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Are plans to overhaul the NHS necessary?

08:29 UK time, Wednesday, 15 December 2010

Government plans for a major restructure of the NHS in England have been announced. Where should priorities lie?

Primary Care Trusts are to be abolished and, from 2013, family GPs will plan hospital care and manage the budgets to pay for it.

Hospitals will also be warned their funding could be docked if patients are forced to share mixed-sex wards.

Do you work in the NHS? Are you worried about the proposed changes? Should fines be imposed for mixed-sex wards? Should family doctors be given more say?

This debate is now closed. Thank you for your comments.

Error: Too many requests have been made during a short time period so you have been blocked.

Comments

Page 1 of 6

  • Comment number 1.

    stop taxing me as much for the nhs? your cutting and cutting but i see no tax cuts?
    id rather not pay for the nhs and pay for private health insurance.
    im also a smoker so that would soon shut up the ill informed than fail to realize if smoking was banned the government would LOSE 5bn profit from smoking a year.

    cut tax's! go private!
    its the way its going anyhow.

    welcome to rip off Britain!

  • Comment number 2.

    No No0 yes yes. Next

  • Comment number 3.

    None of this effects the political elite they are all private health insured at OUR expense when have you EVER heard of a politician or a politicians child waiting for any treatment of any sort? I shall make it easy for you NEVER.
    Its about time politicians had to put up with the same services we do and that includes forking out for their own diesel/petrol, its because of political meddling the NHS has the issues it has, such as wards scared to order a £10 dressing so instead they keep a patient in a bed for a week at the cost of £1000 minimum.
    Not one politician in power has any experience of ANYTHING they are cutting NOT ONE OF THEM.

  • Comment number 4.

    What an arrogant load of people Ministers are, ploughing on with their NHS plans after what just six months in office and against the criticism of the true medical professionals.

    I could understand it if they had been in office for a couple of years and had a really good understanding of how the NHS operates and where changes should be made but then that is the problem with our political system.

    Ministers only set policy and they pass the responsibility of their policy implementation to other people and when they fail the Minister and their policies are is never to blame it’s just the incompetence of the implementers.

    Everyone can tell you why it is too expensive to do something but they can never quantify the cost of not doing something and neither do they quantify the cost of change and if the cost of change becomes too expensive then some poor unfortunate not the Minister is hung out to dry.

    I have worked for a number of companies over the years and I have seen the new broom come in and within weeks start changing things without fully understanding the product the staff etc. I have seen countless man days wasted on change only end up with a system that was more costly and less effective than the current method of working and I have also seen the new broom try and blame other people for the changes failure.


    Since the 60’s I have seen billions wasted on political changes and failed policies. How many millions were wasted on the poll tax?

    It time for the amateur Ministers many of whom have no practical experience in anything but spoutng hot air to butt out and leave many of our public services to the professionals on the ground.

  • Comment number 5.

    I have a car that for some time was giving me troubles, after several visits to different garags I found one that can keep it functioning well, at a reasonable cost, although occasionally I do not have the choice of mechanic. I am content with my garage ,and my car. It aint broken, so I am not going to fix it.

    In the above parable, change car for me Garage for NHS.

    Stupid dogma ridden Government please note!

  • Comment number 6.

    This is the beginnings of the dismantling of the NHS, the best health service in the world. I have spoken to people all over the world who envy our quality of service, the ability for all people to get critical care and attention regardless of social status and the benefits a healthy nation provides the state.

    If they (the government) are allowed to privatise this, most critical of services, they should face the full wrath of public opposition. It must not be allowed to happen, doctors are against it, the public and nurses the same, but of course the influence of private health providers and the large medical companies cannot be ignored by the government.

    This must not be ignored.

  • Comment number 7.

    This is just another step on the road of privatisation.

    Next we'll have private companies owning GP surgeries and then it'll be foreign companies controlling these hospital budgets.

    Welcome to the Tory profit shaving world.

  • Comment number 8.

    The idea of GP's in charge is very very scary.

  • Comment number 9.

    Are plans to overhaul the NHS necessary?
    You mean is it necessary for parts of the NHS to go private? The answer is no.

  • Comment number 10.

    It is vital that taxes support the NHS. If people aspire to the US system then they are deluded. In the US their excellent medical system has a crucial drawback - less than half of the population makes proper use of it and many have no health care at all. It is not necessary to make cuts, indeed NHS spending needs to increase. There is a common trend in the tactics of this coalition 'government' - they claim that what is not necessary is necessary, without presenting a coherent reason as to why, and then set about taking money from the poor to give to the rich, like the zealous maniacs that they are. The NHS is a system that ministers and their fat-cat buddies don't need, ergo they want to reduce it and perhaps one day eradicate it. Ministers 'govern' the nation solely for their own benefit, this is clear.

  • Comment number 11.

    The last thing we should do is let GPs have more say. They are the least trained and overpaid of all doctors. All GPs EVER do is refer patients to hospitals, sometimes without even seeing the patient themselves! A recent conversation with a GP and a hospital paediatrician went as follows "The child sounded weezy over the phone so I'd like to refer him to the hospital". Over the phone! So this GP was not even going to see the child and just wanted to send it to hospital. If GPs did their job (and actually justified their £100K a year) then hospitals wouldn't be so over burdened.

  • Comment number 12.

    Fools rush in where angels fear to tread...

    The Coalition is determined to make itself very ill very quickly in the knowledge that no medical practitioner worth his post will help cure the ailment; indeed there will not be any medical practitioners left the way this is running.

    However I do understand my GP is quite handy at DIY. I hope her Stanley knife is sharp.

  • Comment number 13.

    Sorry, but I feel that the NHS does need an overhaul, but not at the sharp end. Management needs to be cut. Nurses need practical training, not degrees. If you want to be a doctor, be one. You shouldn't need to take 3 years out to do a PhD to be a consultant - leave biomedical science to the scientists - its what we're trained for. Charge for broken appointments. Stop expensive non-urgent treatment - ie boob jobs, sex changes, even IVF. These are the sort of procedures that if you really want them, you'll save up for and pay for yourself. If you won't, you don't want them enough. There are loads of other savings that could be made - but they'll interfere with the sharp end as usual.

  • Comment number 14.

    More of this! █████ ██ █ ████ everything ███ █████ is█████ ████ ████ fine ████ ███ █ ██████ love █████ ███████ ███ your █████ ████ government

  • Comment number 15.

    Just get rid of all the pretend market and competition nonsense and same millions - the NHS is a public service not a chain of dodgy car dealerships.

  • Comment number 16.

    What was that saying 'You reap,what you sow' well my Engleesh cousins, its certainly getting closer to my warnings of don't get sick, old or unemployed! You'll be playing some kind of lottery for the foreseeable future! For sure our captains of politics / industry will not fear these NHS reforms, they've got the likes of BUPA including spouses or whatever thrown in so to speak as part of their huge remuneration packages, excludes bonus payments etc etc...

  • Comment number 17.

    A better start would be to reduce waste. You think the Army wastes money! you ain't seen nothing till you've seen how the NHS can waste it. My husband works in the NHS & is fuming about the amount of idiot decisions, lack of communication & common sense. Trusts being forced to buy simple items like stationary from registered suppiers instead of going to the cheapest ones (who pays £2.50 for a box of paperclips!!!) Training sessions that are run because they meet a quota, but only 2 people turn up & that's only the beginning. Closing trusts will not help the problem if you can't shrink the wastage.

  • Comment number 18.

    Another poorly thought through, rushed bit of political dogma. Yes, the NHS probably could stand some reform but this is not the way to go. Because it is such a large complex organisation politicians should be banned from having anything to do with it.

  • Comment number 19.

    IT'S THE ROAD TO PRIVATISATION STUPID!

  • Comment number 20.

    Is re-organisation of the NHS required? - Most definitely.
    Is this the way to go about it? Definitely not!
    It needs a fundemental overhaul on the basis of what we can and cannot afford. Private insurance is NOT the way to go as the emphasis here is to make a profit therefore they try to avoid payment, delay until treatment is no longer worthwhile, restrict on the basis of risk and usally use the NHS a backup to correct their mistakes when they occur.
    The NHS needs to say what services can be provided and this should be based on the usefulness to the greatest number. This would be politically difficult as it would literally mean openly saying some conditions will not be treated as they are too expensive per person.
    People should be given the option on whether they want to live in agony or a dignified death and not have permanent torture inflicted upon them.
    More emphasis should be placed on prevention than on treatment, unfortunately the effectiveness of prevention is difficult to quantify so does not fit easily into the Governments requirement for figures.
    Make sure people in authority also have responsibility and accountability for the decisions they make.
    Get rid of the internal market which just creates jobs for accountants and non-productive administration staff.
    Stop introducing changes until pilots have proved there are more efficient than previous methods. Where I work they have created jobs for staff to introduce changes. To justify their jobs they make sure change happens and impose their will no matter whether investigation shows the changes to be useful or not. Or they may manipulate the figures to show the change is required, for instance we have increased the numbers going through the department. This shows how things have improved but the fact that wastage and returns have increased is ignored.
    So yes a root and branch overhaul is definitely required but as the people with vested interests are not changeing the causes of the problems are not being removed and the changes being implemented MAY produce savings but at the cost of lives, value for money and overall efficiency.

  • Comment number 21.

    I have had to visit my local A&E on a couple of occasions for different reasons. On both occasions the service received was very good and I can't complain. Let's be honest though money is wasted - not only in the NHS - as there are many inefficiencies within it. These have been exposed in the media in the past in programmes such as Sir Gerry Robinson's on how a particular hospital worked. If you can work smarter and more efficiently then money can be saved. Throwing good money after bad therefore does not work.

    I have no desire to see the NHS being privatised but a private sector mentallity needs to be employed across all government spending.

    If, as people have claimed above, the NHS is the best in the world then why do many people go private and why do they seek treatments abroad?

  • Comment number 22.

    "Government spending plans will test the NHS and social services in England to the limit, according to a report by the Commons Health Select Committee."

    Shouldn't that always have been the test? It's public money. It's not infinite. It isn't the Government's money, it's OUR money. Whether it's being spent efficiently should ALWAYS be tested to the limit.

    Maybe if we hadn't had 13 years of a wild "Spend it without thought, it doesn't matter, there's plenty more where that came from" mentality, we wouldn't be in the mess we are in at the moment.

  • Comment number 23.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 24.

    The priorities should be less chiefs and more indians.
    In other words less managers and more nurses.
    The patients need more attention.

  • Comment number 25.

    The NHS has always been run for the benefit of those it employs and nothing has changed since it was formed. It is run without regard for the costs or benefits of treatment and its funds are used to drive through left wing political desires.

  • Comment number 26.

    Interesting.

    In some of the numerous, previous, HYS's revolving around the NHS there have been frequent cries of "too many Managers", "it's a top heavy Management", "get rid of the pen pushers" and many more similar comments. Now we have a government that appears to have listened to what has been said and are now actually doing something about it we get the opposite complaints!

    It's a no win situation, damned if they do change, damned if they don't.

    This country cannot afford the NHS we have. Change is a must, throwing money at the NHS will only ensure there is more waste. The challenge is to provide better care for a lower cost and thats what the NHS must raise it's game to achieve.

  • Comment number 27.

    Challenging the overbloated unreconstructed nationalised industry that is the NHS is long overdue and the resistance to even the slightest change has to be seen to be believed (except of course for the massive pay rises for doctors in c 2004 thanks to Patricia Hewitt's utterly inept approach). But whether GP fundholding is the answer is very debateable. It sounds like another massive waste of money.
    BTW note the focus of the HYS questions - do you work in the NHS? Are you worried about the changes? In other words the focus is on the producers and not the patients! Very socialist that! Well done BBC, you reveal yourselves for what you are.

  • Comment number 28.

    Curent position, Health Care available to all, irrespective of your ability to pay.
    The initial outcome of this policy will be that private Facility Management companies will take over NHS funding allocation. There are a number of US based HealthCare companies which are already circling around the prospective honey-pot which is the NHS budget.
    The next step will be the awarding of contracts to Health Care providers, a consortium of GPs or others with experience in providing health care.
    Then the management of NHS hospitals will be open to tender as above.
    At all times the Minister will promote the point that the 'NHS remains free at the point of use'.
    Then the Insurance companies and private HealthCare provisers will offer to supplement the basic tax-payer funded healthcare package with a more comprehensive package for a monthly fee.
    At this point the Minister will say people are free to choose the level of health care the want.
    End Point, Health Care available to those who can afford it.

  • Comment number 29.

    "5. At 09:10am on 15 Dec 2010, barryp wrote:
    I have a car that for some time was giving me troubles, after several visits to different garags I found one that can keep it functioning well, at a reasonable cost, although occasionally I do not have the choice of mechanic. I am content with my garage ,and my car. It aint broken, so I am not going to fix it.

    In the above parable, change car for me Garage for NHS.

    Stupid dogma ridden Government please note!"


    And if you found out that your garage spent millions on an unworkable computer system that achieved nothing and hadn't been thought through and had employed hundreds of consultants with no knowledge of cars but who could design great new logos and the garage was simply passing the cost on to you by way of inflated bills, would you still be happy?

    Oh, change 'millions' for 'billions' and 'bills' for 'taxes'.

  • Comment number 30.

    I worked for a Drs. office and was shocked at how many patients they had to take care of. It was nerve-racking to have people telephoning all day and trying to fit them into a limited number of appointment spaces. The Drs. may have been earning big money but they worked themselves to a frazzle.
    We need more Drs. All of this student loan business is going to make young people go for the shorter degree courses. We should be putting money behind gifted young people to encourage them to go into the medical profession.

  • Comment number 31.

    Well I'm not sure about this, it could be a good idea, or it could escalate into a major disaster in which the working-class will once again have to pay the price. One thing's for sure, if this reform does go up Pitt's creek, it will be very difficult to reverse the damage done.

    We should all be very afraid if this happens.

  • Comment number 32.

    In order to provide public services, you need to raise taxes.....rather than pretent they're not being raised, bite the bullet and make sure the money raised goes where it's supposed to....forget VAT and petrol, alcoholand tobacco tax hikes...do it in a proper, regular way...that way you'll know how much is coming in so you can plan accordingly....

  • Comment number 33.

    Take a look at how Germany and France do things because their health services are streets ahead of ours.

  • Comment number 34.

    12. At 09:27am on 15 Dec 2010, Aneeta Trikk wrote:

    Fools rush in where angels fear to tread...

    The Coalition is determined to make itself very ill very quickly in the knowledge that no medical practitioner worth his post will help cure the ailment; indeed there will not be any medical practitioners left the way this is running.

    ---------------------------------------------

    Actually the reality is we are heading in the opposite direction

    http://www.healthcarerepublic.co.uk/News/article/1040634/bma-scotland-warns-generation-unemployed-doctors/

  • Comment number 35.

    It probably does need restructuring but it would also help if we did not have so many health tourists and bogus asylum seekers using the service, this includes other EU member states.

    In fact I would suggest that the law needs changing so that anyone that is not a British citizen should have to pay the full amount for any medical treatment they need while they are temporarily in the UK.

    The NHS is paid for by UK tax payers only and should be restricted to the treatment of UK citizens only and no one else.

  • Comment number 36.

    1. At 08:56am on 15 Dec 2010, scotty1694 wrote:
    "stop taxing me as much for the nhs? your cutting and cutting but i see no tax cuts?
    id rather not pay for the nhs and pay for private health insurance."

    You'd end up paying more and the insurance would refuse to pay out. Then that terrible smokers cough of yours would just get worse and worse and you'd wish you still had an NHS.

  • Comment number 37.

    I was rather hoping for more than an overhaul. It needs massive cuts and it needs them right now. Working practices, purchasing methods, staffing levels are all a bad joke within the NHS. Don't get me started on the silly "union rate" salaries being paid while qualified doctors and nurses are on the dole and would work for half the pay.

  • Comment number 38.

    Are plans to overhaul the NHS necessary?

    It is if we are to have a USA style 3rd world healthcare system, which is the ultimate aim of the Tory party.

  • Comment number 39.

    Last week there was a news item on the BBC about medical mistakes in a hospital in Yorkshire. The BBC described it as mistakes made within an NHS hospital. What they did not clarify was that the mistakes were made by a PRIVATE company running a medical centre. BBC you would make Pravda proud of your limited information. Rip off Britain is supported by the BBC, though its own employees live off the taxpayer.

  • Comment number 40.

    No they are not its just a scam, a smoke screen by the Con/Libsdems to bring in more cheap unskilled labour from over seas' and make many of they friends companys,vast increase profits !!! The N.H.S. is the best, but this government wants' to see it in private hands, or sold off to the highest bidder. or every one pays' for private health insurance, a {rip off} or die in the gutter, like the bad old days.

  • Comment number 41.

    "The priorities should be less chiefs and more indians.
    In other words less managers and more nurses.
    The patients need more attention. "

    We need neither more doctors nor more nurses. We need the ones we have to do what they get vastly over paid for. Could not agree more on managers though.


  • Comment number 42.

    A stupid idea from a government who hardly touch the NHS unless they have a barge pole


    HOW LONG BEFORE INSTEAD OF FIRST BEING ASKED WHERE DOES IT HURT, YOU ARE ASKED WHO ARE YOU INSURED WITH.

  • Comment number 43.

    This debate is incredible!

    What did people think was going to happen when the tories got in power. They tried to dismantle the NHS in the 80's when it wasn't even under as much strain as it is now, they started by dividing it up into Trusts, the first step in privatisation and now Cameron is continuing the legacy.

    The tories want to privatise it so to move the blame for any issues onto the private sector, and at the same time collect the corporation tax, this is how a tory government has always worked, it doesn't matter how you get tax money in the door, just as long you get it with as minimal effort as possible.

    The NHS is an incredible thing, it doesn't matter if you're poor, rich, black or, white. Everyone gets the treatment they need, granted there are those that abuse it, but then again people abuse private medical insurance as well, which directly affects the premiums of other members of the scheme! The NHS stands for what England is supposed to be about, equality, fairness and wellbeing. To destroy it will only put us further into the tory void of becoming a nation of class segregation, where the poor die and the rich prosper. This is how England used to be 100's of years ago, to allow the Tories to continue like this is to put in England in a time machine that only goes backwards.

    SAVE THE NHS!

  • Comment number 44.

    17. At 09:33am on 15 Dec 2010, RubbishGirl wrote:
    "A better start would be to reduce waste. You think the Army wastes money! you ain't seen nothing till you've seen how the NHS can waste it. My husband works in the NHS & is fuming about the amount of idiot decisions, lack of communication & common sense. "

    Totally agree. The NHS employs so many useless people. I mean "Play Therapists" for example. Also, cut GPs pay (see my other post about how overpaid and lazy they are) and make them actually treat more patients themselves instead of referring to the hospitals all the time.

  • Comment number 45.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 46.

    simple, do what it says on the tin - re-organisation is required

  • Comment number 47.

    The business of Government has come to be perceived as "change" and we have come to believe that "change" is good and necessary. If it aint broke dont fix it no long applies.
    As government changes every decade or so all that went before is swept away and "changed" by a new broom. In a fever of different dogma change is rapid to show how good the new is and change is the measure of "good management"
    In all the change and its massive costs, only to change again a decade on good or bad, the objective of all the services is secondardy to the change. In this case NHS dogma and policy is put before patients. The last government spent a lot of badly needed money on the NHS, money we apparently didn't have? Some bits of what they did were good some not so. As I get old(er) I have more contact with the NHS. Frankly I am not impressed. It took me 30 years to find a good GP and I wonder how long that will last so I don't know whether GP's are right to control the purse. They probably will get a "bonus" for all the budget saved in a year so the doctors incentive is cheap or not at all.
    I have found all the nonsense about choice is just that nonsense. There is little or no choice in reality. My eyesight is failing. The problem affects 1 in a 1000 but because cateracts are the flavour target now I am pushed down the queue as my eyesight fails. Thats the sort of thing that needs change. I dont hold much hope for the future of the NHS.

  • Comment number 48.

    So much for Cameron's support for the NHS, steps towards privatisation will be something neither party leader will be responsible for and inevitably will be blamed on Labour mismanagement in the previous thirteen years, same as everything else this coalition spouts, "The coalition has inherited blah blah blah and have had to make compromises to policy for fairness, we are all in this together." seems to be all we hear as we hurtle headlong into a massive pile of excrement after paying NI and income tax all of our working lives. Refund my tax and national insurance, I'll gladly place these into a pension and private health fund, using the remainder for my children's university education. Yes, we all know where this lot are leading us, civil unrest is unavoidable in the very near future and as the "have nots" greatly outnumber the "haves", the outcome too is unavoidable, you're treading dangerous grounds here Mess'rs Cameron/Clegg

  • Comment number 49.

    From BBC website:
    "Hospitals will also be warned their funding could be docked if patients are forced to share mixed-sex wards."

    Why should hospitals be punished for treating the disease of a ill person, rather than trying to do that in a gender divde manner?

    Is there a gender that is "more ill" than the other or if a man/woman with a similar disease, are they medically treated differently?

  • Comment number 50.

    I'm sure that many people have their own NHS horror story about the way treatment and diagnosis is delivered . I have two things that need to be tackled.

    The first is that GPs need to be more accessible at weekends/night. These guys get paid a lot of money. They need to accept that this entitles their patients to see them or a practice colleague at worst when they need help rather than some locum service staffed by people of uncertain quailty, often unsatisfactory English, armed with no history and having no future. For many surgeries these days it would require a GP to be on call and in a position to make calls a night or two a week and maybe a day every third weekend. This is not too much to expect or indeed demand from a highly trained and expensive resource. I'm not sure right now that GPs spend enough time in front of patients rather than in dealing with other matters that in other professions are carried out at least partly in the job-holder's own time. I don't think I'd be prepared to give GPs more responsibility till they stopped subcontracting that which they've already got, and without establishing a clear regime to get GPs in front of patients. Otherwise if we just pile responsibilities on them, we can stop training them in medicine and start giving them business degrees.

    Second there appears to be an attitude in NHS hospitals that its OK for a doctors appointment to be very late and that its OK for there to be a hugely inefficient number of admin people and nurses involved in the process. I can't help feeling that not only must it be easy to work out a process of handling an outpatient appointment with a lot fewer people involved but that the process would be better , slicker, faster without many of these people. There must be thousands upon thousands of people in the NHS employed to do things that just shouldn't be done, or shouldn't be done that way.

    There also appears to be a culture that the doctor starts his/her clinic when they can, not when its scheduled. In essence the doctors are rated above the patients. I've had appointments delayed for hours because the doctor has a childcare problem! I'm not one of the people who believes that the commercial world provides a model of efficiency that should be a template for everyone. But I do know that if a manager is systematically late for work to the point that he affects the efficiency of colleagues or upsets customers, then he will face disciplinary action. If the doctor is running a clinic at 9am, then barring the gravest emergency they should be there and working on time and giving their patients respect rather than disdain.

  • Comment number 51.


    Interesting.

    In some of the numerous, previous, HYS's revolving around the NHS there have been frequent cries of "too many Managers", "it's a top heavy Management", "get rid of the pen pushers" and many more similar comments. Now we have a government that appears to have listened to what has been said and are now actually doing something about it we get the opposite complaints!

    It's a no win situation, damned if they do change, damned if they don't.

    This country cannot afford the NHS we have. Change is a must, throwing money at the NHS will only ensure there is more waste. The challenge is to provide better care for a lower cost and thats what the NHS must raise it's game to achieve.
    ---------
    if i got a tax break to justify the cuts( if there spending less why charde the same) also known as a rip off or con then most wouldnt complain but now there spendin less degrading quality for the same price as before.

  • Comment number 52.

    The first thing needed is to reduce the load put on the NHS.

    1.Stop all cosmetic surgery unless it is life threatening.
    2.All IVF treatment to incur a £500 up front charge (Any prospective parent thinks thats a lot of money is in for the shock of their lifes when they realise the cost of bringing up baby)
    3.Any patient undergoing private treatment in the UK or Overseas that goes wrong within 5 years must ensure that they have private insurance cover,why should the NHS have to pick up the bill for botched private treatment.
    4. NO EU immigrant to have free NHS treatment until they prove they have 5 years uninterupted resident in the UK, along with associated NI and Tax. Not the ludicrous 1 year as at present.

  • Comment number 53.

    #34 Roger Grant says “Actually the reality is we are heading in the opposite direction”

    Ah, So it would seem unemployed doctors will be performing the operations as part of their community service. Interesting!!!

    Nothing like helping to keep your hand in is there?

  • Comment number 54.


    Family GPs will plan hospital care and manage the budgets to pay for it.

    But why will family GPs be any good at planning hospital care and managing budgets?

    The family GPs do a wonderful job – but they are not specialists. Why would the government expect family GPs to plan hospital care? If I have a broken leg – maybe my GP could do a bit of planning. If I need open heart surgery, I expect my care to be planned by cardiac specialists thank you.

    And why should someone with a medical degree be any good at managing a budget? From past experience, the GPs are very good at negotiating a huge pay-rise for themselves for less work. Is this supposed to fill me with confidence that they will manage the NHS budget for the benefit of patients?

  • Comment number 55.

    17. At 09:33am on 15 Dec 2010, RubbishGirl wrote:

    A better start would be to reduce waste. You think the Army wastes money! you ain't seen nothing till you've seen how the NHS can waste it. My husband works in the NHS & is fuming about the amount of idiot decisions, lack of communication & common sense. Trusts being forced to buy simple items like stationary from registered suppiers instead of going to the cheapest ones (who pays £2.50 for a box of paperclips!!!) Training sessions that are run because they meet a quota, but only 2 people turn up & that's only the beginning. Closing trusts will not help the problem if you can't shrink the wastage.

    -----------------------------------------------

    Now there is some sound common sense being spoken. If the press (Are you listening BBC) ever started to investigate who decides how purchases are made and why we often pay many times more than we need to for everything from simple items to major items then they would uncover a scandal that would dwarf MP's expenses.

    Start taking a long hard look at who ends up on the boards or payroll of companies and how companies that are offering anything but the best deal for the taxpayer end up getting contracts. Why are no clauses written into contacts as in the private sector to prevent things running massively over budget and the taxpayer picking up the cost. Why does the taxpayer pay for systems that fail to do the job that was specified? Those and many more questions slip by unanswered.

  • Comment number 56.

    1. No
    2. Yes
    3. No
    4. No

    I didn't see the more important question. "Should you pay to fund the NHS for unemployed people or immigrants to pump out kids and get free healthcare"

  • Comment number 57.


    The government has carried out a public consultation on reform plans

    Once again I find out that the public have been consulted on something and yet I saw no consultation nor knew that I had a chance to contribute. Where does this "public consultation" occur and who are invited?

  • Comment number 58.

    RonC @ comment 4.

    Well said!

  • Comment number 59.

    It has taken a learning curve of decades for NHS administration to function as it does today and put in place all those necessary practices to avoid attrocious failures of which patients still experience quite a few, but much much less than would be otherwise the reality.

    These NHS administration systems also have highly trained & dedicated staff, with years upon years of experience, yes, there will be those minority who are basically non-needed unproductive dross, but it would be simpler to just get rid of them anyway.

    To basically start all over again, at HUGE HUGE extra and unecessary expense is just pure political bias and neglect of duty to the public.

    I dont know of any doctors practices which already have the facilitys and capacity to house an army of administrators who will STILL be needed, hence doctors practices will have to build whole new buildings and present NHS offices, computer systems, fixtures & fitting & everything else is just being WASTED, NOT very environmentally friendly.

    These new facilitys will be made up of new teams of people administering systems which will enevitably have their endemic faults, the serious problems of which will just result in misery for patients.

    Presently, there is MUCH compatability of systems across the UK, Labour have also just spent/wasted £BILLIONS on new hi tech computer systems, how are these going to continue, function/work in totally different places/environments and WHAT will be the ADDED cost to provide security of systems etc at so many local sites and will this new system actually be used/continued, at these new doctors administration suites.

    WHO is going to be responsible for the COMPETANT CHANGE OVER.

    At present any changes to administration in hospitals etc can be overseen by those who are endemically a part of systems functionality. With this total change of people and buildings and equipment at what point of competance is the hand over of responsibility going to be. Is it when new systems and personel are 80% competant or 40% competant or what.

    What this change over ultimately means is MULTIPLE £MILLIONS of professional consultancy fees, most probably over £100 million and maybe as high as £200 million or even more. These fees etc are going to be needed to avoid COMPLETE CATASTROPHY and FAILURE of new systems.

    These administrations are NOT just your ordinary microsoft word or plain & simple data bases.

    In my view, there may be need for radical change and disposing of waste & unproductive dross withing NHS administration, but basically as far as I can acertain, this policy is relatively similar to outrageous and incompetant politicians of WWI who promised so much at a low price but which resulted in endemic failures and incompetance and attrocity beyond what I would regard as treasonable acts upon the people.

  • Comment number 60.

    More political dogma from the party who's member publicly stated that the health service was a 60 year mistake. If the virtually private dental industry is an example of the future help us all ! Most people I know can no longer afford dental work whilst the dentists income has increased and only the wealthy seem to be able to afford to have good teeth as cosmetic denistry is a good earner. Even with dental insurance the premiums seem vast welcome to the future. I hope that soon cleggy and cammy will have their perfect expensive smiles wiped from their faces student fees might not command sympathy from the population as a whole but the NHS?

  • Comment number 61.

    Never mind fines for mixed sex wards, it simply should not happen.
    A lot of people may be uncomfortable with the principle sitting in a bed next to a lady who has no option but to show you all her bits and bobs. I doubt the lady would be happy either. Its also not nice to sit in a bed eating your awful cold and sloppy looking meal while the dear in the next bed behind a curtain attempts the first 5 bars of God Save the Queen on trumpet followed by the most appauling smell which with the appearance of the meal in the first place finally does for the appetite.
    It simply should not happen, never mind fines. If the money isnt there to facilitate better what point the fine? Its not the enviromnet condusive to reduce stress and ease recovery.

  • Comment number 62.

    It's the same as with all public services. The cuts have to come, so the over bloated middle management cut those jobs 'at the coal-face', ie the ones who actually do the hands on work, while keeping themselves safe. Nurses and doctors can no longer do the job of looking after people as they are two busy filling in forms and dealing with a management who have no understanding of the job at hand.

    These reforms with cut the service to the tax payer and further extend the management structure.

  • Comment number 63.

    43. At 10:01am on 15 Dec 2010, Ben wrote:
    This debate is incredible!

    The tories want to privatise it so to move the blame for any issues onto the private sector, and at the same time collect the corporation tax, this is how a tory government has always worked, it doesn't matter how you get tax money in the door, just as long you get it with as minimal effort as possible
    ---------------------------------------------------------------------

    Privitisation of NHS? - Based on dogma, rather than fact......
    On taxes - You are a bit blindfolded and blinkered by the stacks of stealth taxes that the last labour government brought in.

    In essence, things in the NHS are not great, but they are not bad. That is to say that if you are ill, you will get treated. Some people get better treated in other parts of the country than others - but thats life... is it fair? probably not - but how on earth can you get an identical homogenous medical service when it employs millions of different doctors/nurses/managers etc. with differing local needs.?

    There clearly must be efficiency savings - the NHS has many new services that were introduced by last governement over last 13yrs, whilst all very well intentioned - I do not think they were properly costed, not totally necessary... money that could have been better diverted to better fundamental facilities

  • Comment number 64.

    yes it does need a huge overhaul. It's a money pit and the hole is just getting bigger and bigger.

  • Comment number 65.

    Yes and it must start at the TOP !
    Sack all "Blue Sky thinkers", those who work "outside the box" The "Brainstormers" and the "bean couters"
    Then we may just have enough money left over for a bottle of bleach and a cleaner to clean the filthy wards where thousands catch unnecessary infections every week, many sadly....fatal !

  • Comment number 66.

    37. At 09:56am on 15 Dec 2010, RightWingIDBanned wrote:

    Don't get me started on the silly "union rate" salaries being paid while qualified doctors and nurses are on the dole and would work for half the pay.

    ---------------------------------------------------------------------------

    Sorry to change it slightly but I would like to see your philosophy applied to banking as well. I'd like to see their salaries reduced to a socially acceptable level. Big city fat cats don't have 1% of the qualification requirements that our doctors have to have. Yet these are the people who are really behind the demand for changes to the NHS. After all they bankroll the Tories and this is their pound of flesh as payment in return. The only problem is that the flesh belongs to the common working people.

  • Comment number 67.

    The government is seeking 'payment by results' in the NHS, more or less the same as their deal with the banking fraternity. No change there then. Only difference I see is that the banks couldn't care less about their customers whereas the NHS does! I don't care what financial mess we are in, money should be no object when it comes to our health and if that means punishing the banks where it hurts, I'll be amongst the first to sign up to that.

  • Comment number 68.

    36. At 09:56am on 15 Dec 2010, Dominic wrote:
    1. At 08:56am on 15 Dec 2010, scotty1694 wrote:
    "stop taxing me as much for the nhs? your cutting and cutting but i see no tax cuts?
    id rather not pay for the nhs and pay for private health insurance."

    You'd end up paying more and the insurance would refuse to pay out. Then that terrible smokers cough of yours would just get worse and worse and you'd wish you still had an NHS.

    complain about this comment
    ---------
    id endup payin mor and gettin much better service, quality and response times instead of never getin told anything, getting appointments for 15 minutes 3 or more months in advance.
    and private health care cannot fob off what is in a written agreeement all you have to do is read the terms and conditions.

    yes id pay more and im willing to pay more for better were as now i pay for crap

  • Comment number 69.

    The Tories are desperate to bring a little "creative destruction" to the NHS. Their haste to cripple the service is frightening.

    Long ago I gave up on "spectrum" politics - all I hope for is consistent politicians true to some kind of values.

    If we need to change to a health insurance system, then maybe that's what we have to do.

    The thing that scares me is that Osbourne and Cameron seem even less competent than their predecessors who privatised the railways.

    I have no confidence that they have the capacity or will to get a good deal for the populace.

  • Comment number 70.

    I agree with first comment, there is a significant difference in attitude of staff and care in private treatment than there is in NHS.

    NHS patients and I have been one, (although now until retirement in 10 months are lucky enough to have private cover) are usually in my experience treated like imbecile's.

    I shudder when I think of the dirty run down smelly hospitals with their MRSA etc, when people often come out worse than when they went in. It is a total disgrace and needs sorting, and it does not need zillions of pounds to do it, just common sense and good management, two things Britain seems to always lack in comparison to other EU states.

  • Comment number 71.

    This should apply to Schools as well. The principle should always be if these State funded Institutions are 'fit for purpose', a legal turn of phrase which means they can simply be held to account.

  • Comment number 72.

    We all knew it was coming once the Tories got in.

    Kiss goodbye to the one good thing the UK has left.

    Privatisation is around the corner.

    God help us all...

  • Comment number 73.

    I assess claim for the largest private health insurer and I can assure you there is no money wasted there. Most of the InPatient claims I deal with are for no more than daycase or one night In Patient. For alot of procedures this is all that is necessary. If we do get a claim where a customer appears to have been In Patient for longer than is medically necessary we would query this and if we feel that they have been in hospital and not receiving any treatment, we would only pay benefit if they had a scheme which includes rehabilitation cover. There is so much waste in the NHS. Patients are kept inpatient for unecessary length of times. We need to hold these hospitals to account for this.

  • Comment number 74.

    51. At 10:07am on 15 Dec 2010, scotty1694 wrote:

    Interesting.

    In some of the numerous, previous, HYS's revolving around the NHS there have been frequent cries of "too many Managers", "it's a top heavy Management", "get rid of the pen pushers" and many more similar comments. Now we have a government that appears to have listened to what has been said and are now actually doing something about it we get the opposite complaints!

    It's a no win situation, damned if they do change, damned if they don't.

    This country cannot afford the NHS we have. Change is a must, throwing money at the NHS will only ensure there is more waste. The challenge is to provide better care for a lower cost and thats what the NHS must raise it's game to achieve.
    ---------
    if i got a tax break to justify the cuts( if there spending less why charde the same) also known as a rip off or con then most wouldnt complain but now there spendin less degrading quality for the same price as before.

    --------------------------------------------------------------
    You seem to be ignoring the fact that the government has a massive bill to pay in the form of a very large budget deficit. Thats why you cant have a tax rebate, it's being used to pay past debts.

  • Comment number 75.

    Of course they are 'necessary'....so that the NHS can be sold off to private company's.
    The Forensic Service is being closed....severe disability payments withdrawn...Coastguard Stations closed or sold to private company's......Search and Rescue to be privatised....etc etc.
    This 'coalition' is intent on privatising everything it can flog of to it's mates......and you and me, ordinary people, will be the victim.
    Anyone out there that thinks that it will not effect them better have lot's of lolly or be of a very trusting nature because it's not the 'Big Society' that will benefit but the rich.
    Read the book 'Shock Therapy' and it will be made very clear what this coalition intends.

  • Comment number 76.

    17. At 09:33am on 15 Dec 2010, RubbishGirl wrote:

    A better start would be to reduce waste. You think the Army wastes money! you ain't seen nothing till you've seen how the NHS can waste it. My husband works in the NHS & is fuming about the amount of idiot decisions, lack of communication & common sense. Trusts being forced to buy simple items like stationary from registered suppiers instead of going to the cheapest ones (who pays £2.50 for a box of paperclips!!!) Training sessions that are run because they meet a quota, but only 2 people turn up & that's only the beginning. Closing trusts will not help the problem if you can't shrink the wastage.

    ----------------------------

    I couldnt believe they employed my mum (a secretary) when they were cutting doctors and nurses!

  • Comment number 77.

    I cannot understand when savings have to be made in all areas, then why so much is said about the sacred NHS. Had the previous government not been so extravagant, then the cuts wouldn't have been so drastic. We must all make savings where we can.

  • Comment number 78.

    35. At 09:54am on 15 Dec 2010, Alan Baker wrote:
    It probably does need restructuring but it would also help if we did not have so many health tourists and bogus asylum seekers using the service, this includes other EU member states.

    In fact I would suggest that the law needs changing so that anyone that is not a British citizen should have to pay the full amount for any medical treatment they need while they are temporarily in the UK.

    The NHS is paid for by UK tax payers only and should be restricted to the treatment of UK citizens only and no one else.


    -------------------------------------
    So in your little world, I, having worked in Uk for the last 24 years, paying substantial direct and indirect taxes would not be allowed free use of the NHS because I am not a British citizen.

    Where do I go to get my tax refund?

    BTW I have never had recourse to use said service and pay for private dental care as the UK is world famous for it poor dental service. I actually make sure that my dentist is one that has not trained in the UK.

  • Comment number 79.

    It is quite clear to see where spending priorities should lie, having regard to the dreadful mess the Labour government left this country in.

    Only those who are genuinely ill should be admitted to hospital, the only exceptions being self-inflicted illnesses such as alcoholizm and cancer contracted through years of self-abuse. No public money should be frittered away on those types.

    So far as Accident and Emergency Departments are concerned, everyone with minor complaints should be refused treatment, turned away and referred to their local surgery or pharmacist. I have heard of a number of cases of very minor injury, such as a cut finger, being dealt with by professional hospital nurses who should be spending their time caring for the more deserving instead. Quite why some half-wits think they merit special attention and free plasters or painkillers defies logic, but I suppose they think they fall among the "vulnerable" and "disadvantaged" categories I hear about every time I listen to news broadcasts.

    Paramedics should be instructed to ignore the drunks reported lying in the streets, and to refrain altogether from involving themselves in any incident that places them at risk of injury. If some yob gets hurt in a fight, that's his problem; leave him where he is. He might think twice the next time.

    Local surgeries must take on the minor operations - after all, it was what the doctors have been trained to do, instead of dispensing bits of paper with the help of medical websites. When I was a lad, I saw my doctor about a cyst on my forearm - he carried out a minor operation there and then. No waiting, no hospital appointment, no overnight stay.

    The NHS needs a complete overhaul. For too long, it has gone from day to day with no real concept of budgeting, and has steadily assumed responsibility for trivial illnessess and injuries that should have been dealt with by the patient's own doctor. This must stop.

  • Comment number 80.

    8. At 09:21am on 15 Dec 2010, tony wrote:
    "The idea of GP's in charge is very very scary."

    Indeed. Why do governments always look to the least trained of all doctors for advice?

  • Comment number 81.

    I used to work for the NHS and the waste is horrendous as is the over staffing. My mates mum worked in medical records. She worked part time with one other full timeer. The full timer left, my mates mum went to college part time for three months and was made director of medical records with a staff of 10 in a new custom built office. She had nothing to do all day and left out of boredom.

    Also, We had so many people who openly admitted faking occupational injuries to boost their pay. I am not talking about the odd bad egg, I am talking 20% of the department I worked in.

    So there is room for improvement and savings yes. The only issue is if the NHS is prepared to go along with this change or will the unions get their brazer out and start their scaremongering? The union officals in the hospital I worked in were like an organised crime syndicate. They all tucked each other up for the best shifts, best wards, best hours and didn't give a damn about the drones that paid them. Our department left en masse after they blatantly fixed a ballot. They really won't want their fiefdoms being trespassed on.

  • Comment number 82.

    Locally, SSO-SOA makes little difference, but at regional and national level it depends whether LUNs are ironclad or globull, probably not any fault of the patient…

    Perhaps our professional concerns are much higher now and conditions, that means symptoms, worse.

    A kick in the shins for organ donors

  • Comment number 83.

    The problem is that the NHS is there now and there is no way this juggernaut of wasted money can be stopped.
    The NHS is the biggest single business in Europe, is the ninth biggest in the world, is the single biggest employer in Europe, and is wasting money faster than it can get it in.
    The best cut to save money in the NHS would be for every members pension to be paid at market rate. Thus pensions would be scaled to the CPI of the year the person retires, and index linking would be applied the same way. This would save an inordinate amount of money on senior executives retirment packages which at the moment are on a selective basis with many judged at double/triple market value.

  • Comment number 84.

    Isn't this just regional news? Why does it have a banner?

  • Comment number 85.

    74. At 10:40am on 15 Dec 2010, Tio Terry wrote:
    51. At 10:07am on 15 Dec 2010, scotty1694 wrote:

    Interesting.

    In some of the numerous, previous, HYS's revolving around the NHS there have been frequent cries of "too many Managers", "it's a top heavy Management", "get rid of the pen pushers" and many more similar comments. Now we have a government that appears to have listened to what has been said and are now actually doing something about it we get the opposite complaints!

    It's a no win situation, damned if they do change, damned if they don't.

    This country cannot afford the NHS we have. Change is a must, throwing money at the NHS will only ensure there is more waste. The challenge is to provide better care for a lower cost and thats what the NHS must raise it's game to achieve.
    ---------
    if i got a tax break to justify the cuts( if there spending less why charde the same) also known as a rip off or con then most wouldnt complain but now there spendin less degrading quality for the same price as before.

    --------------------------------------------------------------
    You seem to be ignoring the fact that the government has a massive bill to pay in the form of a very large budget deficit. Thats why you cant have a tax rebate, it's being used to pay past debts.
    complain about this comment
    -------
    oh that ok then take all my money then!

  • Comment number 86.

    I really wish people would stop shreiking "Privatisation!"

    This isn't about privatisation it's about making efficiency savings and cutting out waste. The NHS is being asked to make savings of 4% a year - if it was a private business in the current financial climate it would be making savings of a hell of a lot more than that!

    I used to work for the NHS; it's over-bloated, over-staffed, wasteful and inefficient. It's a money pit - for as long as successive Governments keep throwing money at it, the NHS will continue to waste it.

    I can say that this restructuring is long overdue and I hope it goes a lot further over the coming years.

  • Comment number 87.

    Yes reforms are necessary - whether these will do the trick is another question. Inefficiency is rife in the NHS with the excuse always being the patient comes first. I do not disagree with this - its just that I believe it is used too many times as a cop out when big decisions need to be made. The biggest problem is that it is a victim of its own success and, to be honest, a money pit as no matter how much it is given it will always want more and, in the present climate, the only way to release funds is to become more efficient. I know most people hold the NHS near to their heart (I do!) but I firmly believe the funding of the NHS is something we will have to face one day I'm afraid. I can certainly see a day where it clearly states what it will and will not treat........ :-(

  • Comment number 88.

    the nhs is a right and always will be a right as long as your charged for it without a choice. until then the goverment should increase efficiency thats it.

    and were was this public consultaion i never heard of it im sure many didnt

  • Comment number 89.

    53. At 10:08am on 15 Dec 2010, Aneeta Trikk wrote:

    #34 Roger Grant says “Actually the reality is we are heading in the opposite direction”

    Ah, So it would seem unemployed doctors will be performing the operations as part of their community service. Interesting!!!

    Nothing like helping to keep your hand in is there?

    -----------------------------------------------

    You conveniently forget to include my link but there is nothing like trying to cover up the truth to fit in with a political agenda. Here it is again:

    http://www.healthcarerepublic.co.uk/News/article/1040634/bma-scotland-warns-generation-unemployed-doctors/


    Your original statement was that we were short or were going to be short of doctors. The reality is we currently have unemployed doctors and in the future the BMA is warning we may have more.

    Soundbites about unemployed doctors performing operations as part of their community service don't alter facts.

  • Comment number 90.

    this government and every other government to follow should leave the NHS alone
    if this government wants to lose my support then messing with the NHS is the way to lose it.
    the NHS above all else should be protected and more money not less paid into it.

  • Comment number 91.

    Plans to overhaul the NHS are most definatly needed. After Labour have made it a mess, hopefully this government can sort it out. I also hope that health tourism is stopped.
    Not sure if docking hospitals funding if they refuse mixed sex wards is the best way to go about things though.

  • Comment number 92.

    38. At 09:57am on 15 Dec 2010, ady wrote:
    Are plans to overhaul the NHS necessary?

    It is if we are to have a USA style 3rd world healthcare system, which is the ultimate aim of the Tory party.
    -------------------------------------------------------------

    And you have facts to back that up do you? All these claims that the Tories are out to completely dismantle the NHS and yet not one shred of solid evidence to prove it is so...

    Like many, I don't trust the Tories, I trust Labour even less, but i am sick to the back teeth here of people making such wild claims with not a shred of evidence to back up their claim.

    Its not that you might be wrong, but without evidence to prove your point, you are just another in a long, long line throwing conspiracy theories about and causing more crap to clog the gears.



  • Comment number 93.

    "Are plans to overhaul the NHS necessary?" - HYS:

    ALL successful Industries have to constantly investigate their methods of operation - if they hope to REMAIN successful - and the NHS can be no different.
    Unfortunately, most of us are aware just HOW wasteful NuLabour have been
    in their constant setting-up of Quango's etc. I have NO doubt that the re-structuring of certain areas of the NHS - is a must.

    IN MY EXPERIENCE:
    The truth is, most of those who work in the NHS are aware of areas that NEED trimming or even improvement. There are MANY members of the NHS who virtually work flat-out on a daily basis - such as MOST Nurses and other direct-patient-contact personnel. Unfortunately, there are also MANY other personnel / departments that do NOT.

    It is in the interests of ALL NHS staff and their Patients - for more effective methods of working to be considered.
    Along with investigating the 'systems', Staff-effectiveness also needs to be looked at - how many negligence / incompetence claims (many of them FATAL) have been made against Health Trusts in recent years? - TOO many.
    Obviously, high-level Pay-rates, Bonuses and Perks among Managerial Staff ALSO need re-considering - we are ALL affected in this Recession...

  • Comment number 94.

    78. At 10:43am on 15 Dec 2010, PompeyOops wrote:
    35. At 09:54am on 15 Dec 2010, Alan Baker wrote:
    It probably does need restructuring but it would also help if we did not have so many health tourists and bogus asylum seekers using the service, this includes other EU member states.

    In fact I would suggest that the law needs changing so that anyone that is not a British citizen should have to pay the full amount for any medical treatment they need while they are temporarily in the UK.

    The NHS is paid for by UK tax payers only and should be restricted to the treatment of UK citizens only and no one else.


    -------------------------------------
    So in your little world, I, having worked in Uk for the last 24 years, paying substantial direct and indirect taxes would not be allowed free use of the NHS because I am not a British citizen.

    Where do I go to get my tax refund?

    BTW I have never had recourse to use said service and pay for private dental care as the UK is world famous for it poor dental service. I actually make sure that my dentist is one that has not trained in the UK.
    -------
    begs the question why come here? if you never use the nhs and know the dental care is crap why else did you come? considering the nhs is considerd one of the main reasons immigrants come here

  • Comment number 95.

    • 78. At 10:43am on 15 Dec 2010, PompeyOops wrote:
    35. At 09:54am on 15 Dec 2010, Alan Baker wrote:
    It probably does need restructuring but it would also help if we did not have so many health tourists and bogus asylum seekers using the service, this includes other EU member states.

    In fact I would suggest that the law needs changing so that anyone that is not a British citizen should have to pay the full amount for any medical treatment they need while they are temporarily in the UK.

    The NHS is paid for by UK tax payers only and should be restricted to the treatment of UK citizens only and no one else.


    -------------------------------------
    So in your little world, I, having worked in Uk for the last 24 years, paying substantial direct and indirect taxes would not be allowed free use of the NHS because I am not a British citizen.

    Where do I go to get my tax refund?

    BTW I have never had recourse to use said service and pay for private dental care as the UK is world famous for it poor dental service. I actually make sure that my dentist is one that has not trained in the UK.

    Pompeyops, You are of course right and maybe I should have put that a little better and said that people should not be entitled to treatment unless they have paid taxes in this country for a certain amount of years, however having said that I find your attitude rude and arrogant, you could have made your quite valid point without trying to put a “little Englander tag on me”.

    But I am still correct that the vast amounts of foreigners (including those from the EU) who use the NHS do not pay taxes in this country and are merely health tourists and bogus students and bogus asylum seekers, and by the way if you feel that strongly about dentists and other services in the UK why are you living here?.

  • Comment number 96.

    I think the NHS has been top heavy with managers. It was that wretched Maggie Thatcher (the one who really kicked this country onto a downhill path that it's still hurtling along - even faster now we have this shower in power) who insisted on 'internal markets' which was a recipe for having far more 'managers' and bookkeepers pretending they were saving their dept loads of money when it was all the same pot in the first place.

    However, the new format is just as ideologically motivated and impractical as what it is replacing. Giving public health responsibility to local authorities who haven't a clue what they will be doing is a nonsense and a recipe for ensuring that important things don't happen. (Well that may save money, I suppose, except that LAs will have been grossly underfunded in the first place). And has anyone met a GP that actually wants commissioning responsibility? Of course not. It's not what people become doctors to do and it demands skills and expertise they have not routinely got. Plus more specialist services like forensic CAMHS, that currently are commissioned at regional level, are going to fall through the cracks because at local level they are too small to bother with.

    Yet more vandalism of our public services.

    Let's hope the coalition collapses VERY soon so that we can vote them all out.

  • Comment number 97.

    A quick question for those who like to go on about the NHS being the best in the world: if that is the case then why does the World Health Organisation rank the United Kingdom's health service as 18th in the world ?

    The World Health Organisation's ranking of the world's health systems.

    1 - France
    2 - Italy
    3 - San Marino
    4 - Andorra
    5 - Malta
    6 - Singapore
    7 - Spain
    8 - Oman
    9 - Austria
    10 - Japan
    11 - Norway
    12 - Portugal
    13 - Monaco
    14 - Greece
    15 - Iceland
    16 - Luxembourg
    17 - Netherlands
    18 - United Kingdom
    19 - Ireland
    20 - Switzerland

    Source: http://www.photius.com/rankings/healthranks.html

    Personally I'd like to see how they do things in the 17 countries that are above us in this list in the hope that we could emulate their success and improve our health system.

    The NHS was a great idea but it has become a bottomless pit of waste and excess, as is the case with every national monopoly and the time has now come for the entire system to be reformed. I'm now edging towards supporting a system of privatised health care providers while continuing with a system of national insurance so that we can retain the single payer, free at the point of delivery health service that provides for everyone, regardless of wealth.

    The real fear for me is that the insurance system will be privatised which will then result in a significant percentage of people being left without appropriate health insurance whereas the privatisation of service delivery seems to be a perfectly acceptable system - it certainly works in several other countries and it works much better than our current system, as can be seen by the WHO health rankings above.

  • Comment number 98.

    are you having problems with the site.help!

  • Comment number 99.

    GP's should treat patients without a financial motive! I am interested to see if GP's salaries increase because of the changes for what I see is an overpaid profession at the moment.

  • Comment number 100.

    We need to weed out the excess of administrators we acquired over the past 13 years. Absolutely necessary.

 

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