obviously been  a complete sham.

    The general public is not stupid and realise if the Healh Service ,upon which they depend on so much for themselves and their families is broken up ,many lives will inevitably be put in jeapardy.

  • Geraldine O’Connor

    Hi all!  Geraldine O’Connor here! The day after we handed over our massive petition to Nick Clegg I went down with flu.  Rather ironic!  I’ve been so impressed by everyone’s passion over this issue.  O.K. the NHS has it’s flaws, but it is precious.  Even Barack Obama expressed his admiration for it during his visit.  Let’s hope that Lansley rips up his ill thought out plans and slides under the nearest available rock!  Together we are strong and can move mountains.

  • Ashley Leaney

    “I hereby set out my concerns about Andrew Lansley’s proposed changes to the NHS. I do not support these changes, I think they are seriously flawed and that a fundamental rethink is needed.

    For example, promises to prevent “cherry picking” are very vague. How will this be prevented in practice? IT WILL NOT. There needs to be much clearer plan to safeguard NHS services and prevent private companies destabilising them.

    Privatisation has been shown NOT to work for such vital services as Rail and Gas and Electric. All of those services are anti-competitive, and over-priced due largely to ‘confusion marketing’ and in the case of fuel, large companies undercutting small companies to facilitate take-overs.

    Allowing the level of privatisation proposed by this government will – regardless of what this government says – damage the NHS and will NOT make it more efficient as a whole.

    It will, of course, make healthy profits and bonuses for managers and shareholders at the expense of the taxpayer.

    Nationalised industry and efficiency are NOT mutually exclusive concepts if nationalised industries are properly run and receive realistic state investment.

    FIX the NHS – don’t sell it off for profit or make it a Conservative cash cow.”

  • James

    I want to make a contribution to the NHS listening exercise. I am deeply concerned that the changes that this government wants to make will result in catastrophic damage to our national health service.
    Given past efforts to introduce ‘competition’ into areas of public services and life and their abject failure to deliver on their promises I have no confidence of a better outcome for the NHS. These proposals really seem like more of the same. They are both hasty and ill conceived and I believe will cause irreparable damage to the service we all rely on.
    These proposals are opposed by the vast majority of both the professionals within the NHS and the general public, surely this factor alone should be more than ‘pause for thought’ by the government?
    GP’s do indeed have insight into their patients needs but this does not make them the right people to ‘do’ the commissioning. I have many years professional experience in procurement both in the public and private sectors and personally do not believe that GP’s either have the necessary experience to achieve the best results or, where the skills do exist in their consortia their time spent in these activities would be an unwelcome burden, distracting them from what we pay GP’s to do. They are extensively trained in medical practice not procurement.
    The likely outcome of this is not GP’s commissioning at all, but a giant, fragmented new low level of bureaucracy being created in the NHS unable to drive value by leveraging the marketplace through aggregation.
    I am also concerned that new commissioning bodies will not be properly accountable and will not operate in a transparent way. GPs should not be able to take decisions behind closed doors, and other stakeholders including patient groups and other health professionals should also be involved.

  • Henrycatuk

    Instead of instigating
    major reform of the NHS at vast cost and with no guarantee of it working why not
    simply fix the bits that don’t work. Most people are happy with their treatment
    on the NHS so most of it doesn’t need changing

  • Geraldine O’Connor

    Hi
    all!  Geraldine O’Connor here!

    Have
    a look at this: 
    http://www.38degrees.org.uk/NHS-listening-exercise

    I’ve
    just sent a message to Andrew Lansley’s NHS “listening exercise” telling him
    why I want him to keep his hands off the NHS.

    If
    we submit a large number of responses to the listening exercise it will be
    harder for the government to get away with using it as a cover to make only
    small changes to the NHS plans. The more of us that act now, the more chance we
    have of saving the NHS.

    Please
    click here to send a message to the NHS listening exercise – it takes just two
    minutes:
    http://www.38degrees.org.uk/NHS-listening-exercise

    Once you’ve filled in the field boxes with
    your name, email address etc., these will automatically be transferred to the
    letter you send.  ‘Andrew Lansley’ will
    automatically appear after ‘Dear’ and your name will automatically appear at the
    end.  Use the suggestions, but don’t be afraid
    to personalise your letter.  It will only
    take you a few minutes to move mountains! 
    Thank you.

    Here is what I wrote:

    I’m making
    this submission to the NHS listening exercise because I have huge concerns
    about the proposed changes. I think it’s time to drop them and start again.

    For example, I am opposed to the proposal to scrap the Secretary of State’s
    duty to provide a comprehensive health service. This is a duty which has been
    fundamental to the operation of the NHS ever since its formation. It must be
    retained.

    The NHS should focus on providing quality healthcare, not on competition. The
    role of ‘Monitor’ should reflect this and promote collaboration.

    The government has a duty to provide a comprehensive health service. Dropping
    this duty would erode the foundations of the NHS.

    “Cherry picking” by private companies must be ruled out, and specific
    words will have to be included in legislation on this matter to ensure that it
    is prevented.

    Any changes to the NHS of the scale currently proposed should be trialled in small
    areas for several years first.

    Any new commissioning bodies should be transparent and accountable. They
    mustn’t be allowed to meet behind closed doors. Patients and other health
    professionals must be represented as well as GPs.

    There must be no “backdoor privatisation” of the NHS.

    Your plans, as they currently exist, threaten the NHS as we currently know it.
    I am not going to stand by and watch this happen!

    As an epileptic I depend on the NHS on a daily basis. Please think again and
    listen to what patients and professionals are telling you!

  • Gabrielle

    People might like to answer the questions on this
    survey by The Patients Association: https://www.surveymonkey.com/s/2LH5RXB

  • http://twitter.com/ellyoracle Elly W

    Here’s my submission:

    I have worked in the NHS for the last 10 years as a pharmacist, working closely with doctors and nurses. I have worked for a large teaching hospital and with GPs, and have an understanding of both primary and secondary care provider concerns, as well as most importantly the patients. I want to tell the NHS listening exercise that I am very worried about Mr Lansley’s proposals for the NHS. I think he is going about reforming the NHS in completely the wrong way.I believe that the NHS is still seen as a treasure by the British people, providing comprehensive team-led care which would be completely inaccessible to many in a privatised system. The thing you have to understand is that the way the NHS provides training for staff, and the way it works, breeds expert practitioners and expert care, with staff working in teams to provide accountability and considered decision making. Patients who believe that “private is best” are often labouring under a misapprehension. What most people don’t realise is that care in the NHS is provided by teams, and in private healthcare care is led by individual consultants whose staff fear to challenge them because every consultant means money for the private enterprise. (I have colleagues working in private healthcare who see this time and time again). , so while they can be great for routine cases, conditions and patients, throw a curveball and things can get missed. Private hospitals generally don’t have the variety of patients to possess these facilities for critical or complicated patients, nor the regularity of practice to ensure its currency for such situations Private consultants are also used to working with excellent NHS facilities, and they sometimes forget that they don;t have these in private hospitals and will go ahead regardless. This behaviour goes unchallenged because it is consultants who bring in the workload and thus the money – a dangerous culture of hierarchy which has been virtually eradicated in the NHS since the Bristol Heart Babies case and the introduction of clinical governance awareness amongst frontline staff and the integration of its principles into training.Allowing GPs to commission private enterprises which by their very nature cannot provide fit-for-purpose in every situation will compromise patient care, for patients sent for private work, and for patients left in the NHS which will have much diminished funding due to diversion to private care who may be allowed to choose the most lucrative and straightforward procedures to provide. You have to understand that it’s these procedures staying in the NHS which helps ensure currency of practice and it is that which allows the NHS to provide quality care for the more complex conditions. It requires specialist knowledge to identify the most appropriate course of action for the patient, and these commissioning decisions should not therefore be left to generalists (GPs). I am aware change is needed for the NHS to continue to function and to prevent morale dropping even further. Jobs need to be created in the NHS and the freeze needs to be halted. But changes on the scales proposed have not been tried, tested, or well thought out. I urge for a more comprehensive, better informed consultation process whereby new ways of working are realistically considered by experienced staff on the frontline of care. If the quality and accessibility of healthcare in the UK diminishes because of these cuts, then I would personally consider this an act of gross negligence by those that approve such cuts and ill-thought out reforms. I demand good quality quantitative and qualitative trial data to be obtained and independently analysed before large scale cuts are made to the NHS and there is no way back for patients.

  • http://www.facebook.com/profile.php?id=1613583922 Robert Watson

    I am extremely worried about Andrew Lansley’s plans for the NHS. I think
    he is trying to change too much, too quickly and far too radically.

    The government’s “duty to provide” a comprehensive health service must
    be kept intact. Dropping this duty would erode the foundations of the
    NHS and destroy our health service as we know it.

    I know from my own personal experience from being on ESA that this
    government will use any tactic to stop people having their rightful
    healthcare and support.

    I recently had my benefits completely stopped and had to starve for 4
    days without food due to the fact they claimed I was fit for work as I
    could do physical functions. I am very unwell with anxiety and
    depression a factor that they totally ignored in their assessment.

    That is signs of un uncaring and pure cost cutting government who hide
    behind a veil of deceit with their true actions. Every person in this
    country deserves fair treatment and access to health care.

    In my eyes this government has already proved without any shadow of
    doubt that they are not to be trusted and should be questioned and be
    challenged every step of the way.

  • Gabrielle

     At a meeting in
    Bude Golf Club a few weeks ago, Mr Phil Confue (Acting CE of Cornwall NHS
    Foundation Trust, which is responsible for care of patients with mental health
    problems) announced to startled staff and patients that within the next year
    the excellent staff of the day care centre in Bude would be withdrawn (although
    the building might still be available). 
    Patients who attend this day care centre (more than 40 people) were told
    that, if they wished to have some care, they must band together and look after
    each other.  This makes as much sense to
    me as if pregnant women were to be told they must deliver each other’s babies,
    or as if elderly sufferers of Rheumatoid Arthritis were told they must fetch
    each other’s heavy shopping and take it on the bus!  The Big Society!  Here in this rural area, we are already
    subjected to processes the Bill seeks to put into law.  They are already not working well.

  • Coughlan

     
    —– Original Message —– From: Speak Out To: coughlan100@btinternet.com Sent: Friday, May 27, 2011 4:06 PMSubject: Speak Out: Thanks for sending a submission to the NHS listening exerciseHello,Thank you for contributing to Andrew Lansley’s ‘listening exercise’. There is a copy of your submission pasted below. If you would like to share it with other 38 Degrees members, you can do so by posting it here: http://www.38degrees.org.uk/listening-exercise-resources/Can you help get more people to write in? That way we can really make sure our voices are heard. You could forward them the email below.Thank you, David, Hannah, Johnny, Cian, Marie, Becky and the 38 Degrees teamPS Over 400,000 of us have signed our Save our NHS petition. We need to keep pressure building by going to see our MPs. Can you help organise the delivery of our petition to your MP? http://www.38degrees.org.uk/visit-your-mp
    —-
    Hello, Have a look at this:
    http://www.38degrees.org.uk/NHS-listening-exerciseI’ve just sent a message to Andrew Lansley’s NHS “listening exercise” telling him why I want him to keep his hands off the NHS.If we submit a large number of responses to the listening exercise it will be harder for the government to get away with using it as a cover to make only small changes to the NHS plans. The more of us that act now, the more chance we have of saving the NHS.Please click here to send a message to the NHS listening exercise – it takes just two minutes:
    http://www.38degrees.org.uk/NHS-listening-exerciseThanks,
    —Unsubscribe: You can unsubscribe from 38 Degrees mails at any time on this page: http://www.38degrees.org.uk/page/unsubscribeFrompamela coughlan mardon centrewonford rdexeter ex2 4udToNHS listening exerciseSubjectDrop the NHS plansMessageI’m making this submission to the NHS listening exercise because I have huge concerns about the proposed changes. I think it’s time to drop them and start again.For example, I am opposed to the proposal to scrap the Secretary of State’s duty to provide a comprehensive health service. This is a duty which has been fundamental to the operation of the NHS ever since its formation. It must be retained.—– Original Message —– From: P COUGHLAN To: BURSTOW, Paul Sent: Thursday, May 26, 2011 10:11 PMDear Paul,herewith some correspondence for your consideration—– in the light of public reaction to the proposed health bill ,there might be an opportunity to introduce a sea change or tide change equivalent to that which swept away other prejudices , in order to bring long term care up to standards enjoyed by those receiving acute care…..you have worked long and faithfully for adult long term care it would be apt if you led the wayyou know all the groups who would stand up with youwith best wishesPam CoughlanThe behaviour of the Government at that time and of senior politicians past and present has left Pam severely disillusioned and with a burning sense of injustice for all those with profound impairments – such as dementia, severe strokes, the later stages of Multiple Sclerosis, Spinal damage, brain damage, Motor Neurone disease, Parkinson’s disease and other long term conditions – for whom there appears to be indifference at the highest levels. In Pam’s opinion we need ‘a modern day Wilberforce who will stand up for fairness and humanity, and against the powers of money and self interest’.From: P COUGHLAN To: Luke Clements Sent: Tuesday, July 27, 2010 9:41 PMSubject: Re: PANORAMAR HARRISON SAIDWHY SHOULD PEOPLE WHO OWN A HOUSE BE FUNDED BY OTHERS WHO MIGHT NOT BE SO WELL OFF .THE DAUGHTER OF FIRST WOMAN FILMED SAID HER MOTHER AND FATHER HAD WORKED ALL THEIR LIVES , PAID TAXES ETC SO COULD EXPECT CARE BE FUNDED WHEN NEEDED.TO ME IT IS A MATTER OF A CIVILIZED SOCIETY- JUST AS IS THE CONCEPT OF THE WELFARE STATE, A MATTER OF FAIRNESS AND DECENCEY. E.G THIS LADY AND HER HUSBAND PAID FOR MY EDUCATION AND GRANDPARENTS’ CANCER OPERATIONS VIA THEIR NATIONAL INSURANCE CONTRIBUTIONS.THIS LADY , HAD SHE A BRAIN TUMOUR WOULD NOT BE EXPECTED TO PAY .SHE HAS DEMENTIA , ALSO A MEDICAL CONDITION, AND IS EXPECTED TO PAY.THERE IS NO REASON WHY THE LONG TERM SICK SHOULD NOT BE CONSIDERED SICK SIMPLY BECAUSE IT IS LONG TERM.SOME PEOPLE SUCH AS HEAMOPHILIACS NEED LIFE-LONG TREATMENT AT HUGE COST.THE ONLY EXPLANATION IS PREJUDICE.FORTUNEATELY JUSTICE IS BLIND AND WE ARE ALL EQUAL UNDER THE LAW .HUMAN BEINGS MAY NOT BE SEEN/JUDGED DIFFERENTLY JUST BECAUSE MONEY IS TIGHT .WHEN YOUNGSTERS CAN REGULARLY BUY COMPUTER GAMES AT FIFTY POUNDS EACH , WHEN EXPENSIVE COSMETICS ARE PART OF LIFE, WHEN THOUSANDS OF POUNDS ARE CHEERFULLY SPENT ON CIGARETTES , WINE,BEER , HOLIDAYS AND GAMBLING, TO SAY NOTHING OF CARS, IT IS POSSIBLE TO RAISE NATIONAL INSURANCE .PEOPLE WOULD PAY IF THERE WERE PROOF THAT, LIKE FIRE INSURANCE , THEIR CONTRIBUTION WOULD FUND ONLY LONG TERM CARE.[ THE AMOUNT NEEDED ASSIGNED TO A BESPOKE[LONG TERM CARE]SOLUTION]CONTINUING CARE-HEALTH CARE-COULD INCLUDE WHAT IS PRESENTLY CALLED PERSONAL CARE , AND FUNDED BY SOCIAL SERVICES,, AND BE FUNDED BY NHS [THIS WAS RECOMMENDED BY ROYAL COMMISSIONIN 1998][SEE PARA 30 b IN JUDGEMENT]I AGREE WITH R HARRISON THAT THERE MUST BE COMPULSORY FUNDING , BUT BY THE WHOLE WORKING POPULATION -AMOUNT PROPORTIONAL TO SALARY EARNED-AS NO ONE KNOWS WHO MIGHT NEED LONG TERM CARE, OR WHAT THE FUTURE MIGHT BRING IN CURES OR INCREASES IN WORKING POPULATION. INDEED IT WOULD SHOW POSITIVE PLANNING TO FACTOR IN SUCH EVENTS.ANY OTHER SYSTEM OF FUNDING WOULD BE TOO COMPLEX AND INIFICIENT AND ADMINISTRATIVELY COSTLY—– Original Message —– From: Luke Clements To: P COUGHLAN Sent: Sunday, December 05, 2010 10:18 PMSubject: Kings FundDear PamVery many thanks for your emails. Yes, the refusal of Mr Grillet does fly in the face of the Pointon decision – so unfair.It is strange that everyone keeps on mentioning the rising tide of people with dementia and how the NHS will not be able to cope. In fact the number of people with dementia who are getting NHS care has fallen drastically in the last 30 years – as the number of long stay beds have been axed by the NHS. The fact that there has been an increase (from a small base) in the numbers of people getting NHS CC in the last 3 years in no way compensates for this enormous loss of beds. 30 year ago most general hospitals had large long stay wards – with large numbers of long stay patients. Today the average general hospital has no long stay beds. Ho hum!I hope you are coping with this terribly cold weather and keeping warm.Best wishesLuke—– Original Message —– From: P COUGHLAN To: Luke Clements Sent: Saturday, December 04, 2010 6:47 PMChristopher Grillet seems identical to Malcolm Pointonboth in CambridgeIt seems to me numbers are irrelevantdoes NHS say to anyone with cancer ‘ you must pay because there are 800,000 cancer cases predicted over the next 20yrs’? NO.An Interview with Pamela Coughlan 6th August 2010Luke ClementsPam – we are so grateful to you for agreeing to this brief interview. QuestionCan you briefly explain why you took your case to the Court of Appeal in 1999?Pam Response 1. In 1993 I and other comparably disabled patients were moved from Newcourt Hospital, which it was desired to close, to a purpose-built facility, Mardon House. It was a decision of the Health Authority made on 7 October 1998 to close Mardon House which was the cause of litigation.The North and East Devon Health Authority told us that we did not fit the criteria for NHS funding. As our condition had not changed, indeed in three cases had deteriorated; we sought a Judicial Review, which decided for us. The Health Authority and the Secretary of State for Health appealed the decision but the Court found for us. The Court of Appeal Judges realised that responsibility for this type of care had been moved by stealth to social services which had neither the legal right to provide nor capacity to fund.Lord Woolf, gave the Court’s judgment, and he put forward a simple test, namely that one had to look, not only at the quality of care that a person needed but also its quantity. Only if the nursing care needs were of low level in terms of both the quality and the quantity, would it be lawful for social services to support the person. The Court considered that my care needs were (in its words) of a ‘wholly different category’ ie that my care needs were well outside what could be lawfully provided by social services.QuestionPam, I know from the many emails you share with me that you and those who contact you, are concerned that the Court of Appeal judgment in your favour has not been properly implemented. Why do you think that his has happened and who is suffering as a result of this failure?Pam Response 2. The judgment in my case was hailed as a solution to the unfairness people were suffering in being charged for nursing home fees when obviously they should not have been. Nothing however happened. Local authorities continued to demand money for nursing home fees from people who were sick and in need of health care. Many of these people appealed to the Ombudsman, who wrote two damning reports on the response of health authorities to the findings of the Appeal Court. The Joint Select Committee on Human Rights wrote a condemnatory report; two Health Select Committees condemned the failure and further court cases took place, most importantly Maureen Grogan’s case in 2006 – where again the High Court stressed the limited powers of local authorities to fund health care.The problem continued to be that the NHS was the body that defined ‘health’ care and it continued to impose unlawfully severe criteria in most cases. In my case the Health Authority tried to argue that local authorities (not the NHS) should be responsible for nursing care such as artificial feeding, continuous oxygen therapy, wound care, pain control, administration of drugs and medication, catheter care, bladder wash-outs, suction, tracheotomy care, tissue viability – and many NHS bodies seem to continue to believe this today. QuestionIn 2007 the Government in England introduced a new Framework and complaints process to regulate NHS Continuing Healthcare (and Wales has just introduced something very similar). Do you believe that the 2007 reforms have improved the position for those seeking to have NHS Continuing Healthcare support?Pam Response 3. I have not noted any significant change – indeed in my opinion it has been for the most part a travesty and mockery of both justice and care. People contact me saying that they have been told that my case is not relevant – that it was ‘won on a technicality’; that it was a ‘one–off’. I believe that budgetary considerations still prevail over the objective assessment of health care needs. I receive a large number of emails from people who find the process humiliating and the complaints procedures to be an impossible obstacle course –which can take two years and involve endless correspondence – and seem designed deliberately to buy time for finance departments .QuestionWe will, today, be looking at the origins of the NHS and the divide that existed from the very outset, between health and social care funding. Do you think that the spirit of the post war welfare reforms still exits?Pam Response 4. Yes. With the general public, I think it still does. They are still decent and fair-minded. It is the ‘management of decline’ mentality of government on one hand and the rapacious mentality of big business on the other which has created this problem. In the words of Joseph Stiglitz: Market fundamentalism has eroded any sense of community and has led to rampant exploitation of unwary and unprotected individuals. There has been an erosion of trust – and not just in our financial institutions. It is not too late to close these fissuresI really don’t believe that the average member of the public would consider for a moment that someone needing artificial feeding, or continuous oxygen therapy, or suction or tracheotomy care for example, would not be the responsibility of the NHS.QuestionWhat you think that the future holds and what you think we ought to be focusing on in our Conference.Pam Response 5. I fear that the firm intentions avowed by all political parties to address long term care will be shelved again. I believe that disillusion with our political representatives will deepen and public anger will intensify. No doubt the Government will tell us the country cannot afford it – but our country had the vision and stomach to establish a comprehensive welfare state in a period of far greater austerity. Now, when once again we realise our interdependence, we must develop a care provision system that respects the needs of all those who are ill, that promotes their dignity and ability to live independently.QuestionWhat do you think needs to be done?Pam Response 6. A simple answer would be to fund all care for this group. Everyone should be entitled to their health care needs being met without charge at the point of need – help with feeding, toileting, bathing , dressing, and so on are fundamental nursing and health care needs. The Rowntree Foundation and the 1999 Royal Commission on Long Term Care estimated that such funding would amount to an extra £1.4 billion. We spend £9bn on Christmas presents, £4bn on chocolate. Indeed the money that would be saved by NHS on legal and administrative fees – in implementing the current scheme and fighting paying fees for the care of profoundly ill people would go a long way towards paying for this.No virus found in this message.Checked by AVG – http://www.avg.comVersion: 10.0.1375 / Virus Database: 1509/3663 – Release Date: 05/27/11

  • Petra Jarratt

    Dear NHS listening exercise,I am fundamentally opposed to the NHS reforms being proposed by thecoalition government. They will not deliver improved services to patientsbut merely subject the NHS to a slow and lingering death, while enablingprivate companies to profit from its demise.It is indeed difficult to see who will benefit from these reforms apartfrom Mr Lansley or private companies themselves who will surely cherry pickthe most profitable parts of the NHS to compete in.I also do not appreciate the condescension of a ‘listening’ process thatseeks merely to dismiss the genuine concerns of many professional medicalbodies and the general public and intends to force through the reformsregardless.In hindsight this will be seen as the biggest political error within thelast century. Worse than the poll tax. Worse than the Iraq war. And whatgovernment would want to be associated with that?Reform is one thing. The entire destruction of the NHS as a viable entityis quite another. It is a reckless act and one that we will remember at theballot box. Please listen and scrap this entire proposal or prepare to beunelectable for a generation.Yours sincerely,Petra Jarratt

  • Steve

    “The NHS is free at the point of entry”

    This is constantly being said by all ministers, but that implies that we can enter the NHS, for free,, but what happens after that? charges for what?

  • Mavis Holmes

    We recently met our MP and below are some of our concerns:1)- Who will be taking on the Risk of failure in these new reforms, when other Providers (private or charity) run in to problems? Will it be like the banks, that the tax payer will have to step forward and bail out the provider especially after any Private Provider has taken out their profits before failing? – If the Provider is not bailed out, how does the patient get treated, and by whom? Would there still be a viable local hospital funded under the NHS still in existence? – If the Provider miscalculates the amount of funding needed for the contract period and runs out of money (like the dentists in the NHS provision scandal highlighted by Dispatches this week and experienced personally by us), will the patient be told to go privately? If so, how far will that patient have to travel to find another Provider? If the patient can’t pay or travel, does that patient, like in the USA system, have to rely on 2nd class treatment in a church hall somewhere and, if so, who would be providing that 2nd class service? – Does the outcome of all this lead to the patient having to seek Private Health Insurance? If this is the reason for the changes, then say so, and lets have that debate. Don’t say the NHS will stay free at point of delivery – it won’t under these misguided ideas. – The Dentistry contract has broken down because privately contracted dentists say they do not have enough money to treat people in the NHS, yet they signed up to do just that. Doctors are also on private contracts with the NHS in just the same way. Why should they be given responsibility for provision, when they have a personal financial stake in the process. PCTs represent the public and therefore should have no personal financial stake.2) – Surveys of patient support for the NHS is high (despite some inherent problems), so why when problems have been identified, has the Minister of Health not rattled some heads in the NHS, whose Managers should then again see that the staff under them are carrying out their duties correctly.- A Private Provider or Charity will have similar problems to resolve because they are run by people and people have inherent weaknesses. If Private Providers or Charities can run them efficiently, why not the current NHS?- There are many in-house problems with Private Providers as there are with public . Look only to the Care of the Elderly (numerous instances of lack of care, including lack of access to food and drink, and outright abuse). Look at the costs being incurred by the elderly for these poor services (they can’t also be properly monitored and are outside public scrutiny for the most part – families themselves have to keep a sharp eye open for their elderly relatives – goodness knows what happens to people without families.) Look at the costs incurred by the elderly in these care homes (circa £24,000 a year).- Look at the MPs’ expenses scandal – people cannot always be trusted to be forthright and honest and work only for the good of others. If there is a profit to be made, then greed is ever present.3) – When a patient visits their GP, they want to be assured that any treatment recommended is the best on offer and that their GP does not have any ulterior motive for suggesting a particular treatment. They don’t want budget considerations to come in to the consultation. Bodies like NICE are the people to consider treatments and costs, not GPs. PTCs again must be independent – doctors can be asked to be part of the consultation process, bringing their particular skills to the process, but not wholly. – Patients now will have serious doubts about the honesty and efficacy of the advice being offered by their NHS Dentist (we do), because of the abuse of the system by some dentists. Why will this not happen with doctors? Doctors are not messias likely to lead us to the promised 100% efficient health service – Why should they be any better equipped than the current PCT experienced planners, than anyone else?- Why, when we had a deficit of doctors and spent loads of money increasing the numbers, are we now taking them out of their key role as doctors, to become administrators. They are surely less equipped to do this than someone skilled in management. Can we ask the Manager to become the doctor? No.- It is a slight on the skilled and motivated people already working in the NHS to have Politicians (who mainly have no more knowledge about running such an important organisation like the NHS than the man in the street). – If the motivation is to remove the public pension provision for the people working in the NHS, then say so. Then a proper debate can be had about that. – When PFI projects first entered the NHS, they were hailed as good value – no longer. NHS In-House contracts were always more efficient than those that went out to tender. Low cost Private Providers for domestic services cut corners, cut staff costs and created MRSA because of poor management – leading to many deaths that were avoidable. – European laws about competition will cost the NHS millions of pounds in Tendering Costs if ‘any Provider’ contracts are to be sought – who will handle all the paperwork for these? Who will pay for all these extra costs? Who will make up the shortfall when Contacts are not drawn up fully and forget essential items which cannot always be written down in the Contract. Private Providers will seek to make the most they can from a Contract and will not provide more than is written down. See the extra costs associated with PFI contracts which are already accruing. There is no logic in contracting out services which will cost the tax payer more in the long run. Governments must have the debate about how public services are run and put in to the public arena the fact that Governments can raise their own capital and do not need to rely on Private Companies. The Public are capable of deciding what is needed if given the full choices. The tax payer is not happy to be bailing out greedy bankers who played Monopoly with our money. Banks were supposed to be being Monitored………. what happened? The Public do want to see a good NHS, Publicly run and funded. If the present Government want to take an ideological stance for private initiatives in the NHS, then say so, but don’t make out that this is to Save Money or to Improve the Service. The Service has already shown huge improvement in recent years – do not trash it now. There is another way. – Don’t compare our country’s provision of health care with other countries who have a different outlook about many things. The Swedish public appear to be happier to pay more in taxes for the social good of all, or is that overlooked. The Germans have health insurances as part of their system – they also live mainly in flats and are not house owners, but the UK is different – the Conservative Party wishes people to be able to own their own homes as the norm. Don’t compare only when it suits. Don’t forget the terrible disparities between rich and poor in this country – much less so than in Sweden or Germany. These ‘reforms’ will just add to the worries of the least well off in this country. 4) – Private Providers or Charities will cherry-pick the easy bits of treatments (like dentists now do). The present cross-subsidy in the NHS which funds more complex and difficult work will disappear. This will lead to a poorer service and loss of skills. How is it intended this will be prevented?

  • Noshockdoc

    My letter:

    I write for both myself and for the vast
    majority of family, friends and colleaugues of a vast range of wealth,
    background and politcal stance.

    ALL of them are frankly alarmed by the propose changes to the NHS.

    This seems to be echoed by the BMA, GP’s themselves and most if not all Health
    Processionals and their representative organisations.

    The NHS has recently been hitting some of its highest ever levels of user
    satisfaction. Waiting lists have fallen. PFI has provided new hospitals. In
    short the NHS is looking good and working pretty well.

    The drive to introduce competition therefore can ONLY be construed as a drive
    to introduce commercial interests, to enable greater monetisation of the ill
    and the injured.

    The bill needs rewriting to ensure it is collaboration and NOT competition that
    is promoted.

    Some cynics would argue the government does not care about maintaining a
    comprehensive “free” health service. I am sure they do, however, the
    repeated “free AT THE POINT OF DELIVERY” phrase alarms me very much.

    That phrase paves the way to the NHS becoming nothing more than a logo fronting
    a collection of large companies, driven by profit, responsible to investers and
    funded through private health insurance schemes.

    Yes, “FREE AT THE POINT OF DELIVERY” but, paid for at much greater
    expense than now. I fear for those with rare conditions, those with expensive
    needs, those with special needs or disabilities. There will be a higher premium
    for these people to get “free at the point of delivery” service
    provision. The result will be only mainstream common ailments etc will reap
    enough “custom” for the competitively driven down margins to be
    profitable.

    The result will be cherry picking and a likelihood of little or no provision
    for low numbers services. Hence high pricing for them and limited avaialbility
    or choice.

    The sheer scale of the proposed change is not seen before. Many would argue
    that the government has thrown together these proposals in short order and put
    them out to the public. After all it was not in either parties manifesto nor
    the co-alition agreement.

    Thus there is no mandate for it.

    Personally I believe the plans have been forged over many years via private
    lobbying, ministers ex employments and future interests, revolving doors
    between whitehall and health companies and Andrew Lansleys pally relationship
    with Care UK plus other advisors chats with US companies.

    Frankly this, “consultation” process is more “insultation”
    - it’s a very thin veneer and the public are not stupid !

    Again, the service works, satisfaction is high, don’t mend what isn’t broken.

    Instead of telling BMA, medics, trusts etc what they should do and what new
    system you are going to impose (minor consultation tweaks for image sake
    sanctioned) you should halt the entire process. Pause.

    Then, in due course start a fresh, public select committee, think tanks
    comprised of ALL parts of NHS and not private lobby groups interested in their
    private health company clients bottom line.

    Finally, no-one trusts the ConDems. You’ve come to power by a whisker, acted
    like you had a stonking majority and have been busy invoking ideological Tory
    policies left right and centre (sorry, righ right and further right) without
    mandate by way of a shock doctrine “we have no option but to cut” (or
    change radically) mantra.

    Well, the IMF, OECD, numerous nobel prize winners, the US president and more
    disagree with your policies.

    The National Health Service may not be the best in the world, but it is
    universal and based on health needs NOT profits, those facts make it unique and
    precious.

    Continue at your peril. The NHS is a sacred cow to the UK public. After
    education and the rest, it really is possible the stupidest move you could
    make.

    Face it, the Liberal Democrats are toast and if you push this one through then
    come the next election the Torys alone won’t survive in power.

    I leave you humming a certain rap (which is re-markedly telling and popular
    among the new genration of electorate)

  • Anonymous

    Stewart & Clare Faulkner 
    To
    NHS listening exercise
    Subject
    NHS Proposals: ill thought-out, ill-supported, unclear & too
    fast
    Message
    Choice is not a key issue. For most people, convenience for
    consultations, treatment and family visits are more important. Travel is and
    always will be a ‘can and cannot do’ consideration in terms of cost, time and
    reliability (weather, frequency etc).People do not want a post code
    lottery. Why should your entitlement to a quality health service depend on where
    you live?Competition is not a key driver. It is not a guarantee of
    quality or level of service. The only competition that is worthwhile is for a
    provider to compete against itself to achieve agreed challenging
    targets.Privatisation of direct patient contact and medical treatment
    (excludes pathology, X-ray and similar services) cannot be an option.
    Privatisation requires probably at least a gross return of 20% for its investors
    and we do not believe the NHS budget could be reduced by 20% so what will the
    privateers have to do? The corollary would then be if private companies can do
    it why couldn’t the NHS at a saving to the taxpayer?There is absolutely
    nothing in what has been published to date that clearly demonstrates how
    bureaucracy will be reduced. Our belief is that it will increase and be less
    effective because the length of the ‘chain of command’ and therefore places to
    hide will increase. Good accountability requires short ‘chains of
    command’.GPs are generally our first line of contact in our access to
    medical treatment. They have to date been found wanting in a number of key areas
    including : cancer referral; heart/stroke risk; asthma treatments; prescribing
    generic drugs; out of hours services. We need to build on solid foundations so
    let’s get these fundamentals right firstWe think that it is time for the
    NHS no longer to be treated as a political football and for its provisions to be
    enshrined in law. Given that all parties say that it will be protected
    why can this not be achieved? Stop messing!

  • Gwen Shackleton

    Andrew Lansley would do very, very well to “listen” to the words from a very wise and relevant Taoist saying – (changed slightly from “seeing” to “listening” – with EXACTLY the same sentiment and message!
    To LISTEN is one thing, to HEAR what you LISTEN to is another, to UNDERSTAND what you HEAR is a third, to LEARN from what you UNDERSTAND is still something else, but to ACTon what you LEARN is ALL THAT REALLY MATTERS!
    What do YOU hear, Andrew???What do YOU understand by this Andrew????What have YOU learned from this Andrew????HOW WILL YOU ACT, Andrew????
    Nearly half a million of the people you represent (not dictate to!) want the answers to these questions.
    As Winston Churchill himself said…”Courage is what it takes to stand up and speak; courage is also what it takes to sit down and listen. ”
    We have listened to you and your government – it is now your duty to listen to, hear and respond to our replies.

  • Huw Jones

    I wrote to my MP (for Finchley and Golders Green) a few weeks ago on several
    concerns, including my deep unease at the pace and tenor of Mr Lansley’s
    proposed changes to the Health Service. My MP’s response did not convince me, so
    I repeat the arguments I made in the hope that they will receive more
    sympathetic hearing.

    ’2 Health service reform
    I am worried about the
    pace and nature of change proposed by Mr Lansley. I fail to see how making good
    Doctors into managers will improve patient care in the health service. If GPs
    have to be concerned with managing large budgets, that will take them away from
    what they are good at, front line patient care. I experienced a similar career
    path. After being promoted to Professor and head of a research/teaching section
    at my University, I became an untrained administrator who had no time to do my
    own teaching and research, so the final fifth of my career was far less
    enjoyable. Doctors will experience this under Mr Lansley’s plans, or they will
    have to employ managers. There are more Doctors’ practices than there are
    hospital trusts, so this opens the way for even more managers to be employed. I
    appreciate that the system has got unwieldy and there may be need to cut the
    number of administrators, but I fail to see how the Government’s proposals will
    directly attack this is sue. As we approach the age when we are likely to be
    more in need of such services, it is distressing to read of cuts in nursing,
    ambulance and paramedical staff. It is also worrying to think that health
    services may be awarded to the lowest bidder by those concerned with balancing
    their books. Fragmenting control into smaller units will also worsen the ‘post
    code lottery’ in health services often decried by the popular press.’

    I
    add that the Health Service provides all sorts of services for all sorts of
    people. Privatised health schemes tend to specialise in elective services. By
    allowing them to bid for their specialised corner of the market, and perhaps
    underbid public providers, that will condemn the public side of the market to
    undertake only the more difficult and expensive aspects of medical treatment,
    hardly an equitable situation.

    The NHS should be overall concerned with
    providing quality healthcare, and the role of any ‘Monitor’ should be that, and
    that alone. Please do not go ahead with Mr Lansley’s proposals, if change is
    needed, it must be rethought before the quality of service is undermined by
    hasty changes..

    I send this also on behalf of my wife, Judith Jones, who
    is in complete agreement with the above statements.

  • Peter Johnson

    I’m making this submission to the NHS listening exercise because I have
    huge concerns about the proposed changes. I think it’s time to drop them
    and start again.

    For example, I am opposed to the proposal to scrap the Secretary of
    State’s duty to provide a comprehensive health service. This is a duty
    which has been fundamental to the operation of the NHS ever since its
    formation. It must be retained.

    If this is dropped, it will dramatically worsen the inequities already
    present in the NHS due to age and geography, and we will rapidly arrive
    in the same situation as America, which is widely acknowledged to have
    the least efficient system of healthcare in the developed world.

    I for one will vociferously oppose ANY plans which are likely to produce
    one health service for the rich and one for the poor, because it is
    precisely those patients with chronic conditions through no fault of
    their own who will suffer most. It has been said that one measure of
    the degree of civilisation is a society’s ability to look after it’s
    sick, elderly and disadvantaged. By that measure, we will rapidly
    regress into the dark ages.

    The proposals make a dangerous assumption, which is that all GPs are
    competent to manage their budgets. Clearly, even if this is the case in
    a large percentage of cases, there will be some GPs who for whatever
    reason cannot do this. This raises the spectre of the private health
    market stepping in and offering to manage the budgets – for a fee, of
    course. At a time when it is unclear if the NHS funding will be
    adequate for our aging population, the last thing required is
    haemorraging of funds to line the pockets of private industry. Of
    course, with the source of your party funding, perhaps a cynic would say
    that is EXACTLY your intention!

    There is a further issue here, which is the uncertainty of forward
    planning which it forces onto hospitals. When GPs are in control of
    their funding, which hospitals are used, when and for what is likely to
    become very volatile. That can only put up overall costs. When there’s
    no predictable workload, managers have to plan for variable and
    unpredictable demands, which inevitably will lead to a higher level of
    redundant provision – more totally unnecessary waste.

    The one area where change should and must happen is in the area of
    Quangos. For far too long trusts have been privately appointed and run
    as cartels. The auditing arrangements are derisory, and the competence
    and integrity of top managers in many cases highly questionable. I have
    had inside reports from the NHS which suggest that fudging targets,
    internal cover-ups, and political buck passing are widespread. This is
    one area where the public must be able to directly challenge the
    managers. Whistle blowing should be encouraged and facilitated, and
    where incompetence is proven, the manager(s) involved should see the
    result directly in terms of their salaries. The current proposals would
    make this more difficult, not less so, and would encourage secrecy
    about performance even more than at present.

    In short, I completely disagree that this is progress for the NHS.
    Instead it is likely to be an unmitigated disaster in the making and I
    unreservedly oppose the proposals, and any similar chronically badly
    thought out political manoeuvers.

  • Robert J Reynolds

    In writing to ask for a fundamental re-think, I wish to make clear that I take seriously the appreciation of Secretary of State Andrew Lansley and of the Prime Minister and Deputy Prime Minister, for the work of the National Health Service.  I would like to offer the following thoughts relevant to structure, affordability and improvement.

    Towards all aims, including that of healthcare through the NHS, the critical objective for the maximum of fulfilment is in respect of every individual, the release of talent and energy, initiative and enthusiasm, conscience and life-time follow-through.

    If we think of our own careers, of ambition and hard work, luck and disappointment, help and hindrance, performance peak and decline, we should together be able to build  a better world for our children’s pursuit of both personal and collective ambitions.

    Human lives will always be of transition: all journeying from cradle to grave, the most fortunate progressing from willing pupils of wise teachers, through productive mastery, to wise teachers of willing pupils.  It is a matter of ‘faith from experience’ that caring for each other is ‘worthwhile’, and that living together is best regulated by ‘democracy’.

    Opinions will differ as to how ‘caring for each other’ and ‘respect for law’ are best inculcated.  Some might look to ‘care through discipline’, others more to ‘care through kindness’: we might agree to a shared deeper faith in sincerity of parental love, to the expression of love and the setting of consistent boundaries, to the conscious avoidance of exploitation and of hypocrisy.

    In the NHS, teaching by example, and learning from each other, from colleagues of whatever status, and from patients and relatives, are ideals at the heart of daily life and progress, subject to variable realisation.  All has not been well, some will say from under-finance, some will say from financial indiscipline: we might agree that both can be factors, even simultaneously, but what is it at the level of individual function that ‘goes wrong’?

    In complex matters, in the end, some single individual or some small body of individuals may have to take a decision based on judgement.  Towards better decision-making, I would suggest that those used to hearing other viewpoints, in less urgent or final circumstances, could reasonably be expected to have ‘more voices in their heads’ and therefore greater depth of judgement when ‘on the spot’.  How might we secure free communication as ‘normal’?

    The answer lies in the conditions of freedom in general.  Some might think freedom can be commanded, making the warning of possible folly a responsibility of all, despite the existence of penalties for contradiction in general.  My own suggestion would be to make freedom real. This would not be to assert that all questioning should necessarily be welcomed by all teachers, or to assert that repeatedly daft questioning should be supported in terms of continued employment in a particular role. The need would be to ensure for every honest ‘worker’, student or teacher, security of means (principally of income) for personal and family life, such that questions can be ‘risked’ as contributions to our shared enterprise.

    The prescription of egalitarian freedom, if ‘correct’, is not just ‘the best way’ or even ‘one way’ of perhaps achieving democracy: it is the permissive condition of genuine democracy, ‘the only way’.  Imagine, freedom from fear and preemptive greed, freedom to seek amongst possible contributions the best in your own judgement, the freedom – in due authority – to counsel or command as to misplacement or redundancy, knowing that families are safe, that the world is one of rich opportunity not of exclusion, misery, ‘sudden death competition’.

    Could I rest my case?

    The NHS has achieved a remarkable degree of ‘creaky co-operation’, trading on such assets as ‘vocation’ and ‘post-war pluck’, despite deficits of freedom with sometimes scandalous impact.  I doubt that ‘more freedom’ can be commanded within a system of institutionalized competition, rather I would expect a drift or spiral of decline into ‘expensive’ chaos, the everyday worry of all being not just ‘how much insurance / tax can I / we afford’, but ‘will the particular service needed be even in existence when we need it?’

  • Lee Preisler

    It would be wrong to
    make changes that open ourselves to the American medical model, which
    has already proven that it doesn’t work effectively for the benefit of
    its patients. As an American who has lived here for over 30 years, I
    can assure you that I have experienced the truth of the statement I have
    just made. Its not that I think everything about the NHS is perfect or
    that all change is bad. However I think these proposals are fatally
    flawed and need a fundamental rethink. To rush ahead at this point
    could prove a total disaster
    & we cannot afford a mistake of this magnitude.

    It is indeed important for you to actually prove that you are indeed
    listening attentively to our feedback & responding to it, since
    these changes are for all our benefit.

    For example, proposals to make the NHS regulator, “Monitor”, focus on
    competition are flawed and dangerous. The “competition clause” in the
    proposed bill must be scrapped. The focus should be upon promoting
    cooperation to provide quality patient care, not on promoting
    competition.

  • Mr and Mrs M Moody

    We have written to our constituency MP who sits on the government benches. He, in his reply, failed to address any of our points regarding the top-down NHS ‘reforms’ in what seemed to be a very standard
    e-mail response.

    We sincerely hope Andrew Lansley’s listening exercise can redeem itself – since, to date, it seems to be considerably less than wholly open and transparent.

    Here, in Mid-Cheshire, a meeting has been held by a group claiming to represent GPs who are said to be a ‘consortium’. It was chaired by a former county councillor and held during a weekday afternoon. Hardly likely to represent or be of much value to anyone doing a nine to five job! Worse than that is the pretence that such a meeting is legitimate. We are appalled at such seeming implementation of elements of a reform which to our knowledge has not completed its course through parliament or received Royal Assent.

    We love the NHS at least as much as those who seem to be proposing its extinction.
    It is not the plaything of those who wish to hive it off or sell it off to their rich pals.
    It is a public service owned by us all which, given all its shortcomings, provides effective care for all and in which we can take pride.

     It is what makes Britain different from many other countries. It makes us a little more civilized.

  • Judith Bennett

    The NHS is not perfect but its shortcomings will not be eradicated by the Lansley proposals.

    These proposals were not in the recent election addresses of either the Tory party or the Lib Dems who tried very hard to assure us that the Service was safe in their hands. This provides further evidence of the propensity of MPs to ignore their voters. I can truthfully say that I no longer trust anything said by any MP.

    Lansley’s ideologically and economically driven proposals, which were apparently seven YEARS in the womb, have nothing to do with the provision of a regionally fairer, better coordinated and responsive service which can ensure good quality care for all its patients and which ensures that all its staff take pride in the job they do.

    Allowing the private sector to cherry pick the ‘easy bits’ and leaving the NHS to pick up those that are expensive and difficult will guarantee a decline in the NHS and therefore the need for patients and their families to pay or to take out health insurance which will be costly, pace the US. (Read Lionel Shriver’s book ‘So Much For That’)

    And GP consortia . . . where is the evidence that they can even manage their practices, their budgets and their staff?

    So where is the evidence that what is being proposed will heal the broken bits? The very least that a resposible government would propose is a series of trials to test what works and what doesn’t, but I fear they aren’t listening, because that is not an approach that fits in with their style, their ambitions and their hubris.

  • Phil

    geI’m making this
    submission to the NHS listening exercise because I have huge concerns
    about the proposed changes. I think it’s time to drop them and start
    again.

    For example, I am opposed to the proposal to scrap the Secretary of
    State’s duty to provide a comprehensive health service. This is a duty
    which has been fundamental to the operation of the NHS ever since its
    formation. It must be retained.
    two years ago my GP’s failed to properly diagnose acute pneumonia.As a
    result after 24 days I was just about dead.It wasn’t untill my [partner
    made me admit myself to the local hospital that I got properly treated
    and due to their care have made a full recovcery.Needless to say when I
    now visit my local GP’s there are a few shamed faces!.
    These are the people you want to give more powers to! Frankly you must
    be aware that this will result in unneccessary deaths.Its a bit like
    letting the prisoners be in charge of the jail.
    I have no doubt however that most GP’s do a good job -but giving them
    more responsability is silly.They neither have the time or the training
    for what you are proposing and I suspect most would recruit a possibly
    untrained practise manager to take care of these new responsibilities.
    If as supposedly this is a way of getting better practise into the health service it is the wrong way of going about things.
    Your political party is supposed to be a party that claims to be able to
    manage better.Then manage better and stop passing on your
    responsibilies to others.That smacks of complete incompetance.
    Our health service is good -no doubts it could get better-but not by
    passing the buck over to private firms or by making already hard working
    people do more-that is not good management it is buck passing, and the
    fact that you are proposing it also smacks of incompetance

  • Judith Scott

    I object very strongly to Andrew Lansley’s proposed changes to the NHS. The essence of the changes is a belief that competiton will improve services by enhancing patient choice. This will not happen because most patients will not have sufficient information on which to make choices and, in any case, we know from surveys that people want good care available near their homes; in other words, universally good services. These can be ensured by excellent training, monitoring of staff and listening to patients needs and concerns.Opening up the NHS to any provider will allow cherry picking of the most profitable services by private companies and in no time at all this government will have destroyed the concept of a national service, open and free to all at the point of use and providing healthcare for all needs.David Cameron has made much of his admiration for the NHS because of the way it cared for his son, Ivan. The truth is that no private hospital would or could have treated a child with such serious health problems so he had no option but to use the NHS. I have a little grandson with Down’s Syndrome; if the NHS is privatised, he will find it difficult to access the care he needs.

  • Martingarrett

    I suffer from a rare chronic condition called ulcerative colitis. I am
    deeply concerned that the changes that Andrew Lansley wants to make will
    end up damaging our health service, and my health.

    I have little complaint about my GP’s but many will readily admit that they are not all familiar with my
    disease.

    It requires constant monitoring and managing to ensure that it does not flare up with disastrous consequences.

    If my condition deteriorates I have to have rapid specialist advice to
    help me prevent it getting worse. At the moment this is provided by
    phone by a specialist bowel disease nurse at the Bristol Royal
    Infirmary. She is part of the team there and I have met her in person.
    Advice is available within hours rather than possibly waiting days to
    see a GP who may never have seen this condition. The specialist nurse
    can assess my current state, arrange for a same day blood test at
    hospital ( this could take several days and two visits to the GP
    surgery), make a short notice appointment with a consultant if
    necessary, or even prescribe additional emergency medication; she can
    also reassure.

    I could not have the same quality of life without this care.

    When I first acquired this condition I was too ill to visit the GP. The
    after- hours GP service (a contracted out service) failed to give a correct diagnosis over the
    telephone: this eventually ended up with 11 days in hospital and a year
    to recover, leading to high costs for the NHS and time off work for me.

    Please reassure me that I, and others whose condition is supported at
    home by these excellent specialist services direct from hospital will
    continue to receive them, thus preventing more cost and suffering.

  • Rosie Marshall

    The Tories have decided, with no mandate, that our National Health Service, the proudest achievement of this country, is to be dismantled. What sparked this off? (Aside from the obvious ‘ gold in them there hills’ factor, ie: healthcare, like supermarkets, is a surefire moneyspinner – and what does one become a politician for, if not to payback ones rich pals?)  But this country is rapidly becoming swamped with (a) the elderly, and (b) the immigrants. Neither problem budgeted for. Politicians don’t do long-term budgeting, as they’re never in power for more than 4 years. So the NHS is at the point of collapse. And where will the blame fall when it does? On those same hapless politicians, eg: when the press starts to see too many cases of neglect of the elderly going through the courts. The Tories want to fend off accepting blame for the collapse, by destroying it first. What a brilliant idea! The old folks will all be too ill to raise objections to being side-lined, and stopping illegal immigrants getting free health care for no NI input will be a vote-winner bonus!! The fact that illegal immigrants’ labour is needed for the thriving black economy is something that doesn’t ever get discussed – but I digress… The Secretary of State is about to be absolved by the new Bill from the duty of striving to provide for a universal, comprehensive health care service available to everyone free of charge at the point of service. The ‘NHS’ is about to be wimped down into – just a brand name. This is NOT a brilliant idea, it’s an unmitigated disaster. This is a scandal worse than the Poll Tax. So, what’s the answer? Insurance-based system? DEFINITELY NOT. Adds another huge layer of bureaucracy and leaves the poor out of the loop. Charities are all very well in their own way but their service is random and piecemeal and nibbles at the edges of the problem. Privatisation? We all know that this means creaming off the easy stuff and leaving the expensive stuff, like stroke and dementia victims, NOT COVERED.  This is just not being discussed properly. Politicians just tell us that ‘patients want competition’, to give them ‘a choice of options’ – NO, THEY RUDDY WELL DON’T!! They want UNIVERSAL EXCELLENCE AS NEAR TO THEIR DOORSTEP AS IS PRACTICABLE. The last thing they want to have to dither over ‘choice’ when they’re ill. ‘Choice of options’ is utter baloney. Already, a lot of NHS work is subbed out to private enterprise, but I don’t understand why this is done. Doesn’t state enterprise benefit from economies of scale? Are the NHS bean-counters persuaded that the private sector comes cheaper because they have ways and means of bypassing the strength of Trade Union hours and wages protection deals in the State sector? Or is it because someone is bribing the Primary Health Care Trusts managers with brown envelopes, which is what I suspect happens? PFI’s seem to be such a great idea at the outset but they all go wrong, so in the end, the state ends up rescuing them anyway, at even vaster expense than would have been the case if the state had just got on without them in the first place. Health provision has become so damn complex, bean-counters can argue anything they like as to what is prudent practice. In reality, it’s an utter mess. For example, in nursing, they do have to pay some nurses a proper wage – but they also benefit from a host of third world trainees, to whom they pay absolutely nothing for their 6-month induction period. When they get the numbers wrong, as they invariably do, they have to employ agency-bank nurses, at really, really premium rates. Lots of exploitation AND money-wasting going on here. But that doesn’t mean we should smash it up. The Tories are wilfully destroying a leviathan that, in spite of its faults, does actually provide us with the best healthcare in the world, and those who claim that it doesn’t are merely spinning the figures to make them fit their own agenda.
     

  • Flora Page

    As a Legal Aid lawyer, I think there are some relevant lessons to learn from the way competition affects the provision of publicly funded legal services. This was my submission to the “listening exercise”:Consider Legal Aid law firms and the way
    competition amongst them affects the provision of publicly funded legal advice:
    even this is complicated, and yet, far simpler than the NHS. Do you want big
    firms or small firms? Lots or just a few? With one regulator or many? How many
    Government staff do you need to adminster regulation of public funds going to
    private firms? Many to help keep costs under control, or just a few in the hope
    that savings on government salaries will compensate for the unseen sharp practices
    of certain contractors?

    Before doing too much with the NHS, learn some lessons from the difficulties
    faced by the MoJ and the Legal Services Commission, and above all, take it
    slow. Healthy competition is an organic thing, and cannot come from sweeping
    change from on high. All the more so in a publicly funded arena which must,
    perforce, be heavily regulated. Healthy competition can assist, and indeed it
    should be utilised appropriately to encourage efficiency, but an
    across-the-board command-led approach is bound to turn the NHS into an ugly
    battleground. Do some pilot studies. See what works. Let this be a about
    consensus-building, not revolutionary zeal.

    Please don’t impose a radical economic experiment on the NHS, as you will
    surely puts lives at risk.

  • Elizabeth Kinder

     I am deeply concerned that the changes that Andrew Lansley wants to make will damage our health service and impact badly on medical research, education and funding.

    please listen to this:

    http://www.guardian.co.uk/world/audio/2011/jan/13/multiple-sclerosis-health,

    Yours sincerely,

    Elizabeth Kinder

    London

  • Elizabeth Kinder

    please listen to this:
    http://www.guardian.co.uk/world/audio/2011/jan/13/multiple-sclerosis-health,
    I am deeply concerned that the changes that Andrew Lansley wants to make will damage our health service and impact badly on medical research, education and funding.
    Elizabeth Kinder

  • Andy

    I want to register my very deep concerns about the plans
    that are being proposed by Andrew Lansley for the NHS.  There surely has not been anything like
    enough time or thought put into these proposals and their consequences.

     

    As well as being an extremely appreciative user of the NHS,
    I have some understanding of its inner workings as my wife works in an
    administrative role and our daughter is a hospital doctor.  While I acknowledge that there need to be
    reforms to the NHS, these proposals of Andrew Lansley’s seem poorly thought
    through in their detail and outworking if the NHS is going to be properly
    nurtured into the future and remain as the extraordinary organization that this
    country is so fortunate to have with its primary ethos.

     

    As I understand it, we would be utterly foolish to allow
    these proposals to be implemented unchanged in their current form.

  • http://twitter.com/mulberrybush diana smith

    My particular perspective on the NHS reforms comes from the fact that I live in Stafford, and have been an observer and commentator on the Stafford Hospital story since 2008. You will find some of the writing I have done on this on http://www.#pressrefom.blogspot.com
    This government has made a commitment to take account of the findings of the Midstaffs public inquiry. Having listened to or read most of the evidence to the inquiry my opinion is that the Inquiry can give us all very strong indications of the reforms that the Health service needs, and pointers for how this should best be done.
    It has worried me greatly that this government has allowed, or perhaps actively encouraged the press to treat Stafford hospital as the case which demonstrates the “failure of the health service”. It has always been clear to me that the basis for the media reporting of Stafford, which has been actively boosted by Andrew Lansley and David Cameron, was based on very shaky foundations. The Inquiry is showing this to be the case. The most damming “facts” about Stafford Hospital have been I believe conclusively shown by the evidence given to the inquiry to be very ill founded.
    Though there may have been failures, and many things that could have been done better, none of this is on the scale that the press have indicated. As the recent report from CQC into basic nursing standards show, the main themes from Stafford are a widespread problem, to do with our aging population. The government is completely right to see this as a major challenge, it is, but the methods they are choosing to eal with this are questionable.
    “The failure” at Stafford Hospital has been used to justify the scrapping of Targets, which many of the people have evidenced can be helpful, and for scrapping the SHA and PCT. After listening closely to the evidence from these bodies I can see that they were for a period in 2006 2007 very dysfunctional. This was because they had just gone through a major re-organisation, which left them without many people in key posts, with unclear roles, and unclear relationships with other organisations.
    Major re-organisations damage the health service. Many people will have voted Conservative at the general election because they promised no top down re-organisation of the health service. The government needs to honour this promise.
    The trauma of dealing with the Dr Foster league tables and the Stafford hospital case has meant that these organisations matured over the last 4 years, and have now developed very clear and I believe effective ways of working together and working with the hospitals.
    The role of the SHA and PCT matters. They are able to think beyond the immediate functioning of their town and their hospital and have a level of skill at seeing the broader picture and trying to ensure that we are providing the right services, which I find it difficult to believe could easily be provided by the proposed GP consortia.
    The evidence to the Inquiry from the GPs, and also from members of the Health scrutiny committee and NEDs did not make me feel confident that it is easy for people who are not skilled health service managers to perform the roles that the Heatth reforms are asking from them as effectively as professionals.
    The rhetoric constantly used by Conservative spokesmen that they are doing away with unnecessary tiers of bureaucracy is I think a populist position which does not reflect what health service managers actually do.  These people can play a vital role in helping to monitor the quality of service and assisting hospitals and other providers to improve.
    I have particular worries about the idea of increased competition in the health service.  Listening to months of evidence at the inquiry what has become plain to me is that the health service depends on relationships between people. It requires people to be open, and it it requires people to be supportive of each other. This is something that is a deep part of the ethos of the health service, and it conflicts with the idea of commercial competition.
    There were particular issues which go right to the heart of the Stafford hospital case. The Dr Foster intelligence system which is a commercial company, selling mortality statistics to hospitals became the centre of a huge row. Stafford was condemned in the public eye because of its high mortality rates. These have now been conclusively dismissed as a result of the research into the validity of the statistics, and the HSMR system is no longer to be used in the league table form which sparked the problem.
    The reason why Stafford hospital has had to deal with three years of extraordinarily hostile press coverage, in which many good people have been pilloried is because of commercial confidentiality. Dr Foster intelligence was not prepared to share its methodology, which meant that people who it viewed as competitors were not able to refute their claims without a lot of difficulty. 
    This is a specific case, but it is certain that the public have not been well served by commercial competition in this instance. The taxpayer is footing a bill of well over £10 million in the inquiry costs to undo the harm  that has been done to my community and to the health service by these seriously misleading figures.  .
    The Transcripts of the Midstaffs Inquiry are an extraordinary resource. The tax payer has paid heavily for this. we should now ensure that we use it to give us a health service that can cope with the challenges of the future.
    By studying the Stafford transcripts it is possible to see where the health service needs help, and who is best placed to provide it. It also shows the relationships between the different sections of the health service and what needs to be done to make these work better.
    By studying what is there, and by involving those people who are themselves part of this complex and delicate service the government gives themselves the chance to build reforms, not on the basis of ideology but on the basis of what is real.
    I would strongly recommend that the government should learn all the lessons from Stafford before rushing into ill founded reforms.

  • Christine Wharrier

    Why would any government want to sell off our NHS except to renage on any responsibility and pass on the financing for it.
    then pretend they have worked miracles while people die.
    If we can afford to pay to kill people we can afford to save lives. 

  • Mark Greenway

    Having spent a considerable amount of time in the USA, I have witnessed
    at first-hand the effects of private companies having a big hand in the
    healthcare system. I have seen the misery of outlandish premiums, people
    worried sick to go to the doctors because of outrageous one-time
    consultancy fees, and in the end convenient get-out clauses for
    healthcare companies for the purpose of avoiding provision of treatment -
    the so-called ‘pre-existing condition’ clauses.

    You claim that ratcheting up private involvement will not change the
    nature of the NHS being free at the point of source, but competition
    naturally creates markets and this will be the inevitable outcome.
    Frankly, Mr Lansley, you or any other health minister would be powerless
    to halt it after a time.

    Our health is not a business opportunity, so I hope the provisions are
    reconsidered before we go down the same path as the USA – a first-world
    country with third-world health for the majority of the people.

  • Jan

    To add to everyone’s reasons for wanting to scrap the plans – I would add:-

    The loss of the relationship as I know it, between me and my GP when my care may be based in resources not need

    The lack of equity of care from one consortium to another – challengeable under the public duty clauses of the Single Equality Act

    The lack of any meaningful involvement of patients, service users or carers in the consortia – despite Lansley’s mantra of “Nothing about me without me”. This a hollow sham – just like Lansley’s thinly disguised  ideologically driven plans to dismantle the NHS and his colleagues’ plans to dismantle public services on which many disabled or frail, elderly people and their carers rely.

    I don’t want charity – provided by the so called Big Society-  I want the dignity of services paid for from my taxes based on my right to access them when I need to. As a Carer I am one of the 6 million who provide £119 Billion of care per year to my relatives. Lansley’s plans will not help me in doing this – just make it worse – just like the cuts in the social care budgets.

  • Graham Fraser

    I’ve posted this to the ‘listening exercise’:
    Mr Lansley’s proposals will irrevocably damage our NHS.I grew up with the NHS as a child in the 1940′s and it has seen me and my family through six decades of healthcare. In all that time we could be confident that whatever might befall us and whatever our financial status, the NHS would be there for us with the best medical care. I have also lived in the USA and I have seen relatives lose their life savings to the health care companies in that country. I want my six grandchildren to be able to rely on the same standard of care and support that I have enjoyed in my life so far. Mr Lansley’s NHS will destroy that hope.

  • Hfirth

    Argue for complete withdrawal of the NHS Bill- Arguing for “safeguards” will simply allow the main elements of the Bill to go ahead.

    This Bill is
    - Contrary to  David Cameron’s promise “No more reorganisations”
    - Was not voted for by the public
    - Is opposed or criticised by every professional body
    - Has been widely criticised as dangerous and risk-y
    - Despite Cameron’s recent assurance he will take no risks with the NHS.

    Given this, it is logical to argue not for amendments, but for the complete withdrawal of the Bill,

  • Alex

    To me this is all so obvious, I saw this coming before the
    election. Tory’s and their donors have been planning this behind doors for a
    long time. Privatising the NHS to so called ‘Trusts’ run by themselves and then
    making a fortune from U.S. drugs companies who would then sell their drugs
    making billions. You should be ashamed. Our NHS is the envy of the world and you
    want to abuse it in this way. Shame on
    you.

  • Andrew

    I have several fundamental concerns about proposed changes to the NHS. I think
    it is time to go back to the drawing board.

    For example, I have not so
    far been reassured by what I have heard from the government on the issue of
    “cherry picking” of NHS services by private companies. “Cherry picking” could be
    extremely destabilising to our health service, and there must be a clear plan
    and legal mechanism to rule it out.
    If the motivation for these changes is
    simply to reduce the operating costs of the NHS, then several layers of
    Administrators and Management can be taken out of the system. This is already
    happening with some medical practices being run by Doctors, and the focus is on
    technical expertise with reduced costs i.e. a quality system that is very cost
    effective.
    If this is to be a repeat of the British Rail massacre by Dr
    Beeching, so that Tory Ministers can financially gain from Directorships in Road
    Transport, then this sucks, big time. How many MP’s and Cabinet Ministers will
    have Directorships or paid Consultancy Fees from the Private Medical fraternity
    with these changes?

  • Angie

    This was my post:

    I would like to express my grave concerns about Government proposals
    for the NHS. My primary concern is that I believe the real agenda
    behind these proposals is the privatisation of the NHS. Like many NHS
    consumers, I do not want to be able to choose between competing
    providers (all of whom are out to make a profit). I simply want to have
    confidence that when I attend a service, it will be fully staffed and
    fully equipped to meet my needs. I am also concerned that the most
    profitable elements of the NHS will be creamed off, and that there will
    be no reduction on tax payer burden. Instead of introducing
    competition, the Government should focus on further investing in and
    supporting our world-class service.

    My second concern is about plans to introduce GP commissioning. In my
    experience as an involved consumer, commissioning is a specialised and
    difficult task that is being undertaken by people who have specialist
    expertise and knowledge. GPs by definition are generalists with little
    knowledge of the intricacies and subtleties of specific disciplines. My
    belief is that GPs lack the knowledge, skills and will to commission,
    and will end up employing current commissioners in a new guise. Rather
    than saving the NHS money, this will result in massive upheaval with
    huge associated financial implications and a poorer service at the end
    of the day. As a consumer I am also concerned that I currently have to
    wait a long time to get an appointment with one of the four GPs I am
    happy to see in my local surgery; if these GPs are diverting their time
    and attention into commissioning, this will inevitably result in
    further delays.

  • Colin Wilkes

    I am making my personal contribution to the NHS listening exercise. I am extremely disturbed and concerned as to the direction the changes Andrew Lansley wants to implement will bring about serious damages to OUR National Health Service.The overall responsibility for health care and patient wellbeing should be the Secretary of State for Health, a person we should all know by face and his actions within parliament and especially in providing answers to questions raised on the floor of the House of Commons. If a faceless manager,(the regulator of Monitor), were appointed to hold overall responsibility then this would absolve any government from being held directly accountable to the patients, as individual users of the NHS and the electorate as voters of that government. The Government of the day has a duty to provide a fully comprehensive health service and social care. This must be maintained and encouraged to grow and develop along collaborative lines and not a system of competition. Collaboration is the bedrock on which the German economy is based not competition. How is their economy performing compared to the UK. Its time we learnt from others and applied what we see as good and of benefit. Competition within the NHS will lead to closures of hospitals in areas of the country that are not seen as financially viable. This is what happens now with not enough people living in a certain conurbation deeming not a viable proposition to sustain an A&E department or a Maternity unit. This has to end. There is no room within the NHS for the profit motive. The proposed implementation of commissioning bodies run by GPs is a notion from the annuls of Monty Python which would leave funds to be totally abused. Nepotism and corruption would be rife with lobbying organisations taking away funds for no reason other than they have friends. There are so many more things about this wholesale raping of the NHS i could say but i shall leave it at that.

  • Anonymous

    In the last para of my submission, I have laid claim to publishing of some evidence of harmful practices and outcomes in education whose damaging outcomes impact on teenage mental health and other NHS linked social services. Wish to make known that it is a duty of Lansley’s enquiry to publish this for me in order not to be acting obliviously to evidence in an area of NHS work affecting child safety.

  • Emma

    This was my comment:

    I rely on the NHS to manage my Multiple Sclerosis. No private healthcare provider will go any near me – my condition is too variable and has the potential to be too expensive. There is no way I want different providers “competing” to offer me care. I just want access to a neurologist to understands me and is an expert in my condition. I have that now but I’m worried that competition would mean my GP wouldn’t be prepared to pay for the best care – just the cheapest.Please reconsider.

  • Anonymous

    Promises to prevent “cherry picking” are very vague. How will this be prevented in practice? There needs to be much clearer plan to safeguard NHS services and prevent private companies destabilising them.
    6 million people who provide £119 Billion of care per year to  relatives. Lansley’s plans will not help in this regard – make it more difficult
    Privatisation requires probably at least a gross return of 20% for its investors and it is not believed the NHS budget could be reduced by 20% so what will the privateers have to do?  The natural consequence would then be if private companies can do it why couldn’t the NHS at a saving to the taxpayer?.
    Can £4bn a year for four successive financial years in efficiency gains be made without looking at wages and national pay bargaining?
    Alyson Pollock says  – There are four areas within the NHS that could be addressed.
    1. Abolish billing, invoicing and marketing by reintegrating NHS public services – that would save a great deal of money.
    2. Abolish trusts and capital charges.
    3. Reopen PFI contracts and look at rates of return and interest charges and assumptions about risk transfer and indexation.
    4. Pharmaceutical costs rise ahead of NHS and closer scrutiny is required not just of costs but of effectiveness of vaccines and new medicines and methodology and quality of data that underpins their introduction to the NHS
    John Appleby says  -  The £20bn productivity goal for English NHS is a choice that has been made by the Dept of Health. Other choices include simply carrying on as usual – but without increasing real funds.
    2. While NHS funding in England is close to just about covering inflation over next four years, in NI there’s a real cut of 2% or so over four years, in Scotland a real cut of 3% this year, and in Wales a real cut of 11% to 2014/15.
    The goal in England is to get about 20% more value from every health pound by 2014/15. That value can come from doing things more cheaply or doing things better (more quality) or some combination. Doing things more cheaply but at reduced quality (richardblogger) is not an improvement in productivity. There will be a worry of course that what seem to be improvements in productivity turn out not to be, but the aim is not to make cuts; it’s easy to “save” £20bn – just close wards. But as I say, that’s not the aim.

  • Debznfoz

    I am contacting you to express my concern about Andrew Lansley’s proposed changes to the NHS. I do not support these changes, I think they are seriously flawed and that a fundamental rethink is needed.

    For example, promises to prevent “cherry picking” are very vague. How will this be prevented in practice? There needs to be much clearer plan to safeguard NHS services and prevent private companies destabilising them.

    Its about quality not about competition. This has never worked for past projects and its not about to now. Look at the NPFit programme. This was passed across to private companies who completely messed it up.

    The NHS is one of our proudest princaples. Dont destroy it. The NHS represents everyone and EVERYone but yourselves are against this.

  • Anton

    As a retired couple we have paid into the NHS all our lives. We have done our share of paying,
    However, the service should be only available to contributers and not to economic migrants coming for 
    a free ride. After 5 years contributions they may then qualify providing they arrived here without having
    a criminal record!

  • Anonymous

    As a 62 year old British citizen who has lived in the US for the past 12 years, I’d like to give you a first hand idea of what ‘competition’ in health provision means. The current UK government’s ideology is one deeply rooted in privatization and profit; the changes proposed by Andrew Lansley are the beginning of the slippery slope towards the type of purely profit driven system which exists here in the US. I am extremely fortunate to be part of my employer’s health network plan – working as an university professor, and being one of thousands of employees, means that I pay only a small part of the monthly costs of my plan compared to the $870 per month I would have to pay on the open market. In a time of extreme economic uncertainty the first items that employers are cutting are healthcare and retirement benefits, creating millions more people who are in the situation of having no health coverage for themselves or their families. Can you imagine what it must be like to have your child be diagnosed with a life threatening disease and not have the means to pay for that child’s care? The only option is to sell your home and possessions or declare yourself bankrupt, and then have to deal with all the consequences that comes with it. Almost 80% of all bankruptcies in the US are as a result of medical bills. This is a common scenario – I have friends who are living in their parents’ garage at the moment, while their 8 year old daughter fights brain cancer.Earlier this year I had to go to casualty early one Sunday morning with an seriously infected thumb. I spent 90 minutes at the hospital, 10 of those with the doctor on duty. I had 3 novocaine injections and a tiny incision to drain the thumb. The bill I was sent stated that the total cost of this incident was $7,796.00 – that’s what I would have had to pay if I didn’t have health insurance. In fact, the insurance company was ‘only’ charged $3,100.00 of which I paid $150 to the hospital, and $125 to the doctor as co-payment. Friends of mine received a hospital bill of just over $120,000 for the husband’s three day stay in hospital after a heart attack, including charges of $10 for an aspirin tablet. They had to hire a lawyer to fight to get the bill reduced and succeeded in getting it down to $81,000 plus the lawyer’s fees.Can you imagine the fear of the millions of uninsured in case they get sick or suffer an accident? They have to think even before they go to a doctor’s office, ‘do I have the $100 to walk in the door, let alone what might follow?’An article appeared in the New York Times a couple of weeks ago about how American Health Insurance companies already have people ‘on the ground’ in the UK looking at what areas of an NHS break-up will be profitable for them. So, while politicians swear that a US type system could never and will never happen in Britain, big business seems to know the truth. Once the hungry corporate dogs of hell are let loose, the NHS as we know it is a dead horse.Mr Lansley needs to go back to the drawing board and think again, and stop trying to fob the British people of with a sham ‘listening exercise’. Please, we are not stupid.

  • http://tinnitusexplained.org Bill

    I am 87 and spend over £4000 pa on private health insurance but still rely on the NHS for the maintenance of my health. I believe your stance is mistaken and will leave a legacy you, and all of us will profoundly regret. 

    Profound damage has already been done to the morale of docters and nurses and your ideas need to be changed with both compassion and common sense. 

    My wife and I have voluntarily run a charity helping people with Tinnitus for over 30 years www.tinnitusexplained.org and supply the NHS.Bill howard fo HUSH

  • Trevor Parsons

    Please leave OUR  N H S alone,yes OUR N H S ,you have NO mandate whats so ever to bring in changes which will in effect,open it up to private companies who are only interested in making profit from the sick & needy,that in itself is SICK, you should be ashamed of yourselves, that said we the British Public will not allow you to do this so please think again and listen to the vast amount of people from all walks of life who are telling you that your proposals are wrong.Proud to have worked in the N H S and proud to send in my views. Regards,  Trevor Parsons. 

  • http://www.facebook.com/profile.php?id=561577500 Kevin Somerton

    I don’t know this will be of help to others but this is what i wrote to Andrew “cockin a deaf un” Landsley;

    I am writing to you as part of the listening exercise called by the Government in their reform of the NHS and bill currently going through Parliament. As a nurse working in the the NHS, I know that the NHS isn’t perfect or that all change is bad. However I think these proposals are fatally flawed and need a fundamental rethink.

    For example, proposals to make the NHS regulator, “Monitor”, focus on competition are flawed and dangerous. The “competition clause” in the proposed bill must be scrapped. The focus should be upon promoting cooperation to provide quality patient care, not on promoting competition. The role of the regulator, “Monitor”, should reflect this and promote collaboration.

    I work in an Early Intervention in Psychosis team in the East Midlands. This innovation, driven by pressure from service users and carers and dissatisfaction from within psychiatry itself would not have happened under a private healthcare company with its focus on profit on the bottom line. We are comparatively expensive as a mental health service, yet provide evidence based results in recovery, returning to work, education or training, reduction in suicide rates, reduction in bed occupancy and people leaving the service. The intensive service we offer to service users, friends, families and carers would not be valued by private healthcare firms.

    I feels it is important to maintain a comprehensive health service. I fear that people who experience severe and enduring mental ill health would be a group of people who be alienated and excluded in the future vision of the NHS. “Cherry picking” by private companies of attractive and potentially profitable parts of the NHS must be fully ruled out, and the mechanism for preventing it must be clearly established.

    I also feel that as we own the NHS, paid for by my taxes that any new commissioning bodies should be transparent and accountable. They mustn’t be allowed to meet behind closed doors. Patients and other health professionals must be represented as well as GPs. 

    As in Early Intervention of Psychosis, with the change coming from outside the NHS, the public are a force for good health. We must be allowed to scrutinise every part of the NHS through to local services, participate at general meetings and be a part of our health service.

    I trust you will reconsider your plans on the reform of the NHS.

  • Emily

    Dear NHS listening exercise,

    I am writing to express my concern about the proposed changes to the NHS.

    I have benefitted with help from the NHS when I have been ill, and would
    never be able to afford health care otherwise. We’re very lucky in this
    country to be able to see the doctors for free whenever someone is sick. I
    am concerned that the proposals will erode the NHS. For example, the
    propsal to remove the duty to provide a comprehensive health service will
    erode the foundations of the NHS. In addition, I am very concerned about
    the introduction of competition to what should be a public service. I think
    cooperation works better. If there is a surplus for  companies to be able
    to make a profit, that money is taxpayers money and should be put into
    improving the NHS not making a profit for companies. In reality I suspect
    that private companies could only make a profit by cherry picking the
    eaisest patients and cases, providing poor quality care or exploiting their
    workforce, all of which will erode the quality and comprehensiveness of the
    healthcare service.
    I am also concerned about the lack of transparancy and democracy involved
    in these new commissioning bodies, which are spending public money. I am
    concerned about them becoming locked into contracts with private companies
    to the detriment of future healthcare. This has happened in the past – for
    example the pfi inititative at my local hospital has caused a lot of
    problems, and I think this shows companies whos main interest is not
    helping people but making a profit have no place in publically funded
    health care.

  • http://twitter.com/puerhan puerhan 卜尔瀚

    I want to make a contribution to the NHS listening exercise. I am deeply
    concerned that the changes that Andrew Lansley wants to make will end
    up damaging our health service.

    Firstly I believe that the NHS should focus on providing quality
    healthcare, and absolutely not on competition. The role of the
    regulator, “Monitor”, should reflect this and promote collaboration with
    the specific primary aim of providing quality healthcare.

    Secondly it is essential that the government’s “duty to provide” a
    comprehensive health service must be kept. Dropping this duty would
    seriously erode the foundations of the NHS.

    Thirdly, “Cherry picking” by private companies must be fully ruled out,
    and the mechanism for preventing it must be clearly established. As for
    my first point above, quality healthcare must be the primary aim and
    not competition or profitability.

    Fourthly, any changes to the NHS of the scale currently proposed
    absolutely must be trialled in small areas for several years first. The
    results of the trials must be studied and further implementation plans
    modified based on the outcomes of the trials to ensure the primary aim
    of providing quality healthcare is maintained.

    Finally, any new commissioning bodies should be transparent and
    accountable. They mustn’t be allowed to meet behind closed doors.
    Patients and other health professionals must be represented as well as
    GPs

  • David Kerry

    I have received an e-mail from 38 Degrees inviting me to copy my letter to the Listening Exercise in this blog..I guess everyone will be posting their letters here in the coming days. Dave Kerry

    Dear NHS listening exercise,I am now a pensioner, having worked
    continuously for almost 50 years, I amalso dependent on the NHS taking care
    of me until I die, the NHS to which Ihave contributed all my working life. I
    never expected that any Governmentwould put that expectation in jeopardy,
    but that is exactly what I can seeyou doing if you go ahead with your NHS
    Plan.In the last fifteen years of my working life, I worked abroad as a
    Directorof several of USAID’s Economic Development Programs in the former
    SovietUnion. I was covered by my US employer’s private health insurance
    (BlueCross) and experienced at first hand what “competitive” private
    healthservices gave me and my American colleagues:- overcharging and
    invoice “padding” by ALL the profit making serviceproviders we used,-
    profit making insurance companies setting the levels of payments theywould
    pay the service providers, basing those payments on national billingaverages
    rather than actual cost,- insurance companies limiting the treatment we
    could have and theproviders we could use,- higher insurance premiums
    than most pensioners can now afford.- insecurity as to how most pensioners
    will survive if they fall seriouslysickMy American friends are now
    finding that the latest mix of Medicare andprivate health-care services
    doesn’t provide for all their needs. Theystill need to buy expensive top-up
    insurance and pay for over-pricedmedications. It is a sad reflection of this
    US mix that the hospitals firstask for a credit card, or insurance card
    before asking what is wrong withsomeone.Unfortunately, this is what
    I can see happening to our NHS if you go aheadwith your proposed plans. Many
    important voices, including the BMA andpeople within the NHS are calling out
    for your Plan to be scrapped. I amjust one pensioner and obviously I can’t
    anticipate you listening tome…but please listen to the many hundreds of
    thousands of people like meand take note.The current protest by 38
    Degrees, which I am supporting, is only a smallindication of what will be if
    you go ahead with your Plan. At this moment,most pensioners like myself
    prefer to believe that you have our bestinterests at heart. Now some of us
    are slowly learning that “we have got itwrong”. We are learning that you
    have quite another agenda, one whichpromotes the rise and rise of private
    health-care companies. Isn’t it afact that these companies stand to make
    enormous profit from your plans?Isn’t it also a fact that that loss of
    funding to profit is at thedetriment of the scope of NHS services that could
    be provided if the NHSwere to receive every penny of the available funding?
    Even we old folkunderstand that there is only so much cash available for the
    Government tospend on heath-care…the less of that cash which ends in the
    profit ofprivate companies and the pockets of their share-holders, the
    better forthe NHS…isn’t that right?Please take this very
    seriously..the people of this country did not voteyou into government to
    ruin our future health care with your badlyconceived Plan. If you do go
    ahead, as you are apparently already doing ifwe are to believe the “leaks”
    reported by the press, I predict a risingagainst this government by deeply
    concerned pensioners and their caringfamilies, the like of which has never
    been seen before. Please don’tconsider that a threat, it’s just a prediction
    based on what I can seehappening once we pensioners really start fighting
    against your Plan…aprediction as certain as the BMA’s prediction that the
    NHS will be ruinedif you do go ahead with your
    Plan.PLEASE…STOP…THINK AGAIN…LISTEN TO THE BMA…BE BRAVE ENOUGH
    TO SAY…”WE’RE SORRY, WE’VE GOT SOME PARTS OF THE PLAN WRONG, BUT WE’RE GOING
    TO STOPAND RETHINK”…AND REALLY MEAN IT.Yours
    sincerely,David Kerry19 Victory RoadBlackpoolFY1 3JT

  • Dave Kerry

    OOPS…where did all the line endings and paragraphs disappear to :-)

    Thankfully the letter that went out doesn’t look like this!

    Dave Kerry

  • Dave & Moira Emmett

    I am contacting you to express our concern about Andrew Lansley’s proposed changes to the N.H.S. The N.H.S.is one of the jewels in the crown of this country and its existence is very clearly threatened by these proposals.The N.H.S. will gradually drift towards the totally discredited health system which prevails in the U.S.A. and which is almost entirely in the hands of Mammon . Witness the appalling attacks being made on President Obama’s modest reform proposals ,which would give a modicum of health care to all U.S.citizens. Anyone in the U.K.can access health care when it is needed ,without cost or use of credit card.It is vital that this situation is fully maintained.Please do not use the question of patient choice in this debate.When the simple question of a general choice is presented some may acknowledge its importance.When that “simple” question is refined a little it becomes clear that “choice” is not what most of us want.How on earth can we explore the many and varied factors involved in making a choice and arriving at a balanced decision, especially when the pressures of illness or impending treatment are taken into consideration ? The sheer psychological and emotional pressures preclude any rational decision.What we need at these times is to be able to trust our health service ,with no financial considerations involved.It seems to us to be patently obvious that “choice” is a red herring in health care.
    Choice is for buying vegetables or a new car .In health care what is needed is the best treatment available when and where it is needed.
    Any evidence that is produced that contradicts this should be presented for full scrutiny by all parties and not glibly announced as a sound bite for the Media.
    We think that enough of the sham of these Lansley proposals has been revealed to make it clear that they are a very long from being for the benefit of all the people of our country,
    Dave and Moira Emmett

  • Dave & Moira Emmett

    Please forward this to A. Lansley, N Clegg nd D. Cameron and all the U.K. media who seem to have turned a ‘Nelson’s eye’ to what is going on.

  • Lesleymac_323

    Rather than repeat all those things I agree with on previous posts I would like to add the following:

    My husband works in the estates department of a trust which contracted the maintainance of health centres  out. Three years later the private company handed them back, they didn’t want the work because there was no profit it in.

    We continually hear Tory politicians and the media perpetuating the myth that there are hundreds of thousands of public servants who aren’t needed because there isn’t really a job for them.  This is a gross exagerration, we need medical records clerks so the doctors have patient files in front of them when they see a patient, we need payroll staff so the doctors and nurses get paid, we need engineers and maintenance staff so that when the drains block, or the heating breaks down, and the regulatory testing of medical equipment is required it gets done.  And so on and so on. Nurses and doctors alone cannot run our health service, the government would prefer us to think otherwise. 

    We have family who live in Switzerland who have to pay very high monthly insurance premiums for healthcare.  Even with this, they avoid going to the doctors or dentists when they need to, because of the very high prescription costs and they have to still pay a consultation fee at each visit, which was about £40 a couple of years ago.  One of the family comes to England and goes to a private dentist because it is still cheaper than the cost of treatment in Switzerland using her health insurance.

    80% of personal bancrupts in the USA are due to medical costs and failure of private health insurance to provide enough cover.

    If this massive experiment with our greatest asset goes ahead it could destroy our NHS – who will put it back together again and will it even be possible to do so.

  • Michael Horn

    I have fundamental concerns about these proposed changes to the NHS and I think Andrew Lansley needs to go back to the drawing board.For example, I am concerned that proposals to make competition the priority within the NHS would undermine our health service. The NHS should focus on cooperating to provide quality patient care, not on competition. The role of the regulator, “Monitor”, should reflect this.I have personal experience of private sector healthcare during my recent, severe mental illness. In April 2009, I was declared fit and healthy by an ATOS Healthcare GP after attending a standard Employment and Support Allowance medical at their offices. The reality was that I was severely depressed, unable to leave the house or work and, ultimately, suicidal.As a result of the erroneous ATOS Healthcare report, my benefits were stopped and I almost ended my life twice. I was also taken to hospital on two occasions as a result of suicidal tendencies. ATOS Healthcare is a private sector company, similar organisations if unleashed on the NHS would cause chaos.Profit making and market forces should be kept out of the NHS as private companies base their decisions not on what is best for patients, but on what is in the best interests of shareholders. This can only lead to an erosion of basic services, which will hit the most deprived in society hardestMake decisions based upon your conscience, not on profiteering.

  • Theo Bartley

    I am seriously concerned about Andrew Lansley’s proposals for privatising the NHS.We need more transparency, not secretive, behind-closed-doors politicking and conniving. Turning health into a commercial enterprise for entrepreneurs and businessmen to turn a profit and line their own pockets is counter-productive and open to abuse. It borders on criminal negligence.We can all see with some clarity these days how the financial sector and some commercial and industrial sectors hold the country to ransom, and control our elected leaders as though they are puppets. Healthcare is a very powerful weapon to put into the hands of greedy men and women.I am appalled at your plans.

  • Pingumick

    I’m making this submission to the NHS listening exercise because I have huge concerns about the proposed changes. I think it’s time to drop them and start again.For example, I am opposed to the proposal to scrap the Secretary of State’s duty to provide a comprehensive health service. This is a duty which has been fundamental to the operation of the NHS ever since its formation. It must be retained.Also as a psychiatric nurse working within the NHS, I already have seen first hand how staff morale is deteriorating and that patient care is being compromised through drastic cuts to services.It is also apparent that your proposals is “privatisation by the back door” and is causing real concern to my patients – some of whom are the most vulnerable in society.

  • Michael

    Grave concerns about proposed NHS reformsMessageThis submission is made to the NHS Listening Exercise because I have grave concerns about the proposed NHS reforms.

    The proposed changes need a complete redesign and any future proposals must strengthen and secure the future of the NHS.

    Any changes that may be made in future should be fully trialled on a
    local basis for an extended period before made across England.

    The proposal to remove the Secretary of State’s duty to provide a
    comprehensive health service is unacceptable. This statutory duty is
    fundamental to the maintenance of the NHS and must remain in place. The
    government must continue to bear a statutory duty to provide a
    comprehensive health service.

    The fact that the proposals have received such widespread, well reasoned
    and negative responses from clinicians and managers in the NHS is in
    itself an indication that the proposals are unsound. Government should
    listen to the professionals.

    The emphasis on competition is inappropriate. Our health service should
    be driven by quality of outcomes and patient care not competition and
    profit.

    Where external providers are involved their involvement should be purely
    on the grounds of effective patient outcomes. External providers should
    not be allowed to ‘cherry pick’ the most lucrative services.

    The Monitor should be charged with ensuring quality of service above all
    else. The duty to enforce competition should not be introduced.

    The proposals appear to give increased powers over health to local
    authorities. This is unacceptable as it is likely to lead fragmentation
    of services, lack of expert guidance, and the introduction of local
    political issues into health care.

    As a pensioner I am concerned that the elderly will become particularly
    vulnerable to poorer provision if the current proposals are introduced.

    I do not think that this Listening Exercise has been transparent. Much wider consultation is needed.

  • guest

    Well I have a read & am very concerned about all this. We really do not want to lose our health sevice – such a backwards step. We shouldn’t have to worry when we are ill about how we are going to pay. Ok health insurance can be arranged – but that would come with it’s own problems. Leave the health service provision as it is free for everyone – it’s essential. I really do not need to say anymore – because a great deal has been said already so I just add my agreement.

  • Robert

    MessageI don’t think everything about the NHS is perfect or that all change is bad. However I think these proposals are fatally flawed and need a fundamental rethink.For example, proposals to make the NHS regulator, “Monitor”, focus on competition are flawed and dangerous. The “competition clause” in the proposed bill must be scrapped. The focus should be upon promoting cooperation to provide quality patient care, not on promoting competition.Your parties were elected by default but even so your manifestos state categorically that the NHS will not be interfered with, even the most foolish person must realise that your proposals will have a massive impact on the NHS which in my opinion will be disasterous for patient care with practitioners unable to focus correctly on what they were trained to do.Managing of the current NHS must be more driven and focused on value for money, with all aspects of central purchasing being explored, and the persons responsible for spending and budgets must be answerable to local groups made up of health care professionals and the end users.The general public (rightly) in my opinion only see your proposals as being the introduction by the back door of the total privatisation of the health service, this is totally unacceptable, if we had less highly paid figureheads and managers with fancy grandiose sounding titles, and more workers who are willing to be hands on then the service would improve.It always angers me when the exhorbitant salaries of the senior executives are raised that the old “market driven forces” maxim is trotted out, they are the ones who drive the market and collude in keeping their salaries as high as they are. Why not try a new tack, as we are in the middle of a recession market driven forces are telling us that you are not worth what we are paying you, so you are free to go and get your exhorbitant salaries from the private sector, we will see how many (executives) are snapped up.Mr Cameron and Mr Clegg the NHS is not for sale go elsewhere and find some other business to sell to your greedy amoral friends.

  • Alex

    Virtually all GPs are untrained in business, economics or administration, relying on practice managers and accountants in their own small ‘patch’.Very few GPs have an active interest or experience in Public Health, although the vast majority will recognise the necessity and importance, especially in aspects such as infection control and immunisation policies in local outbreaks.Health and WellBeing as a concept is not in the forefront of the day-to-day mind of a busy working GP. Thinking of the practice as a population is not part of our usual thinking culture.Years of countless hours in PBC meetings with small practice groups unable to achieve many tangible results through internal disagreement or PCTs obstacles does HIGHLIGHT THE NEED FOR CHANGEThe current complexity of NHS care strongly suggests EVOLUTION and EDUCATION are necessary when developing new pathways of working and commissioning which are not going to involve excess amounts of GP time away from their practices.I trust medical education undergraduate and postgraduate is now providing or planning to offer business economics, administration and public health modules at appropriate levels for all doctors of the future. Intensive courses and qualifications for the few GPs in managerial or service development roles for commissioning groups can only bear ‘good fruit’.Consider OBESITY as a practical issue to think through the desired END POINT after legislative change. The health issues around obesity are well known and leads to vast suffering and expense.NATIONAL
    ADDRESS THE NATIONAL NEED THROUGH AN EFFECTIVE MEDIA CAMPAIGN WHICH IS ONGOING (Programmes such as Celebrity Fit Club’ may entertain more than educate). Jamie Oliver schools initiative should develop into the workplace.LOCAL
     COORDINATING AND COMMISSIONING EXERCISE AND COMMUNITY DIETING AND EDUCATION . ACTIVE LIVING and LOSE WEIGHT, FEEL GREAT SCHEMES HAVE BEEN VERY GOOD STEPS. OUTCOMES NEED TO BE EVALUATED, METHODS OF LOCAL POPULATION ENGAGEMENT IMPROVED AND GP COMMISSIONING GROUPS TO DEVELOP THE NECESSARY PARTNERSHIPS INCLUDING LOCAL MEDIAUse of COMMUNITY PHARMACIES: many offer clinical support and can sell OTC Orlistat in the dose of 60mg capsulesPRACTICE
     One main strategy involves prescribing ORLISTAT 120 mg capsules for many obese people without necessarily even arranging monthly weighings. Many doctors will offer healthy living advice, but the success rate of practice intervention is low. Much money is wasted on Orlistat prescribing. My SUGGESTION is to think how proposed legislation could deal with obesity any better than the current structures, pathways and resources.THINK  THINK AGAIN  THEN MOVE FORWARD

    alex

  • Tony

    I
    am very worried about Andrew Lansley’s plans for the NHS. I think he is
    trying to change too much, too quickly.

    Having worked with hospital dotors and GPs for many years I consider that
    whilst most are extremely competent & dedicated clinicians they do not
    make good managers. They are doctors first & foremost, have never had
    training in management, have no knowledge of business planning, & tend to
    think in the immedaite rather than strategically. What will hapen is that the
    Commissioning groups will simply employ the managers and staff currenlty
    employed by PCT’s.
    Whilst the NHS need to improve the proposed changes are ill thought out, will
    be extremely costly & disruptive & will lead to deterioration not
    improvement .

    The NHS should focus on providing quality healthcare, not on competition. The
    role of the regulator, “Monitor”, should reflect this and promote
    collaboration.

    Any changes to the NHS of the scale currently proposed should be trialled in
    small areas for several years first

  • KEN

    IF THE HEALTH MINISTER HAD BEEN ILL IN THE U SA WITH THE INFLATED COSTS HE WOULD NOT CONSIDERED THE SUBTLE DEMOLITION OF OUR FREE AT THE POINT OF DELIVERY SERVICE.
    COMMISSIONING WILL NEVER BE TRANSPARENT. THERE ARE ALREADY, TO MY KNOWLEDGE,  BOARDS  CURRENTLY OPERATING TO DEFLECT REFERRALS FROM G P TO SPECIALIST BASED ON COST, AND THIS WOULD BE WORSE IF PRIVATISATION  BECOMES ENDEMIC. YOU ONLY HAVE TO LOOK AT THE NURSING AGENCY OUTGOINGS TO SEE AREAS OF VAST EXPENSE.. 
    BETTER QUALITY MANAGEMENT IN ALL SENSES  IS URGENTLY NEEDED. ——————–HEALTH SERVICE WORKER

  • Robert

    I am extremely concerned about Andrew Lansley’s
    plans for the NHS. I think his approach would fundamentally change the nature
    of the service in a way that will not benefit either patients or taxpayers.

    NHS reforms should continue to focus on providing us with quality healthcare,
    not on trying to create articificial ‘competition’ mechanisms. Extending the
    ‘market’ approach and encouraging private provision to cherry pick elements of
    delivery will undermine the comprehensive service we receive – whatever pious
    words may be used about this not being the intention. The regulator’s role should
    be to promote quality and collaboration.

    Transparency and accountability is essential in any new commissioning bodies.
    They mustn’t be allowed to meet behind closed doors. Patients and other health
    professionals must be represented as well as GPs.

    I sincerely hope that this ‘listening’ exercise will genuinely take account of
    the views of taxpayers and NHS users instead of the commercial interests of a
    few.

  • Charlesholmes

    My response to the Listening Event

    1.   
    The waiting time target of 18 weeks has been
    abolished. This has already resulted in waiting lists getting longer and it
    will only get worse from now on.

    2.   
    There is no longer a limit on the amount of private
    work that can be carried out in any NHS Hospital.

    3.   
    This means quick treatments for the wealthy who can
    afford to pay and longer waiting times and more suffering for those who cannot.

    4.   
    A two tier Health Service is therfore being created
    by stealth based on the ability to pay and not on clinical need.

    5.   
    GPs
     are to be given 80% of the NHS budget to
    buy hospital and community based health services

    6.   
    Most
    GPs have absolutely no experience of buying these services and will need to
    employ other people to do this work.

    7.   
    GP Consortiums are already contracting with private
    sector companies which are being set up for this purpose.

    8.   
    This means that because tax payers’ money is going
    into private sector profits and shareholder pockets and there will be less to
    spend on patient care.

    9.   
    Your
    GP will have less time available to spend with patients.

    10. GPs will become more concerned about their budgets and less concerned
    about patient care.

    11. The legislation, if passed, will allow GPs to charge for some of their
    services.

    12. European Procurement
    Rules mean that NHS services will have to be put out to tender and this will allow any willing provider from anywhere in
    Europe to bid for local NHS Services. These consequences cannot be described as
    local accountability.

    13. The inevitable inconsistency of GP Consortium policies will lead to a
    tremendous increase in Post Code Lottery treatment availability rather than a
    carefully considered and consistent nationally approved policy approach. 

    14. All these changes will lead to a fragmentation of health service
    provision and risk the disintegration of the NHS as we now know it.

    15. More contracts resulting from this legislation will mean more legal
    advisors, managers and administrative staff needed to write contract
    specifications, monitor contract compliance, certify and pay invoices and
    resolve the inevitable complex legal disputes over service specifications and
    contract interpretation which will occur.

    16. This means that the
    cost savings that the Government claims for these reforms will not be achieved and that it is much more likely that
    administrative costs will actually increase.

    17. The Government says that GP Consortium areas need not be the same as
    Local Council’s Social Care boundaries.  

    18. This means that there can be more than one GP consortium in any Social
    Care area and also they also say that any GP Consortium can operate in more
    than one Local Council’s Social Care area

    19. Managing these additional business relationships, which will be much more
    complex than if the two Health and Social Care services were co-terminus, will inevitably
    result in duplication of effort and consequential increases in administrative
    costs, not only for the GP Consortiums but also for the Local Councils whose
    budgets have already been dramatically reduced by the Government.

    20. All these inevitable consequences are the very opposite of what the
    Government claims it will achieve through these reforms.

    21. All these risks clearly demonstrate either a reckless disregard for our
    future health and welfare or that this Government is totally out of touch with
    reality.

    22. Before the last election Cameron promised that there would be no more Top
    Down reorganisations of the NHS. This is the biggest Top Down reorganisation
    since 1948.

    23. No one voted for it. It was not in any manifesto.

    24. It will not save money.

    25. Such a revolution is not needed. Incremental and evolutionary change
    would provide better sustainable outcomes for patients, the Treasury and the
    Tax payer

    26. There is no evidence that it will improve the quality of health care

    27. There is no evidence that it will be more efficient

    28. There is no evidence that total management and administration costs paid
    for by the NHS, internally, to GP consortiums, NHS providers or Private Sector
    providers will be reduced overall.

    29. There is much well informed opposition to these reforms from:

    Ø  The Royal College of
    General Practitioners

    Ø  The Royal College of
    Surgeons

    Ø  The Royal College of
    Nursing

    Ø  The Royal College of
    Midwives

    Ø  The British Medical
    Association

    Ø 
    The
    NHS Confederation

    Ø 
    The
    King’s Fund (An independent Charity which seeks to understand how
    the health system in England can be improved and how to shape policy, transform
    services and bring about behaviour change).

    Ø 
    Various
    major health related Charities including Rethink, Alzheimer’s
    Society, Asthma UK, Breakthrough Breast Cancer, Diabetes UK, National Voices, The
    British Heart Foundation and The Stroke Association.

    Ø  The Liberal Democrat
    membership and many MPs

    Ø  The Labour Party

    Ø  Some Conservative
    Members of Parliament

    Ø  Unite

    Ø  Unison

    Ø  The Local Government
    Association (particularly about the lack of local accountability for the new GP
    consortia and commissioning proposals for local populations and vulnerable
    groups)

    Ø  Various national,
    health related Charities including: Rethink, Alzheimer’s Society, Asthma
    UK, Breakthrough Breast Cancer, Diabetes UK, National Voices, The British Heart
    Foundation and The Stroke Association.

    30. There is only very
    limited support for these reforms:

    Ø 
    The
    Prime Minister, Andrew Lansley, George Osborne and other Tory Cabinet Members
    and most, but not all Tory MPs plus large national and multinational Companies
    of which Virgin Health Care is but one example.

    31. Most GPs are
    reluctant participants, but have no option to join a consortium if they wish to
    continue to be funded by the NHS.

    32. Over 418,000 people have
    already signed a petition at http://www.38Degrees.org.uk
    in opposition to these reforms. Why isn’t the Government listening to the
    public and to the experts who are making their concerns clear, and why are the
    listening events not available to the public so that these voices can be heard.
    My PCT and Strategic Health Authority have no plans to hold listening events so
    the whole “listening” event scheme is a sham with the already converted talking
    to each other and ignoring the warnings and disquiet which is gaining momentum
    each day. The more we know and understand what is going on the less we like it. 

  • Lewis568

    If these plans are so good for the NHS why were they not spelled out in the manifesto so that people would have a chance to provide a mandate for these changes? Were the Conservatives worried that disclosure would make them unelectable?

  • Susan Clark

    I am contacting you about my grave anxiety in relation to Andrew Lansley’s proposed changes to the NHS. The government has NO MANDATE for these changes which will dismantle a fine, collaborative and patient centred service (patient satisfaction has never been so high) and replace it with a marketised, competitive and fragmented system, organised on a profit basis for the ‘private providers’.
    One serious implication is the threat to access to highly specialist – and thus expensive – treatment. Patients requiring very costly drugs (such as those now successfully keeping their chronic myeloid leukaemia under control with life saving protease inhibitors – nationally endorsed by NICE, regardless of the patient’s postcode) will become a liability when GP practices are referring to competitive private ‘health care providers’ whose bottom line is NOT health but profit.
    This situation will have other grave consequences – with the funding for training and research into highly specialist and academic medical disciplines at real risk. The great teaching hospitals will be having to deal with the most expensive treatments and technologically most sophisticated procedures, while the private companies, mindful of their shareholders, will stay afloat with offering the more ‘profitable’ (ie less specialist) care.
    The fragmentation of the service can only be detrimental to the continuation of a nationally understood and supervised health provision. The introduction of NICE was wonderful in ending the post code lottery. How regressive to now pass such difficult funding decisions to the GPs – and how unfair on them and to patients not living in the right area.
    As I said above – no-one voted for this. The medical professionals oppose these untested and destructive proposals. They are ethically (and medically) indefensible.

  • Ab_hamed

    I do not accept that there is anything wrong with the NHS as it is. All the disruption will do is change the things that are wrong, not eliminate problems. Health heaven is not going to happen. To improve the NHS we need to use an evolutionary process rather than the revolution that is proposed by the ignorant ideas Mr Lansley is pushing.

  • Santeproject

    Health Insurance.  Dont make me laugh! Did you see the US film on BBC last night about a lawyer who won a case for a woman with a son who had needed a bone marrow transplant before he died?  The Insurance company used a policy of refusing every claim at the outset.  Then keeping employees from knowing what the real company policy was.  The case was proven but the company just went bankrupt so as to avoid payment.  So not a penny was paid to the claimant in spite of the correct judgement.  So forget about Insurance for Health.  That’s another racket inspired by the capitalist machine.

  • Edmondo Minisci

    I don’t think everything about the NHS is perfect or that all change is
    bad. However I think these proposals are fatally flawed and need a
    fundamental rethink.

    For example, proposals to make the NHS regulator, “Monitor”, focus on
    competition are flawed and dangerous. The “competition clause” in the
    proposed bill must be scrapped. The focus should be upon promoting
    cooperation to provide quality patient care, not on promoting
    competition.

    Privatisation is never the correct answer to problems of State
    administered “businesses”. It is unbelievable that such a step could be
    carried on now in UK when it has already demonstrated to fail in USA.

    Please, if you like to do a good job, operate to improve the current
    system, from a viewpoint of service and efficiency, but do not give the
    NHS away!

  • Kaia

    I am very concerned that the proposed changes impy that GPs have access to specialist knowledge which they do not necessarily have, and although they can of course buy in such knowledge, under the new proposals this would cost them and therefore they may not do so. This will result in a sidelining of the patients with the most complex needs and potentially creating a very discriminatory NHS.
    I have a very complex mental health condition caused by years of ongoing sadistic abuse, and even under the current system my needs are considered too complex for many of the mental health teams to accomodate- and under the new proposals the frontline services would have even less expertise to appropriately assess my needs. This is the case for many many patients.
    For patients who have complex needs, whether they are physical, psychological or due to a disability not only will GPs be unequiped to diagnose approiately, but they will also have to pay more for the treatment of these patients. GPs by their nature are not specialists and this proposal would expect them to financial mangers as well. If they outsource the financial managment aspect of thier new role, then financail desicions would be made by someone even less specialist.
    We arein danger of creating a very discriminating health system, where disabled people are discriminated against because of the cost to a GP surgery and also because of the lack of expertise to appropriately assess. This would be against everything the NHS stands for and be very dangerous. It will also cost more in the long run as mistakes in treatment will mean a further cost in putting such mistakes right, and such mistakes are inevitable when we ask GPs to make desicions about conditions they have no way of knowing about and are not trained in.
    I suggest that Andrew Lansley seriously considers whether the effect of such changes would actually be illegal under the disabilty discriminations act.
    We currently have an NHS which may not be perfect but is good enough, and to mess with it to such an extent would be disasterous.

  • Mike

    I have fundamental concerns about these proposed changes to the NHS and I think Andrew Lansley needs to go back to the drawing board.For example, I am concerned that proposals to make competition the priority within the NHS would undermine our health service. The NHS should focus on cooperating to provide quality patient care, not on competition. The role of the regulator, “Monitor”, should reflect this.The NHS should focus on providing quality healthcare, not on competition. The role of the regulator, “Monitor”, should reflect this and promote collaboration.The government’s “duty to provide” a comprehensive health service must be kept. Dropping this duty would erode the foundations of the NHS.Cherry picking” by private companies must be fully ruled out, and the mechanism for preventing it must be clearly established.Any new commissioning bodies should be transparent and accountable. They mustn’t be allowed to meet behind closed doors. Patients and other health professionals must be represented as well as GPs.I am only alive today because of the fantastic skill & care available on the NHS. If private profit is to be the centrepiece of this service, more people will not receive the quality of care I received for my life threatening cancer.Forget your ‘private sector good’, ‘public sector evil’ philosophy which forms the basis of these proposals. The NHS is not safe in your hands; the Conservative party is toxic on this issue as so many of the people recognise. Yours sincerely,Mike Smithson,

  • Spaul

    I am very concerned by the proposed plans to offer NHS services out to tender by private companies. This is bound to result in profit making companies taking advantage of tax payers money to make huge profits for themselves with £million salaries to their executives.It is far better to ensure efficiency and control of salaries within the present systen rather than dismantling an system which is at present the envy of the world. I believe that the proposed plans are founded on dogma and not on the principal of improving the NHS. Please stop the proposed plans and think again, you will cause utter chaos with these plans and destroy something we should be proud of; you will also end up paying far more – you only have to look at the appauling and hugely expensive health care system in the USA.. I am not a health professional but a teacher.

  • Peter Gorman

    As a retired consultant in Pain Medicine, among my many concerns about  the proposed ‘reforms’ is that the needs of people with chronic conditions will be even less adequately met  than they are  already. Meeting these is generally not ‘profitable’ and will be given a low priortity in a market-based system.

  • GPO

    I am making this submission to the NHS listening exercise because I have grave concerns about the proposed changes. My concerns include the following:* I am opposed to the proposal to scrap the Secretary of State’s duty to provide a comprehensive health service. This is a duty which has been fundamental to the operation of the NHS ever since its formation. It must be retained. It absolutely should be the Government’s responsibility.* The NHS should focus on providing quality healthcare rather than competition. The role of the regulator, “Monitor”, should reflect this and promote collaboration rather than private provider cherry picking* Any changes of the signficant nature posed should be properly and adequately trialled, taking into account the experience of health care and management professions and not taking notice ONLY of the few that have a vested interest in the change* Let previous changes bed in and be proved before yet another upheaval* Patients DO notice changes whatever the Government may say – patients notice cuts and experience the impacts of cuts – they should not have to worry about this at the same time as worry about their own illnesses* Any new commissioning bodies should be transparent and accountable and should not be groups of only those with a vested interest. They mustn’t be allowed to meet behind closed doors. Patients and other health professionals must be represented as well as GPs. And they should have proper management, commissioning, planning and public health expertise.* Management is NOT a dirty word – properly and adequately managed organisations are effective. Stop cristicising all managers and the “back room” staff that keep the NHS on the road everyday. Management costs are necessary. They exist in private practice and all businesses alike. Yes, go for effectiveness and efficiency but stop doing down the many who really do work for long hours everyday to support health care – it’s not just doctors and burses who work hard. But ALL management, administration and clinical professions will become disillusioned if it is constantly criticised. * Why not give the NHS and its staff a good bit of feedback and identify the good things that are happening and examples of good management and practice – that alone could provide a boost for improvements.

    * AND – there is no mandate for the Government to do this and the wealth of opposition as cited elsewhere on this site is overwhelming.

  • Julz

    I am very worried about Andrew Lansley’s plans for the NHS. I think he is trying to change too much, too quickly.IN PARTICULAR it is obvious that the changes are designed to put the NHS into an organisational state whereby it can be privatised any time – its all very well making promises NOW that the heath service is not being privatised, but no one can make promises for the future – which is the loophole he is using.This is SNEAKY and unforgiveable – we are justifiably proud that Britain has the best service possible and is free at the point of use -unlike the American system he is trying to emulate – which places people with long illnesses in the position of bankruptcy and loss of their homes.So I don’t want us to take ANY steps in this direction, and ask that the whole plan is scrapped and a complete rethinking is put in hand that will be far more suitable for future needs and strains on NHS budgets.thank you

  • AML

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    I have just sent the following letter to the listening exercise because as i point out in my first paragraph I am frightened by what is being proposed.

    Please take on board my concerns about proposed changes to the NHS. I am gravely concerned, in fact I am truly frightened, that I will be denied life saving healthcare which I may need in the future as I will not be in a position to pay for private treatment.

    The explanation that the country can’t afford to provide NHS services with an ageing population and growing expenses as medical and pharmaceutical advances are made is fundamentally flawed, it is a question of ideological choice. 

    If the country chooses to fund the NHS adequately to provide health care for all, free at the point of contact, with no ‘postcode lottery’ determining what services are provided the funds can be provided. It is all a question of how the Government of the day choose to spend taxpayers money. This Government is using the recession to dismantle the NHS and choosing not to provide adequate healthcare for patients. 

    The proposals from Andrew Lansley are setting up the NHS to fail while at the same time providing a framework for future privatisation. The GP Consortia will become private enterprises receiving Government money with no scrutiny.

    At this time many aspects of healthcare have been overlooked by the Government. For example, not enough thought has been given to how the proposed GP Consortia will manage the NHS in a fair and balanced way. I am not alleging that they will intentionally fail to do this but they have been put in an impossible position. The GP Consortia are being asked to take on all the responsibilities of the current PCTs including Continuing Care Provision, Mental Health Servies (both acute and community based), IVF treatment, to name but a few, they are wholly unprepared for this role. Their skills lie in providing primary care to patients and not managing the NHS, it may be an unpopular philosophy but managers are needed to do this, with guidance from Clinicians, which is what happens at the moment. 

    The Government is claiming that many GPs are signing up to get involved and that this therefore demonstrates support for the changes. This is NOT the case, they are signing up to become pathfinders because it is the only way they will have any support implementing the changes. GPs have been told that no support will be available if they are not pathfinders, the PCTs are already being dismantled and good NHS managers are being lost to the NHS as their future is uncertain.

    The Government also claim that many services are currently successfully provided by private organisations commissioned by the PCT. While this is true what they fail to mention is that the PCT underwrite these organisations. Without this security they would be unable to provide the service, without this safety blanket their insurance costs will grow astronomically and therefore the charges they will make to GP consortia will have to rise accordingly. This will hardly save money.

    I understand that savings can be made in the NHS, this is undoubtedly true and is certainly something that should be done as a matter of priority. Smarter management and scrutiny with less bureaucracy can achieve this goal. If this is coupled with clinically driven targets and regulation with sanctions for those not meeting clinical and management standards those standards will improve across all sectors of healthcare and in all geographical areas (as they have done over the past 5 – 10 years). A massive restructuring is not necessary to achieve this.

    Despite the rhetoric about how much they love the NHS all the Government Ministers who are promoting these changes are in a position to pay for healthcare and it is the lives of others, mine included, that they are gambling with. Anyone who doesn’t see that this policy is ideologically driven is sadly misguided.

  • Steve

    Dear Mr Lansley
     
    I’m a doctor, trained in the UK. The NHS provided me training opportunities which are the envy of the world. I worked for 5 years as a junior doctor in various specialties, then as a GP for 10 years. I felt I had benefitted personally from the NHS and had more than paid back my dues (I am of the generation that had a contract to work 98 hours a week but actually did more as a junior, then worked over 60 hours a week regularly as a GP).  The “new contract” and various ill-thought-out changes during the previous Tory government resulted in us making massive changes to staffing and services, only to find the goalposts were moved again. Many good doctors got out when the new contract came in. I myself went half-time as a GP in 1996 and left the following year to start full-time training to become a specialist in Occupational Medicine. I have provide Occupational Health advice to a number of NHS Trusts across the Southeast over the past 7 ½ years and see the effects of change on staff morale and service delivery. Clearly the service must change to address deficiencies and inefficiencies, but this should be done with full consultation, agreement, “buy-in” from stakeholders , pilot studies and in a way which is easy to audit and demonstrate the effects.
     
    Sadly, I don’t see your proposals, taken together with other recent legislation and proposals, as meeting these criteria. Neither do I see the need for further radical change at a time when the NHS is doing very well and about to outshine other models of healthcare delivery in Europe. More power can be given to clinicians in planning and delivering services within the existing legislative framework; as I see it, the reason you need a new Bill is to change the whole foundation to pave the way for a complete shift in how healthcare is delivered and who is responsible (no longer the secretary of State for Health). As I see it the checks and balances in the new system would only look at financial aspects and the benefits of a universal system would go, fragmenting care, allowing the marginalised in society to either miss out on healthcare or receive a second-rate service such as we see in the US. Though clinicians may be motivated to train the next generation of doctors, build preventive measures into acute care and build systems which will endure, the commercial providers who employ them will look to their profit margins and shareholders demands for the duration of their contract rather than the long-term health of the nation.
     
    I was born on 5th July 1958. Exactly 10 years earlier the National Health Service was born. Though some of the principles of its founders have been rather eroded over the years, your proposals logically lead to a very different system which should therefore be called something different in fairness to both those founders and the few folks left in society who still think the Health and Social Care Bill represents just another “NHS reform”.
    Some of these concerns and others, which I share, about workforce planning, confidentiality, responsibility for care, the role of the Public Health service etc. are raised in the BMAs submission to the NHS Future Forum. I did not contribute directly to that submission but wanted to register my views before the end of your listening exercise. I say we don’t need the proposed change in legislation and the NHS is on the brink of demonstrating significant improvements which can be sustained. For the sake of the nation’s health (and I include economic factors in my holistic definition of health) please “don’t do it!” If you are genuinely listening, you will be hearing the same message from the rest of the nation. We trust your hearing will lead to understanding and action to stop the speeding express train you released too soon, too fast.
     
    Kind regards
                                                                                                                                                                                                                                                            
    Dr Steve Waters MB ChB MFOM CMIOSH
    Consultant Occupational Physician (GMC no. 2593209)
     

  • Puffin

    For example, I cannot understand why the government is proposing to
    scrap its duty to provide a comprehensive health service. This duty has
    always been fundamental to the NHS, and it must be retained.

    The duty of care should be maintained, rather than a duty to outsource, increase profits and keep shareholders happy.

    The only duty for shareholders is to make a profit. Full stop. No mention of quality of care there.

    Self-regulation and market forces are a joke: Energy companies anyone?
    I believe a society can be measured by it’s treatment of the
    vulnerable.

    I appreciate that the Hippocratic oath has been altered within the
    countries where it is referred to when providing medical care. However I
    do not believe that it should be forgotten altogether.

    Health care professionals should not be checking credit card balances before patient’s pulses.

    I believe a society can be measured by it’s treatment of the vulnerable.

    Why should our NHS be run on the principle of the lowest bidder wins?

    I do believe that the patient, along with a multi-disciplinary team can
    provide a more holistic approach to care and therefore better than can
    be provided by one discipline on it’s own, such as doctors.

  • Jnelki

    The pct is continuing with the changes – cutting posts, reorganising, merging pcts etc in spite of the so-called pause – they need to stop if there is any real likelihood of doing something else now

  • Katie

    I am very unhappy about the Conservative Party’s plans for the NHS. It is a fundamental human right that everyone has access to heath care. The UK should be proud of its commitment to provide free health care to all, no matter who they are or how much money they have. Our aim should be to improve the NHS, not to scrap it.
    The quality of health care people in the UK receive should not be dependent upon salary, who you know who can get you ahead in a waiting list, or your postcode. Everybody should be equal. This would not be possible under a privatised system.
    The overwhelming majority of people want to keep the NHS – only the people who will financially benefit from the overhaul are in favour of the Tory plans. Surely the Conservatives will not ignore the wishes of the masses in favour of the rich few?
    Please support a health care service which is accessible to everyone, who will treat everyone equally and whose focus is on providing the highest possible standard of care for all. Please listen to the people of the UK. Please support the NHS.
    Thank you

  • Pat_barnes

    I want to tell the NHS listening exercise that I am very worried about Mr Lansley’s proposals for the NHS. I think he is going about reforming the NHS in completely the wrong way.
    For example, I am concerned that changes of this scale are being proposed without a decent trial period first. Why is the government not trialling these changes in a few areas for several years first, to see if they work? Why is Parliament being asked to vote them through without evidence that they will benefit patients?
    I have recently been on the receiving end of the NHS and I have nothing but praise for the treatment I received from all concerned. Surely a better way to improve the NHS is to look at each area in each authority and ASKING the medical professionals and patients/public where they can see a need for change/improvement.. Then, ASK them to say what form they think the changes/improvements should take. By engaging the people who have true knowledge and experience of the NHS you are more likely to carry the country with you.

  • Yamamaclothing

    Just thought i’d share my letter with everyone…don’t expect it to get to him but i sincerely hope it does! dear Mr lansley
    “No amount of cajolery, and no attempts at ethical or social seduction, can eradicate from my heart a deep burning hatred for the Tory Party. So far as I am concerned they are lower than vermin.”Aneurin BevanI am horrified at your plans to privatise the NHS. This is the world’s greatest socialist achievement. you self-obsessed knobhead. I hear your department was bank-rolled by private American Health companies before the election. Have they set-up a trust or foundation fund for one of your obscure relatives, somewhere in the Camen Islands as well? You are indeed an evil man. Shame on you. You selfish, arrogant excuse for a human being. You can sue me for defamation if you like. But i have nothing. No money. no home. no future with fascists like you in control. But i have a conscience (you wouldn’t understand the concept, so just ignore that) and while i am still able to live and breath i will fight YOU to the death. How much personal wealth do you stand to make out of this you sick minded idiot? ”I would rather be kept alive in the efficient if cold altruism of a large hospital than expire in a gush of warm sympathy in a small one.”Aneurin BevanThis will be you, dying in a private hospital, where all the staff pretend that they care about you because they need to keep their de-unionised jobs to pay for their kids healthcare and schooling. But really they spit in your bone china cup of tea and the male nurses rub their dicks in your caviar. And when you are dead, no one will care or remember you.

  • Pipeman

    Hi. This was my contributuin to the “listening” (ho ho) exercise. I live in hope.

    I want to make a contribution to the NHS listening exercise.

    1. The proposal that the Govt should no longer have a duty to provide a comprehensive health service is as repugnant as it is unbelievable. Why are we paying National Insurance? Are you going to refund years of NI payments if we are no longer to be guaranteed health provision when we require it? As a Govt that constantly talks about “value for money” going to defraud us out of the money we have already paid towards health care by not providing it?
    This proposal in itself is a sure indication of the end of the National Health Service as it was originally set up to provide whatever health care was needed free (of course, it isn’t really, because we pay NI all our lives) at the point and time of need.
    And as it appears that the Health Secretary will no longer have a duty to ensuring a standard of health care, what is the health secretary for? Will the Health Secretary’s salary be reduced in line with the reduction in responsibility, in the best interests of value for money?

    2. What on earth makes you believe that GPs, trained in medicine and health care, will have the business and/or entrepeneurial skills to negotiate contracts to procure best value services? This is a specialisation in itself, and will require a new tier of “Business Support Officers” to support them. Hardly a saving of money there – or did you have it in mind that the staff of the private companies would assist them? No conflict of interest there, then!!I understand other contributors have commented extensively on the use of private companies and the ethos of competition, the potential for “cherry picking” and the move towards an American style health care system which our “essential” ally is trying to get rid of. I would just say that I very strongly support those who are against the use of private companies.

    3. Can you please explain why you took on a £150k Permanent Secretary (a little more than the PM, eh? is the PM going to strike for pay parity?) to oversee the changes to the NHS (that’s what the ad on the Civil Service jobs website said) before there was any public consultation?

    4. Over the years, successive governments of all colours have fiddled and interfered with the National Health Service – and not always to its benefit – but yours is the first to actively try to destroy it entirely. The voting public may initially listen to the constant mantra of “the mess left by Labour.” When a Govt tries to justify its policies by putting everything on the previous administration, that is only good for the first couple of years until we start to look at the current administration’s own record and the immediate personal effect its policies have on us. With your commitment to your ideology, you probably would not understand, but there are some things so precious to the voting public that no mantra is going to blind them: nothing will save the Government which initiated the break-up of the National Health Service.

  • Mortimer254

    amanda mortimer 9 ferndale grovebradford bd94leToNHS listening exerciseSubjectNHS Proposals: too much, too fastMessageI am appalled at the underhand manner in which the coalition government – and Andrew Lansley in particular – are trying to rush through privatisation plans for the NHS after assuring voters at the General Election that there would be no ‘ top down’ changes to the NHS. Mr Lansley had planned the changes years previously. There is therefore absolutely no mandate to destroy one of the institutions for which we can be proud and which make British society civilised.The Observer newspaper revealed recently that one of Mr Lansley’s top advisors has communicated to private health companies that they can look forward to some very highly profitable business very soon. It is wrong to seek to make a profit out of ill health and disability, especially while we know that the ability to pay will become paramount and the most vulnerable and less well off people in our communities will suffer. As American President Obama put it in his visit here this week, at least Britain has a health system where you can be ill without having to face bankruptcy – unlike in the States.Andrew Lansley’s changes are “so big they can be seen from space” but there has been very little testing before the government has rushed to implement them. And this listening exercise has been widely exposed as a sham and indeed Mr Lansley demonstrated his complete inability to listen when responding to the Royal College of Nursing overwhelming vote of no confidence in him by claiming that they supported him. The way to prove to the electorate that this government have any integrity left is to sack Andrew Lansley, scrap his plans and start again from scratch with alternative plans to develop and improve the NHS with proper and full consultation with those that provide and receive health care, and the bodies that represent them, in our health service.

  • hnnrs

    Hospitals have long been bashed by the government starting with the Thatcher era. They now are struggling for money as each ‘target’ (now called quality indicators that are near impossible to achieve), single sex assessment units which the physical structure of hospitals does not allow without cost implications, venousthromboembolism (VTE) assessments and shrinkage of bed numbers to save money (but not lives) causes more hardship pushing hospitals to the limit. Undoubtedly these factors will eventually force privatisation onto hospitals with one massive benefit to the government – a reduction in pensions in the biggest public sector workforce. Is this the main reason for Mr Lansley and the Tories wanting to get this bill through?

  • cwilliams

    My contribution to the “listening exercise”:

    I am writing to express my deep concern about Andrew
    Lansley/David Cameron’s proposed changes to the NHS. I do not support these
    changes, particularly those concerning increased competition based on price and
    the removal of the government’s duty to provide a comprehensive health
    service.  If allowed to go through, these
    changes would ultimately lead to the break-up and privatisation of the NHS.

     

    It has been suggested that “cherry picking” by private firms
    would not be allowed, but it is difficult to see how this would work in
    practice.  The NHS will effectively be
    subject to EU competition laws and there will be no going back.  The NHS should focus on cooperating to
    provide quality patient care, not on competition.

     

    The Secretary of State’s duty to provide a comprehensive
    health service is fundamental to the operation of the NHS and scrapping it
    would in effect lead to the dismantling of the service.  The only people to benefit from this would be
    the private health care providers who are waiting in the wings, or are indeed
    already taking advantage of the situation, such as United Healthcare in
    Hounslow.

     

    Unfortunately, while this “listening exercise” is going on,
    the reforms are already being pushed through, waiting times are starting to
    rise and US private providers are moving in.  If David Cameron really did “love” the NHS he would
    stop these damaging plans and tell Lansley to go back to the drawing board.

  • Ian

    I have several fundamental concerns about proposed changes to the NHS. I think
    it is time to resign and leave the the NHS alone.If your unelected coalition
    concentrated on doing all it could for the people of this nation rather than
    giving billions away in foreign aid and wasting billions without the consent of
    the people you wouldn’t have to try to save in the NHS.The NHS may not be
    perfect but a group of millionaires who have no worries about funding healthcare
    are not the people to decide what is best for OUR NHS. Your plans will leave
    many without healthcare whilst filling the pockets of greedy private companies
    at the expense of the poor taxpayer as usual,the working class taxpayer is
    squeezed of so much in excess taxes that health insurance is not an option,all
    our families have paid for a first class NHS since it started,leave it
    alone.

    Remember the railways,priced off the trains with extortionate costs
    and kept in our cars while we subsidise the running of them at a higher cost
    than if they were nationalised,meanwhile,the private owners announce massive
    profits.This seems to be the same goal for the NHS under an unelected
    quango.I’ve also read on the internet that American and other companies are
    queueing up rubbing their hands at the chance of grabbing British taxpayers cash
    by being given a contract by your good selves,I do hope you are being given a
    highly paid position in those companies for when you are voted out of office.There is really only one statement to make regarding the present and previous anti British non governments and that is good riddance to bad rubbish,it’s about time the lot of you left the country to practice your sick policies,we didn’t vote for destitution,poverty and no NHS in a dictatorship that ignores the people,just leave and do us all a huge favour,the donkeys on Blackpool beach could do a better more honest job and they wouldn’t be fiddling their expenses.

  • Jamie B

    The impression I’m given is of a government doing its damnedest to tackle the enormous deficit our economy faces. Commendable, well, not in this case because the government I see is also running scared in the opposite direction to the group they should be targeting concerning deficit reduction: the bankers, their bonuses etc… Instead you are taxing the people’s health through these ill-advised ‘reforms’ that if implemented, will ensure our health service struggles to provide the healthcare that every tax paying citizen deserves. Let’s face it: if the bankers relinquished large proportions of their bonuses, collectively, every year, this type of NHS reform wouldn’t occur. Full Stop. The fact that the conservatives believe they can get away with this farcical exercise baffles me. The bottom line is this: listen to what the people at ground level are telling you. Thanks for everything.

  • Ivan

    I am concerned about the speed and scale of the current proposals for NHS reform and would urge much more caution.  It would seem to me that introducing whole-scale changes across the whole of the NHS in a very short period of time is a ‘nuclear’ option – what happens if the theory just does not work for the expectations / needs of the British people?

    I am not opposed to any form of change but would urge:
      – the trialling of any new proposals in a limited number of areas initially with a full and transparent audit of their impact before any more widespread introduction
      – a greater emphasis on co-operation and collaboration rather than just competition
      – total assurance that people will not suffer poorer healthcare provision because they live in an area that is less easy to serve
      – the maintenance at all costs of the government’s duty to provide a health service for all

    Our society has suffered too often from the rapid implementation of whole-scale changes pushed through without full consideration of the possible repercussions.  Please move wisely and carefully!

  • Anonymous

    All the salient points seem to have been made, so for whatever it’s worth, I sent this following comment in as my contribution to the so called “listening exercise”…lol… (you know, I do wonder at the authenticity of organisations such as 38° here, or Avaaz for instance ; is this real ‘turf’ or the ‘astro’ stuff? Just saying….we take a lot on trust don’t we..?)

    ===============================

    I am writing to register my deep concerns about Andrew Lansley’s NHS proposals, however, words almost fail me to describe my horror and disgust at the mentality to conceive such proposals and the manner in which they are being inveigled into operation. It only goes to show, yet again, how people such as Mr. Lansley, like so many others in influential positions, are unfit for public service.

    Until meaningful values generally, are rediscovered and nurtured by those we entrust to govern, this sort of nonsense will not go away. While monetary value remains the be-all and end-all measurement of the quality of life, driven by the endemic insanity of corporatism, ‘making (so called) profits’ at any cost (however damaging to the common good), we the people will continue to be nothing more than serfs. The wealthy have to have more than they need, that’s what makes them wealthy, obviously! More is never enough though, they always need more and more. It’s an unsustainable, corrupt, politico-economic system which needs a tsunami of sorts to sweep it away. Maybe sometime the time will come, the call will be made, “SERFS [sic] UP!!!” Tired of being fed faeces day in, day out? I know I am :-|

    As we are promised a variety of ‘austerity measures’, these NHS proposals of Mr. Lansley should really come as no suprise to us ; they are just another one of the many symptoms indicative of the sickening current state of affairs that we find ourselves in ;-j

  • Shoca74

    My conrtibution to the listening exercise:The NHS is a mark of our civilization, if its basic principles are re-written; if we as a country take this backwards step, I fear the type of society we are becoming. We will have nothing left to be proud of as a nation. We must ask ourselves, what sort of country do we want to be? That is why I am writing, to register my grave concerns about Andrew Lansley’s NHS proposals.Our elders set up the NHS in 1948 for the good for the country and its people, what has changed? People still need and want a comprehensive health service, and anything less will betray this nation and its democratic principles. People pay very high taxes and deserve, and must be listened to. The people will not give up what they hold most dear, what belongs to them; they will not stand by and see their most valuable Institution vandalised beyond recognition.

  • Patrick McGowan

    The NHS is safe with who? I don’t think so! I don’t want to see private
    enterprise bidding for NHS work as it infers profit from the sickness of others.
    The NHS nurses and doctors are doing a fine job so please leave well enough
    alone. If you want to save the NHS then get back all the unpaid corporation tax
    from the big banks and corporations who are taking the mick out of this country.
    The London corporation may be the major source of corruption in this coiuntry,
    but seems too powerful for anyone to tackle, labour and conservative. So, maybe
    it’s a time for us to follow Egypts lead

  • R Dineen

    I am hugely concerned that the changes that Andrew Lansley
    wants to make will damage our health service irrevocably. The mass of
    GPs and nurses are against the changes: their voices should be listened
    to before the ideological, market-driven whims of here today, gone
    tomorrow politicians.

    Stakeholders including patient groups and other health professionals
    should also be involved seriously and genuinely in this discussion. 

  • F. Sipi

    As a valued social institution the NHS has
    become the envy of the world, including the US (and their current president,
    Barak Obama), for the service it delivers to UK citizens based on need for
    health care instead of ability to pay. This is one of the most fundamental
    guarantee a civilised (egalitarian) society can provide for its citizens;
    namely that of good health.

    The conservative hard-liners are obsessed with modeling and trying to implement
    policies to emulate practices in the USA that have increased social inequality
    despite the huge wealth of the United States. What are their motives? Who is
    motivating them? Who stands to gain from these obviously flawed
    “reforms”? It will not be patients, that is for sure. It must be big
    business, waiting to suck out public funds as profits and bonuses on the back a
    dismantled NHS, which will pick an choose who and what is treated and who and
    what is not!

    Remember the Credit Crunch, the huge pension reward for one of the culprits,
    Sir Fred Goodwin and the bonuses that followed. What has this Government done
    about that?

    Therefore, these plans are a neo-conservative, ideological attack that is being
    promoted by politically powerful corporations, via their agents in the house of
    commons, i.e., the conservative MP’s who support these plans, to give them
    legitimacy.

    The population did not vote for these changes, during the last general
    election. In this respect these plans will always lack legitimacy even if the
    those agents of big business in parliament vote them through.

    But not all people are as stupid or ignorant as the conservative hard-liners
    seem to think! And they will remember, next time voting takes place. This
    government should take heed and stop patronising the population!

  • Mike O’Brien

    If GPs take over the money-management role of the PCTs then
    either GPs will have to manage (instead of doctoring) or they will have to hire
    private managers, which could be the same people as the PCTs (defeating the
    object) or bring in private companies like the highly-questionable US ones.

     

    Each GP centre could effectively become a separate, private
    (or semi-private) organisation with huge power but little co-ordination and
    insufficient regulation.

     

    These “reforms” seem seriously flawed and are being rushed (and
    pushed) through.  Surely any manager
    knows that large-scale changes work when you take everyone concerned with you. I
    have never known such changes to be successful in the teeth of such widespread
    opposition.

     

    Andrew Lansley will end up as the Dr. Beeching of a crumbling
    health service.

  • Sarah

    My local hospital is Homerton, and its maternity wards are already so oversubscribed, that the staff are struggling to cope within them, and women in particular suffer because of this. The hospital supports one of the largest boroughs in the capital, a borough which is losing governmental money hand over fist despite the poverty and unemployment which is a well known fact of the area. The population stands at around 200,000. I’m sure you’ll agree that more money should be going in to the area, and the hospital supporting this amount of money not less. Compared to the richer boroughs of London, Hackney lost a lot of money, because more people need help, not because there are more ‘spongers’!Will it ever be time to ask the bankers for the countries money back? Or was that one of the greatest frauds of our time, which we will spend years suffering for? If it is too difficult to imagine life at the other end of the social scale, then take the time to meet the people most affected by what seems to be slow deliberate privatisation of one of the hallmark organisations of this country,

  • http://www.facebook.com/people/Wendy-Greenhalgh/1040089988 Wendy Greenhalgh

    I am getting a customised car window sticker on-line – something simple like SAVE OUR NHS – NOT 4 SALE (white on blue) and GO TO www.NHSdirectaction.co.uk. I am sure many people would be willing to pay for one of these stickers, maybe 38 degrees could negotiate a deal and use this to raise funds for the advertising/billboard campaign. I would love to see billboards with the same message. Billboards last longer and get more attention.    

  • http://www.facebook.com/people/Wendy-Greenhalgh/1040089988 Wendy Greenhalgh

    I am getting a customised car window sticker on-line – something simple like SAVE OUR NHS – NOT 4 SALE (white on blue) and GO TO www.NHSdirectaction.co.uk. I am sure many people would be willing to pay for one of these stickers, maybe 38 degrees could negotiate a deal and use this to raise funds for the advertising/billboard campaign. I would love to see billboards with the same message. Billboards last longer and get more attention.    

  • Berbitace

    We simply cannot let this group of millionaire ministers and groups of wealthy individuals who never use the NHS anyway destroy this most loved and valued public service.  It’s in our hands to stop it.  The Tories and in particular Cameron before the election said “there will no top down re-organisation of the NHS” and in fact these changes go beyond simple re-organisation they are criminal destruction in the name of re-organisation.  They have NO MANDATE OR INDEED SUPPORT for these changes, yet they are plodding on regardless…  They see the NHS as wasteful and think the answer is to hand it over to massive American health care and insurance companies… no way is this fair or equitable and it will lead to major social unrest and change in the fabric of our communities that is without doubt. 

    How many tory MP’s are non executive directors of companies who have an interest in a private health system?  If they are not now, they will be after it is privatised Lansley will be paid off by comapnies who have benefit….   Lets make sure we do everything in our power to stop it.  Take to the streets.

  • Judith Tomlinson

    The NHS is at the very core of our national decency. Any changes must encompass, not undermine, this.I fear that the current proposals will allow a profit motive to reign in too many areas. One only has to consider the effects that widespread private company involvement has had on residential care, with low paid employees, high fees and little security to see how profit can undermine a service. The rate of current satisfaction with the NHS is high. Given the amazing rate of advance in medical procedures, since its birth, and the concomitant raising of people’s hopes, this reflects an unshakeable of confidence in its practitioners, which flies in the face of the large-scale, untrialled proposals.Competition does not necessarily lead to improvement. It can prove a great distraction and lead to an erosion of co-operation. My experience in education saw this happen as school was set against school, teacher against teacher, to gain statistical, NOT educational leads. Most people enter professions associated with fields such as medicine and education, not to make a fortune, not to be winners, but to help others.

  • Am

     want to tell the NHS listening exercise that I am very worried about Mr Lansley’s proposals for the NHS. I think he is going about reforming the NHS in completely the wrong way.For example, I am concerned that changes of this scale are being proposed without a decent trial period first. Why is the government not trialling these changes in a few areas for several years first, to see if they work? Why is Parliament being asked to vote them through without evidence that they will benefit patients?My other concerns are decisions being taken behind closed doorsThe threat to the Government’s duty to provide a comprehensive health serviceCompetition versus co-operation“Cherry-picking” by private healthcare providersThe Government is not listening to experts and patientsAlso Doctors, nursing and ancillary staff cost us a huge amount to train, private providers do not do this level of training and will depend on the NHS for well trained staff.Has anybody proved that private medicine at a clinical level is better or even cheaper than NHS treatment? My experience as a nurse in private clinics and hospitals is that they use staff that are not trained in the specialities that they are employed to work in. ie eye treatment patients being treated by nurses that have no experience in eye care (that was me). Relatives that so believed that private care is better and not being able to shift from that view even when the treatment their relative was receiving was far inferior to what, we begged him to allow, under the NHS with a specialised nursing team and facilities for constant monitoring of the patient’s condition(me again)Medical consultants still working in private clinics into their 80sPlease take into account my views in the listening exercise.

  • Chris2

    Cancer can be cured by tuned rf frequencies, Homeopathy does work and the Rothschilds are worth Trillions! Wake up Sooty!

  • Redtom43

    I want to make a contribution to the NHS listening exercise. I am deeply
    concerned that the changes that Andrew Lansley wants to make will end
    up damaging our health service.

    For example, I am concerned that new commissioning bodies will not be
    properly accountable and will not operate in a transparent way. GPs
    should not be able to take decisions behind closed doors, and other
    stakeholders including patient groups and other health professionals
    should also be involved.

    If competition is allowed to be introduced within the nhs it will mean
    the cheapest service for the patients whilst delivering the highest
    possible profit for the shareholders of the companies involved. If this
    is allowed to happen, i feel that within a very short period of time the
    nhs will become a medical system resembling a third world enterprise.

    the nhs was built by the people of this country for the people of this
    country, the government have no right whatsoever in implementing their
    ultra-capitalistic business methods for their own monetary gain.

  • Bernard

    To

    NHS
    listening exercise

    Subject

    I
    am concerned about the NHS proposals

    Message

    I
    am a retired consultant paediatrician, My major qualification is 38 years
    service to patients and the NHS. My academic qualifications are B.A., MB, Ch
    B, F R C P London, F R C P Edinburgh, F R C Paediatics & Child Health.

    I wish to to register my dismay at what I fear will be the deleterious
    effects of Andrew Lansley’s NHS proposals on the experiences of sick people
    and the health of the nation

    I wish to make five points

    I am concerned that the legislation proposes to remove the Secretary of
    State’s duty to provide a comprehensive health service. I feel that this duty
    is crucial to the maintenance of the service and that unless the ultimate responsibility
    remains with the Secretary of State the service will not survive.

    I am concerned that commissioning by General Practitioners is combined with
    the possibility that they may personally retain unspent parts of their
    budgets. I feel that this must inevitably create a conflict of interest
    between those of the patient and those of the individual doctor. Such an
    arrangement would inevitably destroy the patient’s trust in the doctor’s
    commitment to their health as his/her first priority.

    I am concerned that the suggested arrangements for competition, combined with
    European competition law will destabilize the service, leading to an American
    style service with it’s associated poor outcomes as measured by population
    studies.

    I am particularly concerned at the suggestions for the ‘Balkanization’ of
    Public Health, which appear to show an ignorance of its fundamental nature
    for the maintenance of health and for the practice of good evidence based
    medicine. As a paediatrician in the 1970′s I experienced the damaging effects
    of local authority control of the service.

    I also wish to emphasize that I feel that the Health service and welfare
    services are synergistic. Evidence shows that any cut in welfare services
    produces inordinately greater expense in the NHS.

  • Michael

    I am deeply worried about the changes to the NHS
    proposed by this bill.

    My 6 year old son has Leukaemia and his treatment through the NHS has been
    fantastic. The staff are so dedicated and kind. They have saved his life. If we
    had a privatised system, either we would be bankrupt or he would be dead.

    This amounts to a massive costly, untested re-organisation of the NHS at a time
    when it is already having to make huge savings.

    Furthermore these changes were not mentioned in the manifestos of the Coalition
    parties or in the coalition agreement and so as such there is no mandate for
    these changes. The Prime minister promised prior to the General election that
    there would be no ‘top down re-organisation’ of the NHS.

    It is obvious that these plans have been under development prior to the General
    Election and probably for many years. Therefore the prime minister and his
    party lied to the electorate.

    The NHS should focus on providing quality healthcare, not on competition. The
    role of the regulator, “Monitor”, should reflect this and promote
    collaboration.

    The government’s “duty to provide” a comprehensive health service must be kept.
    Dropping this duty would erode the foundations of the NHS.

    “Cherry picking” by private companies must be fully ruled out, and the
    mechanism for preventing it must be clearly established.

    Any changes to the NHS of the scale currently proposed should be trialled in
    small areas for several years first with a full cost/benefit analysis and
    proper scrutiny.

    Any new commissioning bodies should be transparent and accountable. They
    mustn’t be allowed to meet behind closed doors. Patients and other health
    professionals must be represented as well as GPs.

    If these changes are pushed through without the backing from the electorate or
    the major Healthcare organisations (BMA, Unison, Nurses, RCGP, etc), then this
    Goverment will never be forgiven.

    It is obvious that these changes are designed to push through the privatisation
    of our NHS, and move it to a more Americanised Medical insurance system. A
    system that provides the most expensive healthcare in the world and which only
    the rich can afford, leaving everyone else with little or no healthcare.

    As with most of our public utilities that have been privatised the only people
    to benefit are the private companies themselves, with higher prices and rich
    shareholders and company executives.

    Please listen WE DO NOT WANT YOUR PROPOSED CHANGES. Scrap this bill and start
    again. Start listening. PLEASE.

    Our and our future generations healthcare is too important to be played with in
    this way. The NHS staff also deserve much better.

    As we all knew ‘the Tories cannot be trusted on the NHS’.

    Thank you for listening.

  • Elaine Wasilewski

    I sent these comments to ‘the listening exercise’ yesterday – they are still ’being moderated’ @ 30 May 10:44 - weekend/holiday perhaps?
    There are some very valid comments being made on the NHS Listening Exercise website http://www.dh.gov.uk/healthandcare
    This was my contribution:-
     The reality of profit over service should be acknowledged as the outcome of any measure to ‘outsource’ or ‘privatise’ – we need only look at dimishing services within and beyond city boundaries, Post Offices, bus services, railway maintenance, and the extortionate if not illegal private clamping companies, added to the already observed results of privatisation of ‘care homes’.
    Any changes on this scale should be trialled in a few areas for several years first.
     
    I then noticed the wording throughout this exercise and further wrote:- 
    This ‘listening excercise’ is another example of the subversion this government is so fond of. These are leading questions with no real choice.
    “How can we best ensure that competition and patient choice drives NHS improvement?”
    We’re not being asked if we want competition (privatisation by any other name) to be the future of the NHS, or even if we think it will improve it for staff and patients, just ‘how can we make it work?’. The NHS greatly improved under Labour after years of neglect from the Conservative party, and patient choice is an area I didn’t witness until Labour came to power. There is no proof the Conservative party has ever or will ever consider the NHS, or the public’s ‘lot’, worthy of ‘improving’, and every proof the public are just the ‘cash cow’ to be milked till dry then ignored.
     
     
    And on ‘Andrew Lansley speaking to the BBC’ I wrote
     
    Therein lies the problem.
    “…if we actually think patients are really the most important people…”
    Do ‘they’? Would ‘they’?

    Anyway, they’re not ‘up there’ yet, perhaps you could have a try?

     

  • CHRIS PERCY

    From my business background I have fundamental concerns about the
    proposed changes to the NHS and I think Andrew Lansley needs to go back
    to the drawing board.

    The NHS is a very large and very complex organisation. Revolutionary,
    rather than evolutionary change, at a time of significant cuts, is a
    recipe for disaster, almost regardless of the actual changes proposed.

    Kieran Walshe’s exhaustive study of past Reorganisation of the NHS in England concluded:

    “The government should learn three things from the history of NHS reorganisation:
        
    Firstly, STRUCTURAL REORGANISATIONS DON’T WORK … Indeed, some would argue that the perceived failures of healthcare
    commissioning result not from any particular structure but from these
    repeated reorganisations and the discontinuity and disruption they
    produce

        
    Secondly, the TRANSITIONAL COSTS of large scale NHS reorganisations ARE HUGE … I estimate that the proposed NHS reorganisation will cost between £2bn and £3bn to implement, at a time of unprecedented
    financial austerity

        
    Thirdly, and most importantly, REORGANISATION ADVERSELY AFFECTS SERVICE PERFORMANCE. It is a huge distraction from the real mission of
    the NHS—to deliver and improve the quality of health care—and it can
    absorb a massive amount of managerial and clinical time and effort. It
    saps morale and creates uncertainty for many people about their careers
    and futures. … new or merged organisations take time to become
    established and start to perform well.”

    BMJ 2010; 341:c3843 at http://www.bmj.com/content/341/bmj.c3843.full

  • Martin

    GPs don’t know mental health: I know this from personal experience.  Mental health services have been among the first to suffer under successive “cost-cutting” exercises; this will get worse if GPs are commissioning Mental Health services.  Patients are referred by GPs to Mental Health service teams, and GPs then have very little to do with ongoing treatment; GPs therefore don’t understand mental health treatment or appreciate the value of these services.  The commissioning of Mental Health services should be undertaken by experts in the field – the Mental Health Service teams themselves.  The same applies for many other specialist areas of health care, which GPs have no hope of ever understanding well enough to effectively commission.

    The NHS has been under constant reform for decades – David Cameron promised in the General Election, “no top-down re-organisation” but the new policy is a total re-organisation.  Constant reform hurts performance and morale, and any benefits of a particular reform take time to emerge, time that the NHS has never been given.  Any new reforms should be developed on an evolutionary not revolutionary basis, with clinical judgement at the centre, and with trials undertaken and reviewed.

    Doctors and Nurses should be able to avoid the impression that decisions will be taken for financial rather than medical reasons – even the impression itself will lead to a loss of trust in the Doctors and Nurses (even if it’s a false impression).  Involving the private sector in the NHS will only add to this impression; that we’re getting the “best value” health care that puts profits in other pockets, rather than getting the “best” health care possible regardless of any other considerations.

    I note that these proposed reforms have not been put on hold during this “listening exercise” – this indicates that the Government is not prepared to change their reforms, regardless of what people say.  I also note that I have not been given an opportunity to have my say; I have not been made aware of any events, surveys, publicity, letters, or articles in the press, until the 38degrees campaign.  This all shows it to be an “exercise” rather than true “listening” – where someone is prepared to discuss their case and have their mind changed by another.

  • http://www.facebook.com/theholyllama James Russell

    Despite the rhetoric from Government Ministers, it is clear that the intention
    of the reforms is to open the NHS more and more to private healthcare provision,
    to the extent that, eventually, ‘NHS’ will become nothing more than a brand name
    for a profit-driven insurance service. We only have to look at the United States
    of America to see the disaster that this would be – where we have one of the
    most efficient healthcare systems in the world, with universal availability, the
    USA has some of the worst health outcomes in the developed world, at the highest
    per-capita cost, and in an incredibly unfair system that gives greater access to
    the well-off, almost completely excludes the poor from all but the most basic
    care, and allows private companies and their shareholders to take extravagant
    profits.

    NHS reform was in the manifesto of neither the Conservative
    Party nor the Liberal Democrats. It was not in the Coalition Agreement. In the
    election campaign, the Conservatives promised that there would be no wholesale
    restructure of healthcare. The people of this country did not vote for Andrew
    Lansley’s reforms, we do not want them and we will oppose them at every turn.
    The Government has shown that it is capable of listening to the people over
    forestry sales; it must do so again and radically alter its direction on health
    and social care.

  • Ross in Leeds

    I am extremely concerned with the proposed NHS reforms. As a medical student, I would like reassurance that my future career will be serving the needs of my patients rather than private business. The NHS provides the framework for this service and the government should take extreme care not to damage this. I understand that consortia will give GP’s a stronger voice to make decisions which best suit their patients, however the involvement of private health providers in these consortia is deeply troubling. Medical care is not comparable to telecommunications or gas and water providers. Many of those people who work under the NHS do so through a sense of care and duty to their patients. They work antisocial hours and go beyond what is asked of them because it is a vocation rather than a job. Private companies are motivated by profit and not the well-being of the population and as such I am highly sceptical of the introduction of an open market in healthcare providers.There must be clear unequivocal evidence that the role of Monitor is to maximise the standard of care for patients rather than promote competition with private providers. Moreover I can not see how the involvement of these private multinational corporations can do anything positive for healthcare in this country. They stand to fragment the NHS which is the envy of developed countries around the world (Mr Obama isn’t reforming healthcare in the US for nothing). By handing healthcare over to “any willing provider”, the government is simply selling off a highly equitable system to private industry. Claiming that this is “liberating the NHS” in any way is farcical.Please remove the creeping privatisation from the health and social care bill. There can not be an open market in healthcare because the open market doesn’t “care” about health.

  • Pat_barnes

    I agree with what you – and everything everyone else here has said. To your point about all the privatisation we’ve had in the past, I’d like to add Utilities to the list. The Big 6 energy companies in particular are found very wanting – I’m speaking from personal experience as I’ve found myself caught between two, them saying I owe the 1st company money, even though they credited my account when I left them 11 months ago. Privatisation just doesn’t work.

  • Lynn Denham

    I have worked in the NHS since 1976 when I started out as a pre-registration pharmacist.  I have an MSc and a MBA.  I have worked as a senior manager in hospital pharmacy, obstetrics, gynaecology and paediatrics and, for the last 3 years as a commissioner.  I have experienced and delivered numerous organisational and policy changes during my career.  I would therefore like to make the following comments to the listening exercise.The proposed Health and Care Bill is an unnecessary re-organisation.  It has deflected the whole NHS away from the real issue which is how to meet the growing demand for healthcare within an affordable budget. Most PCTs were making good progress with world class commissioning and the local re-design of clinical services, involving clinicians of all kinds and the public and using evidenced based practice.  Since the publication of the White Paper, everyone has been trying to understand how it should be implemented and worrying about their future employment prospects instead of remaining focussed on delivering a difficult strategic change programme.  Changes to practice based commissioning and the greater involvement of GPs in mainstream commissioning could have been achieved without massive legislation.  
    GPs are an expensive workforce (more than twice the cost of most NHS managers) who have been trained in diagnosis and clinical decision making.  The skills for commissioning and managing health care budgets are quite different.  It is more cost effective to utilise experienced managers working with clinicians.
    Most GPs are private provider businesses, not NHS employees, with investments in a range of providers.  There are huge conflicts of interest if they are given responsibility for commissioning budgets – they will be able to engineer services to maximise their personal and business income to the detriment of tax payers funds.
    Patient choice in health care is only meaningful in large urban areas with alternative providers within easy travelling.  This is not the case for the majority of the country.  The population of Worcestershire, for example, only requires one provider of acute hospital care.  The hospital must deliver good, local, comprehensive services and be financially sustainable.  If competition results in some ‘profitable’ services going to a private provider, the hospital trust becomes unsustainable and the public will lose local services. 
    Collaborative healthcare systems are for more effective and efficient.  They are able to plan and deliver optimum patient pathways without the bureaucratic obstacles of payment by results, profits, invoicing and contracting.  The management overheads for this and for quality monitoring are far greater in a competitive market with a plurality of providers.
    The current duty on the Secretary of State to provide a comprehensive health service to the people of England must not be weakened.  As Professor Martin McKee said at a recent meeting ‘many people … each weekend, act with a view to winning the national lottery, but this is quite different from actually winning it’.
    It must be clear which organisations take responsibility for the whole range of services for a geographically defined population.  There must be no possibility of discrimination against patients based on their current or perceived future healthcare needs.  A civilised country has a responsibility for the vulnerable members of society who are not registered with a GP.I hope that the government will listen to all the responses that it receives to this listening exercise.  It is a pity that greater attention was not paid to the consultation which took place prior to the drafting of the legislation.Our NHS is the envy of the world.  The government does not have a popular mandate to destroy the essential principles of its success.

  • julian

    ToNHS listening exerciseSubjectPlease listen re: the NHSMessagePlease take on board my concerns about proposed changes to the NHS. I think these proposals have many fundamental flaws.I am writing to you as a consultant who works in hospital, in the hope that you are able to show some principles and backbone in modifying the most damaging of the health service reforms. The NHS is a jewel in the crown of world healthcare. Unless you can show some resistance, it will be destroyed by the current bunch of self-serving, out of touch millionaires.The single most damaging part of the health reform white paper is the introduction of any willing provider. We have watched the preferential treatment granted by the Labour government to independent treatment centres. What has happened as a result of this development is that the treatment centres cherry pick the easiest cases and leave the complex ones to the NHS. In the context of payment by results, this is disastrous. The complex cases are more costly and have increased lengths of stay. The Health Resource Group is calculated as an average for any procedure, so that the independent treatment centres end up making a profit and the NHS a loss. This is further compounded by the independent sector not having to pay VAT, which gives them an automatic 20% reduction in costs. If the legislation on any willing provider is passed, combined with a clause saying that the cheapest option has to be selected, we will see the piece by piece destruction of hospitals. Given that department s within hospitals are interdependent, there is a critical mass which, when reached, will mean the hospital will not be able to continue and will have to close. This will have an even greater impact than just loss of local services. Loss of training opportunities for junior doctors will mean that we will not be able to provide sufficiently qualified and experienced consultants and GPs for future generations. A further danger of any willing provider is that multinational companies will win contracts by offering loss leaders. They will then go on to charge large amounts when loss leaders expire. In addition, the private companies are expert at negotiating contracts in which they gain maximum profit and the benefit to the NHS is of secondary importance. The debacle of Connecting for Health IT system is the classic example of this. The NHS managed to buy computer systems that were not fit for purpose, did not provide the functionality that was needed and the contracts made sure that any development from any individual hospital would cost large amounts of money. The IT companies have been completely amoral about this, willing to take billions of pounds from tax payers without any compunction. The other insane part of the legislation is to hand over control of health budgets to GPs. Why on earth are GPs considered to be the arbiters on how to spend money? GPs are largely ignorant of how hospitals run and the interdependency of hospital departments. I know this from my own experiences, as I have been involved in a lot of interface work between primary and secondary care. They also do not, as a matter of routine, provide the highest quality of care for their patients. Although hospitals are held to account to ensure that patients are treated in accordance with both NICE recommended pathways and treatments, no such standards exist in primary care. It is widely acknowledged that the Quality Outcomes Framework (QOF) does not set the standard high enough to ensure that the right care is given. This is actually a disgrace. If your mother was treated by her GP for a disease such as heart failure, there is no guarantee that she would receive the care she is entitled to, and is likely that she would not have access to the drugs she needs that have been shown to improve survival. GPs know this and your government wants to put them in charge of health service commissioning. Why oh why do you not insist that the commissioning bodies have representation from both primary and secondary care, GPs and consultants working together? Integrated pathway development, with consideration of what is needed across both hospital and community, is realistically the only way forward for improving health care and reducing cost by decreasing both morbidity and mortality. Reorganisation without this is counterproductive and is likely to increase costs rather than reduce them, as many people have already pointed out.Finally, we are all aware that personal interest is behind much of what is being recommended. Yet another prime example is the MP for Enfield North, Nick de Bois. He has private interests in a company, Rapier Design Group, that recently bought Hampton Medical Conferences, that is due to prosper from involvement in health service provision should the reform bill as it stands go through. Worse still, he did not declare this as a private interest at the same time as demanding that the changes were implemented as soon as possible. We know that a number of private American health care providers are sitting waiting for the reforms. It is almost inconceivable that a country that is unable to provide any sort of decent healthcare for their own people, think that they can come to Britain, offer us their second rate version of medical care and line their pockets with good money from the British taxpayer. We know that money that is currently well spent will go outside of the UK, with i rreparable damage being unleashed on the NHS. It is not a great leap to think that the legislators are in bed with these companies. When will politicians learn that the public can see through their empty promises and smooth words? Do you not think we know what is happening? It is no wonder that politicians, lawyers, bankers and journalists are all seen as the least moral and least trustworthy of professions. Self interest, lust for power and greed rule. Making election manifesto promises that you completely reverse is in keeping with the same behaviour we have seen from politicians for decades. I repeat again, do you not think we see through your polished superficiality?Please, please, please find some backbone and resist these reforms. If they proceed, the damage will be irreversible. Everybody knows that the Cons have wanted to do this for decades. Millionaires do not need the NHS unless it is as a source of profit. For the sake of us all and our future health, stand up for the NHS. Your legacy is already in tatters, don’t take it further down the drain.

  • Dick Willis

    Too much, too fast – no evidence, no pilots, no mandate. Meanwhile the PCTs are about to or have already passed the point of no return.

  • Andrew A

    I object to Minister Lansley’s plans for the NHS, which I consider ill-conceived, flawed and not in the best interests of patients.GPs are not equipped and trained to carry out the role he envisages for them and private health companies will cherry pick the most profitable parts of the health service, leaving other parts to decline, deteriorate and eventually disappear. There is a lack of transparency over the links and contacts that politicians have with the providers and there will be inadequate accountability and opaque decision-making on the part of providers.

    My wife has been in receipt of oncological treatment for the past three years at our regional cancer centre: the service has been first class, professional and timely. The oncologists, surgeons, nurses and, yes, even cleaners work as a TEAM and a very successful one at that. Scans, chemotherapy, consultation, after care etc have all been excellent and FREE at point of delivery. However, I feel the words TEAM and FREE are probably anathema to Mr Lansley and definitely anathema to his cronies in the private health care sector. (That includes Labour politicians such as Alan Milburn who should be embarrassed and ashamed of his role in these soi disant reforms.

    Time for us to have an NHS Spring (and Summer) and put pressure on this pathetic shambles of a coalition and kick out the ‘reforms’ that are, in truth, retrograde and damaging.

  • Anonymous

    thanks for the suggestion Wendy – what do other people think about the idea of car stickers? Billboards are also interesting, maybe located in the constituencies of key MPs?

  • Judywilliams191

    Dear NHS listening exercise,

    Dear Mr Lansley,  I have several fundamental concerns about proposed
    changes to the NHS. I think it is time to go back to the drawing board.

    For example, I have not so far been reassured by what I have heard from the
    government on the issue of “cherry picking” of NHS services by private
    companies. “Cherry picking” could be extremely destabilising to our health
    service, and there must be a clear plan and legal mechanism to rule it out.

    The NHS is a service to provide health care and treatment for people with
      needs there are increasing severe compromising challenges to the NHS -
      this is not an industry Mr Lansley, this is a structure designed to
      provde good standards of ethical care and treatment. This is not just
      about doctors and nurses. It is about comprehensive working systems to
      enable good wholistic quality care and treatment. You are demoralising
      the staff of the NHS. They are being placed within working structures
      that have an impact on the quality of care they can actually deliver and
      the pressure of time restrictions means that clinicians stop listening to
      patients carefully and mistakes happen. Patients will begin to have an
      increasing experience of abrupt styles from health service staff. There
      will be no trust between patient and clinician. In addition I already
      know that GPs have been asked not to make referrals for their patients.
      That is clearly a step towards actual clinical negilence and to
      make it look like it can be handled in a GP surgery by GPs who would
      ordinarily refer on to specialists for proper consulation is lost. These
      are called CUTS Mr Lansley through dangerous DoH directives. Any new
      commissioning bodies should be transparent and accountable. They mustn’t
      be allowed to meet behind closed doors. Patients and other health
      professionals must be represented as well as GPs.
    NHS staff are too frightened to speak out on site because they would be
    victimised and lose their jobs. The pockets of the NHS to manage legal
    disputes seem to be forever deep – the dedication of a DoH and the
    Government in nuturing aN NHS is far less. Figures are manouevered to
    establish readings of targets and achievements which sadly do reflect the
    truth of the struggle to provide proper health care. An entire appointments
    system has been devised and changed and revised and changed so that the
    entire process of referral and appointments “allocated” is sent up and down
    the country and eventually so depersonalised that it takes more time, more
    mistakes are made and the public who are in need and likely unwell are
    struggling with unnecessary bureaucracy which debilitates the patient and
    the staff.
    The NHS should focus on providing quality healthcare, not on competition.
    The role of the regulator, “Monitor”, should reflect this and promote
    collaboration. Yet interestingly in a conversation I recently had with a
    very pleasant member of staff from Monitor – they said they have no
    authority in regulating NHS Foundation Trusts. What is this about?

    The government’s “duty to provide” a comprehensive health service must be
    kept. Dropping this duty would erode the foundations of the NHS.

    Yours sincerely

    Ms Judy Williams
    9 Beech Road
    Chorlton
    Manchester M21 8BX

  • Anonymous

    Your comments are all up there Elaine, on the ‘healthandcare.dh.gov.uk’ DH Department of Health page. Is that where you meant? (Is that page part of the (laughable) ‘Listening Exercise’?) I had my input sent via the 38° ‘form page’ and then later received an email receipt from the ‘NHS Future Forum’.
    ———————————————————————————————————————————

    Elaine Wasilewski says:
    May 29, 2011 at 11:14 am

    The reality of…

    &

    Elaine Wasilewski says:
    May 29, 2011 at 11:59 am

    This ‘listening excercise’ is another example of the subversion…

    &

    Elaine Wasilewski says:
    May 29, 2011 at 12:36 pm

    Therein lies the problem…

    —————————————————————

    Yes…indeed ;-j

  • Bill Grigg

    SubjectDrop the NHS plansMessageI’m making this submission to the NHS listening exercise because I have huge concerns about the proposed changes. I think it’s time to drop them and start again.
    For example, I am opposed to the proposal to scrap the Secretary of State’s duty to provide a comprehensive health service. This is a duty which has been fundamental to the operation of the NHS ever since its formation. It must be retained.
    Cherry picking” by private companies must be fully ruled out, and the mechanism for preventing it must be clearly established. This is altready happening and increasing NHS unit costs!
    I am also concerned that the public do not realise that GPs are NOT employees of the NHS. Since 1948 they have been ‘independent contractors’ and as such outside direct management control. In effect you are giving the NHS to private contractors.
    In addition it is a gross misrepresentation of the facts that because a lot of GPs have already signed up it shows support. The majority of GPs recognise the inevitable and want to jump before they are forced into a partnership they do not want! Not an opinion but fact based on my own GP contacts.
    Recognise that increased management costs are a direct result of policy and organisation changes, most of which have not been allowed to become effective before yet another change is forced on the service.
    Ask the NHS what proportion of inpatient care and primary care (including on going drug therapy) is being spent on asylum seekers and other immigrants, especially ethnic minorities that come from areas with little or no primary care or preventative medicine programmes. Not that we should not be generous in providing high quality healthcare to individuals in desperate need, but be HONEST with the public about where the money is going!
    Finally, obesity. Unless there is a medical cause, all costs should be borne by the patient! It is self inflicted and if people have money to gorge themselves on fast food and not work then they can spend that money on their extra healthcare needs. Stop their healthcare costs from their benefits.

  • Geoff Turner

    SubjectNHS proposals are flawedMessageI am in total opposition to the proposed NHS reforms, particularly those sections aimed at handing tax-payers’ money over for private profit. The report on the railway system last week showed what a disaster fragmentation and privatisation has been, with a 5 fold increase in subsidy from the days of British Rail.As a pensioner, I simply want suitable treatment in my local city. I have no interest in wasting time and money “choosing” doctors, hospitals, private healthcare providers etc. Please put patients before profit, and stop these attempts to destroy a successful and popular NHS.

  • Jim Dignan

    I would like to make a contribution to
    the NHS listening exercise as I am deeply concerned that the changes
    that Andrew Lansley wants to make will end up damaging if not
    destroying our treasured National Health Service.

    The changes that have been proposed
    seem designed to pursue a misguided ideological agenda to effectively
    privatise the NHS by fostering competition with private providers.
    The government has no electoral mandate to pursue such an extreme
    political agenda and should halt the reform programme altogether
    since it is clear that it has very little public support and is
    opposed by the vast majority of national health service
    practitioners.

    It would be misguided to inflict such a
    radical restructuring on the NHS even if the economy was sound and
    there was sufficient additional funding to finance changes on this
    scale, but to inflict such a change in the current economic climate
    while also seeking massive savings from within the health service
    budget is reckless in the extreme.

    I object to the way Andrew Lansley
    seems bent on abdicating the essential role that Health Secretaries
    have always had for ensuring that the NHS has a duty to provide a
    comprehensive National Health Service.

    I cannot see why the government seems
    intent on copying one of the least efficient and socially unjust
    healthcare systems in the world – namely the US – by inviting their
    private health corporations to come in and cherry pick the most
    profitable parts of our publicly funded national health services.
    Our National Health Service is rightly regarded with envy by much of
    the rest of the world and the government should be seeking to
    maintain and safeguard this heritage rather than opening it up to
    damaging competition.

    This deeply damaging, divisive and
    unpopular programme needs to be stopped in its tracks and thought
    through again more soundly from first principles.

    No reforms on this scale should be
    adopted without first consulting thoroughly with NHS practitioners
    and the public and, only after securing unambiguous support from
    them, proceeding carefully by piloting the reforms before proceeding
    further.

    The NHS is far too precious to be used
    a plaything by unscrupulous politicians who are bent on perusing
    ideological changes irrespective of the damage they will inflict on
    popular public services.

    Please stop this madness now before it
    is too late.

  • Richard_benns

    PROPOSED NHS REFORMS –
    A PATIENT PERSPECTIVE
     
    Perceived Inequities of the NHS ‘Internal Market’
     
    1      How can NHS patients benefit from a Public Health Service that is forced to buy services from its self? This is surely an unnecessary burden of bureaucracy especially as the Bill promotes competition for health care services to be based upon ‘Patient Choice’ and ‘Quality of Care’ rather than cost.
     
    Every transaction presents an opportunity to the unscrupulous for the misappropriation of public funds and poses a particular temptation for NHS purchasers whose operational budgets are in overdraft or under threat of being cut.
     
    2      The Bill provides for Monitor to be given legislative powers to enforce ‘good procurement practice’.
    Under the proposed organising structure, such enforcement would be retrospective, responding to a particular complaint.
     
    This is surely ‘too little too late’. As should have been learnt from the banking crisis, for fiscal regulation to have any chance of success, it must have a remit to provide a ‘pro-active’ rather than a ‘re-active’ response.
     
    If Clinical Consortia are forced to provide a purchasing roll, each and every transaction will require constant independent scrutiny at local, grass roots level.
      
    The current proposals fail to provide for any legislative mechanism or funding to facilitate public and patient involvement in this respect.
     
    3      It comes as no surprise that services for mental health and the elderly are among those hardest hit by an increasingly ‘market based’ health service that has lead to cuts in funding and facility closures. These cuts and closures are inevitably blamed on ‘market forces’ but these forces have been deliberately unleashed upon the NHS by successive governments beginning with the 1990 ‘Community Care Act’. This introduced the ‘internal market’ concept creating the ‘Purchaser-Provider split’ within the health service.
     
    This ‘market lead’ framework has lead to purchasers being incentivised to ‘trade off’ services between NHS and private service providers. This poses a real risk of the proceeds being siphoned off to ‘line the pockets’ of the purchaser and private provider shareholders.
     
    More importantly, from a patient perspective, the focus of General Practice is being increasingly diverted away from the core principal of delivering a personal, family orientated quality service in favour of a systemic cash orientated business operation.
    Patients demand a National Health Service not a National Health Business!
     
    Proposed Solution – A Patient Lead Reform
     
    4      It is clear that, to abolish the NHS ‘Internal Market’, would involve radical reorganisation but surely the future of our NHS is far too important to be consigned to the ‘too difficult to’ action tray.
     
    The current demise of our national finances demands more than ever a radical and entrepreneurial approach to achieving optimum value for money from all of our public sector services.
     
    This solution is, perhaps less risky than the current proposals in that it would, in many respects, require the NHS to revert to the pre.1990 operational model.
    However, it must be acknowledged that there is an increasing demand upon what has, and always will be, a finite resource. For this reason, it is clear that any solution will require the continued involvement of ‘private sector providers’ to have any chance of success.
     
    The key is to establish a procurement method that can be centrally managed and easily monitored by a relatively small group of administrators, the only involvement required by clinicians being with the selection process.
     
    The introduction of ‘Contract Retainers’ could be the most effective solution.
                         
    5      The establishment of an annual ‘contract retainer’ for existing private providers could be based upon an historic value of service over the past 5 years, for example, including allowances for inflation and any perceived increase in service.
     
    In the event that a ‘retainer’ is in danger of being exceeded at year end, the provider could be empowered to apply for a ‘top-up’ which would be subject to validation and negotiation with the administering body.
     
    An assessment of service volume together with a defined set of resources and quality assessment could determine the value of an ‘initial contract retainer’ for new providers.
     
    Any surplus to the retainer fund for both new and existing providers would be deducted from the retainer fund allocation for the following year.
                                                                                   
    6      The abolishment of the NHS ‘internal market’ would negate the need for the SHA and PCT’s together with Hospital Trusts and other ‘for-profit’ providers currently operating within the NHS.
     
    Each independent NHS hospital/service provider could be allocated an annual operational fund valued and administered directly by the DoH.  
    Fund values for established hospitals could be based upon the average bed allocation for the previous five years together with the number and type of clinical procedures undertaken and general overhead and running costs. Plans for additional resources and services could also be factored in subject to negotiation with the DoH.
                                                                                             
    Operational fund values for new hospital facilities could be based upon the building overhead, number of beds and estimated allocation, employed personnel and an estimation of the number and type of clinical procedures to be delivered. The estimation could be based upon audits from established hospitals that are comparable in size and breadth of service.
     
    7      Each service provider could be independent and autocratic. They could have their own ‘in-house’ management team made up from senior clinicians and administrators working on an equal footing and responsible for the procurement of all medical equipment, building maintenance, cleaning and catering contracts and all associated operational facilities as required to meet NHS quality standards within their allocated fund.
     
    Hospital matrons could be re-established in every hospital and be equal in status to that of the appointed Chief Administrator. They, along with other principal clinicians, could share the burden of all key decision making where this has a bearing upon the standard and quality for the delivery of care.
     
    8      Similarly individual GP’s and partnerships could receive an annual ‘operational fund’ direct from the DoH. The fund value could be based upon the surgery building overhead and running costs, contracted GP and other appointed clinician salaries, the number of registered patients, taking age and medical profiles into account and established local needs etc.
                    
    The GP(s) and practice manager would be responsible for procuring all associated clinical and administrative personnel and equipment within their allocated fund as required to accord with the NHS quality standard for the delivery of primary health care.
     
    Patients should have the right to be assigned to an individual family GP of their choice and to receive a continuity of care. Individual GP’s or Partnerships serving an urban district or rural village should be required to co-ordinate their ‘on-call’ availability to provide 24/7 care to their community.
     
    9   The NHS and Local Government are both publicly funded.
    The abolishment of the ‘internal market’ would negate the need for charges.
    GP’s and Hospitals could refer patients to their relevant local authority for the clinical services they provide.
     
    Those services delivered by Local Authorities could receive annual funding direct from the DoH as previously described for the NHS (Item 5 refers).
     
    10    Where are the incentives?
    In an ideal world all clinicians should be motivated by an overwhelming desire to make a difference to the quality of life for the patients placed under their care. Achieving a successful clinical outcome should be incentive enough.
      
    The generous contract remuneration awarded to Hospital Consultant’s and GP’s, whose working hours have also  been considerably reduced should negate the necessity to provide additional ‘incentive payments’ for services that are considered by the current administration to be beyond the remit of their contracts.
     
    As is the case with most private sector service industries, success or failure is dependant upon ‘customer’ satisfaction leading to repeat business. If, as suggested previously, the value of a retained fund allocation is ‘patient lead’ by the numbers of patients registered to a GP practice or Hospital bed allocation, then this, coupled with the vocational nature of the profession, should be incentive enough to motivate clinicians to ‘go that extra mile’. 
                                                                                   
    11    The NHS is, of course, a finite resource and can never meet the financial and operational demands driven by the combination of an ageing population and relentless medical advancement. It can never be ‘all things to all people’.
     
    However, it is incumbent upon government to provide a framework under which the NHS can deliver an optimum value and quality of service which is patient driven to improve the standard of care that is paramount to achieving successful outcomes.
     
     
     
     
       —– END —–

  • C Ostrer

    geI have several fundamental concerns about proposed changes to the NHS. I think it is time to go back to the drawing board.
    My points are as follows:
    GP Commissioning: GPs will not have more power to organise improvements tothe NHS, they will be responsible for administering the cuts of £20 billion that you propose.
    Creating competion: The company Monitor will ensure every GP helps bring in private competion, and part of the NHS budget will pay for Monitors work. GPs will have to be in touch with multiple organisations to obtain what they consider is the best deal.
    Patient trust: I understand that the NHS has recently had the highest rating ever in terms of patient satisfaction with the NHS, so I do not understand why you are planning such a major reorganisation. The main reason overwhelmingly seems to be to create a free market out of our NHS. This will severely impact on patient trust with their GP. GP Consortia will put pressure on GPs to cut their budgets, especially in relation to secondary care – referrals that the GP makes. GPs will be less able to refer patients to secondary care because of budget constraints. Also patients will not actually know whether the GP is referring us to any particular provider becuase it is best for them, the GP Consortia, or the GPs relationship with a privat provider. This fundamentally undermines the Doctor Patient relationship.
    Post Code Lottery: It has been said by Government that the proposed changes will reduce variation in care/medication. But budget restraints will increase variation becuase of budget restraints. Will this mean that patients will move home becuase different GPs offer better serrvices?
    Cherry picking: The private health companies are essentially there to make a proft, and more complicated health care is less likely to be given by the private sector. Those private patients who need more complex care will be moved to the NHS. Becuase the NHS will be left with the more complex treatments, this fundamentally undermines the ability of NHS hospitals to cope financially. It has been shown around the world that competition n health care provides lower quality of health care.
    Hospitals: The law that will require all hospitals to become Foundation Trusts – businesses who can for instance gamble on the stock exchange – is an outrage! Abolishing the current cap on how much the newly formed Foundation Trusts can make out of private patients will encourage a 2-tier health care system, becuase the Trusts, as they become strapped for cash under the £20billion savings they must make will encourage them to offer more services for private patients and therefore less to NHS patients, and those patients in pain, for example waiting for a knee operation will be encouraged, or feel pressure themselves, to go for private health care – if they can afford it that is.
    The Government Mandate: The PM said that there will be no top down reorganisation of the NHS. These huge plans, the biggest reorganisation in 62 years, was never on the Manifesto of the Conservative Party, nor in the Coalition Agreement. I feel we have been lied to in the most awful way. It is said that you, Mr Lansley, have been planning this for 5 years, but had to keep it a secret. I think that your proposals, and the Goverments proposals are a terrible breach of trust. You havent even trialled these changes – and so have no idea how they will affect the quality of our health care services.
    We will never accept it.

  • Health expert

    To all thinking about NHS reforms,The NHS has plenty of
    resources but these resources are wasted in a shambolic purchaser –
    provider spilt that has been mismanaged since its introduction.

    I keep hearing spokesmen on radio and TV saying that people want more
    choice. NO THEY DO NOT WANT MORE CHOICE. People just want a local
    effective service. I have had excellent service from my local hospital 3 times this year, having not used them for many years
    previously. I was pleasantly surprised by standards of care at every
    turn.

    I couldn’t care a jot about choosing between competing providers.
    Competition improves the breed in formula 1 cars, and indeed in consumer
    products from rival companies. Healthcare is not a consumer product.

    I had experience of the American system as a student when I drove an
    ambulance there as a student job. I had further experience when my well
    insured partner was injured in a road accident during a visit to NYC in
    2000. Both experiences were more reminiscent of third world countries
    than the splendid, though not perfect, health care systems i have seen
    all over western europe.

    Please go back to the drawing board.
    Kind regardsSomeone with experience of many healthcare systems

  • AndymillerH61

    Dear Mr Lansley

    In our small Derbyshire town of Wirksworth a group of us collected over 200 written messages to our MP, Patrick McLoughlin, during the course of a couple of hours one Saturday morning in April. In these messages, local people voiced their various concerns about the Government’s proposed changes to the NHS. These have all been sent to Mr McLoughlin.We have asked Mr McLoughlin to summarise the main points made by these people and forward them to you. We have also asked that our MP address the individual points made by his constituents.You should know that a large number of people where I live have deep misgivings about the motives behind, and the workability of, the proposals you have put forward in respect of the NHS.

    Yours sincerely

    Dr Andy Miller

  • Richard Ayres

    I am writing as a practicing doctor to register my deep concerns about Andrew Lansley’s NHS proposals.For example, I am very concerned that the legislation proposes to remove the Secretary of State’s duty to provide a comprehensive health service. I think the duty to provide a comprehensive health service is crucial and should be retained.The recent “red lines” comments by Nick de Bois show the full extent of Conservative wrong-thinking. There is zero evidence that competition between providers (especially private providers) improves care. Health is NOT a commodity to be traded in the market place. Patients do NOT clamour for more choice, but for good, “joined-up” care in their local surgery or hospital. This is best achieved by collaboration, not competition.I am not against GP commissioning. I am totally opposed to increased competition and greater involvement of the private sector. Privatised healthcare is expensive, inefficient and inequitable.Dr Richard Ayres

  • J Clark

    I am writing to express my opposition to the Health Service
    reforms as set out in the Bill before Parliament as proposed by Andrew
    Lansley.The NHS should not be about competition within the NHS and
    outside providers. The NHS is about providing a comprehensive health care and
    the reforms proposed would destroy the holistic basis of the NHS.I have
    fundamental concerns about these proposed changes to the NHS and I think Andrew
    Lansley needs to go back to the drawing board.For example, I am
    concerned that proposals to make competition the priority within the NHS would
    undermine our health service. The NHS should focus on cooperating to provide
    quality patient care, not on competition. The role of the regulator, “Monitor”,
    should reflect this.I do not believe the Coalition have a mandate to
    push through these reforms against the wishes of the professional bodies in the
    Health Service, who have voiced their opposition to these
    changes.Fundamental changes to the NHS should not be implemented until
    there have been pilot trials and seen to work and only after widespread
    consultation and agreement by the healthcare professionals.This Bill
    should be scrapped in its entirety. Effective reforms should be driven by
    evolution not revolution. Any Government that attempts to undermine the NHS by
    privatisation will do so at their peril when so much informed opinion within
    Healthcare is opposed to these changes.

  • Adrian Hopper

    From
    Adrian Hopper 10 Bushy Coombe
    GardensGlastonbury Somerset BA6 8JT
    To
    NHS listening exercise
    Subject
    Please listen re: the NHS
    Message
    Despite your and other spokespersons assurances to the
    contrary,these proposals are nothing but the break up and sell-off of the NHS by
    stealth and ,frankly, lies . We have seen the comments from investment houses
    that the NHS will be’ shown no mercy’ and we have understood the implications of
    your proposed re-structuring and changes to financial provision.For example
    we cannot believe you expect to get away with proposing to scrap the
    government’s duty to provide a comprehensive health service. This duty has
    always been fundamental to the NHS, and it must be retained.The whole
    excercise is a corrupt and cynical attempt to move into private ownership the
    results of generations of effort and goodwill provided by dedicated and
    concientious people. You should be thoroughly ashamed of the whole rotten
    exercise. Do not imagine it will be forgotten.

  • Francis

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    Please go slowly in any reforms of the National Health Service. There is no guarantee that the current proposals will result in a more effective service. Yes, there is room for improvement but I don’t believe more privatisation will bring that about.

    The government needs to convince the electorate that we all have a stake in a properly functioning NHS. Such a system has been and still is the envy of others. It must not be destroyed. We should all be willing to make sacrifices in order to maintain a high standard of free medical care. The profit motive should not be the driving force. Especially in this area, the concept of the Big Society should hold sway. Everyone should work for the common good. The government should be inspiring us this way and encouraging the training of medical professionals in management and on the clinical side who believe in the NHS and are not themselves in thrall to their own financial gain, dipping in and out of both sectors, private and public as they choose. Fair not excessive remuneration should be the guide throughout. 

  • Bill Cameron

    FromBill Cameron 7 Whalley Lane Uplyme Lyme Regis DorsetLyme Regis DT7 3URToNHS listening exerciseSubjectPlease rethink NHS changesMessageI
    have fundamental concerns about these proposed changes to the NHS and I
    think Andrew Lansley needs to go back to the drawing board.

    For example, I am concerned that proposals to make competition the
    priority within the NHS would undermine our health service. The NHS
    should focus on cooperating to provide quality patient care, not on
    competition. The role of the regulator, “Monitor”, should reflect this.

    The evidence used by Andrew Lansley to show poor performance in various
    fields of the NHS has been shown to be flawed. Indeed much of the
    evidence has been taken out of context and demonstrates performance on
    fixed dates rather than showing a continuum of progress. As a result it
    seems clear that the proposed changes are ideological in nature and
    nothing to do with improvements in the service provided by the NHS.

    ‘Cherry picking’ by private companies is, in my opinion, against the
    whole ethos of the NHS and should be dropped. Such a proposal would
    undermine the fundamental principals of the NHS. The government’s ‘duty
    to provide’ a comprehensive health service, free at the point of
    delivery, must be maintained.

    If changes are required for the NHS they should be trialled on a small
    scale for several years, be monitored by an independent committee and
    the results made known to the public. Patients and a variety of health
    officials should be represented on any such committees or commissioning
    bodies.

    Our NHS has provided superb care to the whole population, regardless of
    wealth or status for over 60 years. I believe Lansley’s proposals set
    out to undermine that function and replace it with a system where
    competition is paramount and the ability to pay comes before actual
    health requirements.
    I appeal to you to think again, remove the potitical element of these
    proposals and allow a fully representitive commission to study the
    performance of the NHS and decide how the institution needs to move
    forward in the best interests of the whole nation.

  • D.Farrow

    Where is the real savings in privatisation. Because the company will want up to 15% profit, will cut the employees wages etc and will always look to employ the lowest dominater in peoples qualifications. Also they always look to give minimum service, because profit and shareholder payouts matter most, why can’t politicians keep thier untrained fingers out of departments and leave them to the professionals who do know and understand it. The MoD or what is left of it is typical of what politicians and politics can do to wreck a large government department. I know because I saw it with my own eyes.

  • Royalan01

        My e-mail to the “NHS listening exercise” said:

    Subject    Please rethink NHS changes
    Message    I believe changes to the NHS should be piloted (i.e. tested on a small scale) to establish what effect they will have in practice. The coalition’s sweeping changes may have effects different from those expected.

    For example, I am concerned that proposals to make competition the priority within the NHS would undermine our health service. The NHS should focus on cooperating to provide quality patient care, not on competition. The role of the regulator, “Monitor”, should reflect this.

    Roy Heaps

  • M Sly

    Sorry, but I have to disagree. I too work in primary care and our patients are more interested in when/where they can be soon more quickly. Our patients thoroughly like the fact they can be seen at a Spire or BUPA hospital more quickly than the local hospital. Also, there is a quality factor….. As a patient myself I had to have 2 colonoscopies …. The first at my local NHS hospital ….. Appalling, mixed sex ward with males either side … An absolutely awful experience, the next via choose and book at my nearest Spire hospital (via NHS funding)…….. A far less traumatic experience. patients actually do clamour for my choice … Witness the news today …. patients want choice of where they can register, i.e nearest to their place of work. we have to remember that the labour party introduced private companies into the NHS …. To cut waiting lists, to improve access to primary care … Darzi Centres …… We now have grown a monster of expectation which won’t go away …… Our patients “sniff” once and demand to be seen, twice and they need a referral!!!! We can’t afford our NHS as it is, yes we don’t necessarily like the proposals …. But just what do you thnk can be done to improve things???

  • C Ostrer

    I have also worked in secondary care in private maternity unit in an NHS maternity hospital.  I wanted to see what it was offering and how it fitted together.  This is what I found.  Clinical care was exactly the same as that which NHS patients received, but aftercare and room facilities were of higher standard.  Also the workload was much smaller for all staff involved, so it meant that private patients did get more attention in aftercare services.  They also got a whopping great big bill at the end of it, a normal delivery or birth of a baby would cost them between £2000 and £3000, and this was in 1987.  I do understand your point about aftercare and wards etc.  And I personally believe that the quality of these things leaves much to be desired in the NHS as it stands.  However, I believe that once the private companies have to compete amongst themselves for “customers”, quality will inevitably deteriorate, it will have to in order to pay profits to shareholders.  Thats the law of the market, and there are plenty of examples overseas to draw upon, too many.  Just for information, I use the NHS carefully,  i certainly dont “sniff once and demand to be seen”, and research shows that many of us are just like that.  This isn’t a political swipe at the Tories,  I think that it was wrong of Labour to introduce Foundation Trusts.  But atleast they put a cap on the amount of money they could make from private patients< and in fact, the introduction of the private market into health care was in 1987, under Margaret Thatcher's leadership.  Our great grandparents fought and sacrificed for a welfare state, when healthcare was considered a luxury..and, the NHS was set up when the country was completely broke – after the second world war .  We are now constantly told that we are the 6th largest economy in the world, it seems that it is more about where our prioities for spending lie, not that we cant afford it.

  • Sol

    my e-mail to Mr Lansley

    The NHS listening exercise should be listening to those who matter most,
    the patients and people who contribute most to the cost of our NHS.

    Mr Lansley,s proposals are worring in that they are paving the way for
    US style Health care where profit and market forces are the driving
    force. Our NHS is for everyone not just those with the ability to pay.

    Health care for all regardless of ability to pay should be maintained in
    the spirit of which that NHS was founded with the government
    maintaining it’s “Duty to provide” guarantee.

    Parliament should not be asked to vote these swingeing changes through without first consulting the electorate in a referendum.

    On what basis is it assumed or argued, that the Private Sector could run the NHS any better that it is now?

    Our NHS is not for sale at any cost.