Comments on: The NHS “constitution” – a charter for spin doctors, lawyers and management consultants.

By: pp

pp — Mon, 16 Feb 2009 11:16:56 +0000

As the benefit of whole constitution project is based on driving up NHS quality by making it easier for the public to complain, and the fact that the national audit office have previously reported that complaints do not improve NHS standards. The whole thing appears to have demonstably been a waste of money before it was even singed off.

I have written asking the department for more info on this:-

http://www.whatdotheyknow.com/request/nhs_constitution_projected_benef

They are going to be out of office soon – I hope these stupid projects will be reviewed and dropped as soon as possbile after the new government taking over.

By: GH

GH — Sun, 25 Jan 2009 08:48:21 +0000

The DoH has also been caught out trying to weaken medical confdentiality, again. From the BMJ:

Organisations that are charged with safeguarding patient confidentiality had objected strongly to a section in the draft handbook that said, “Patients can . . . expect that a health professional or a research professional who owes the same duty of confidentiality as a health professional may use care records, in confidence, to identify whether they are suitable to participate in approved clinical trials.

“Appropriate patients will be notified of opportunities to join in, and will be free to choose whether they wish to do so, after a full explanation.”

The organisations that expressed reservations included the UK Council for Caldicott Guardians (UKCCG), the Patient Information Advisory Group, and the new National Information Governance Board, which came into operation this month. The UKCCG, whose members are responsible for safeguarding patient confidentiality in the NHS, called for the statement to be removed from the constitution pending “much deeper discussion and legal consideration.”

By: bill

bill — Sat, 24 Jan 2009 15:02:56 +0000

The Conservatives are partly to blame. They have never dared to attack the NHS. They have never pointed out the obvious truth that it was a flawed attempt to manage the mass health service which had emerged from the ability to mass produce safe and effective drugs. Year after year labour has been able to make political capital out it . There has never been any valid reason for the conservatives to continue to acquiesce in this myth.

By: A Griffin

A Griffin — Fri, 23 Jan 2009 14:45:24 +0000

The solution to the problems of health care. is not more competition between all hospitals, which would be very wasteful of resources, but better competance. Using competition as a reward system, would result in the better services being monopolised by the middle classes, who are very good at hunting out anything to their advantage, to the detriment of the weak (just look at the schools!) More competition would provide a business solution, but would require extra top-up funding by society (if choice is to be real and not just a lie), and therefore would result in the loss of ‘free’ care for all, which could no longer be afforded. It would just cost too much public money to make it work and would be unfair.That’s why the general public are so wary of it. Private companies can also hide all sorts of nasties, just look at some of our banks! I have personally seen filthy toilets in private hospitals as well as N.H.S. ones. Private medicine is not better than the N.H.S., they both have their faults as well as their advantages and there are good and bad providers in both. We all rely on the N.H.S. when we have a medical emergency however rich we are. We need it to be there, and we need it to be a quality service. Money used as a main motivator in health care delivery, contaminates the relationship between doctor and patient (just look at the States) and ultimately that with society as a whole. Equally medical care driven by patient wants rather than patient needs will guide the providers in the wrong direction. and be just as demoralizing. Competition will probably drive services into the private sector, which may be the cheapest, but not necessarily the best. The other side of the patient treatment experience is determined by the quality of the medical (in its broadest form) staff. Let these staff be responsible for determining the way treatment is delivered with rewards for successful innovation and let them be accountable to the patients for best outcome and to the government for best value. The downside to all this is that there will be a limit to public resources.The goverment needs to be open about rationing of health care and clearly state what can and what cannot be afforded and yes, if funds are inadequate, those that can pay towards their care should be asked to do so (many will be happy to do so for a good service that is fair if they have access to insurance for it). I believe that a system like this ,within the N.H.S.,will empower and reward (yes financially as well) the most competent staff, and ultimately give best value to taxpayers. Most health care professionals have a true vocation to do their best for their patients and it is this which needs to be allowed to blossom. If they are required to work in a deadening environment where they have no say and only the cost or targets matter, is it any wonder that their patients complain, or that they just decide to go through the motions for the pay cheque?

By: A Griffin

A Griffin — Fri, 23 Jan 2009 11:00:01 +0000

I accept that there are many brilliant female doctors (I was one!),however what I was trying to allude to by stating that the medical undergraduate couse has been ‘feminized’ was the simple fact that it no longer appeals to the best male A level students. I believe that this is because much of the core science has been removed and replaced by light weight politically inspired content. This lowering of standards for both sexes will eventually lead to more compliant, less questioning and lower value medical staff. They will just be workers in a medical treatment factory.

Reply: Thanks for the clarification. You make a very interesting point

By: THE ESSEX BOYS

THE ESSEX BOYS — Thu, 22 Jan 2009 22:01:27 +0000

Sarah – I think most folk accept that it’s the interfering bureaucrats and meddlers and not the professionals who are to blame. Did you see Gerry Robinson’s review?

And as for Postman Pat we also regularly ask why a bunch of former trade union officials, polytechnic lecturers and back office political workers should suddenly be endowed with the skill to understand and manage the complexities of a government department employing thousands of staff and spending billions of (our)pounds!

Yes, we do think AL can only be better and so can the shadow cabinet so, irrespective of the odd niggling doubt, let’s both keep up the pressure shall we? Best wishes

By: THE ESSEX BOYS

THE ESSEX BOYS — Thu, 22 Jan 2009 21:50:49 +0000

Oops – sorry Stuart. GOVERNMENT OF NONE OF THE TALENTS should have been refered to as GONOTTS which, come to think of isn’t such an inappropriate acronym!

We also rather like your GONADS, something this government clearly lacks!

By: steve harris

steve harris — Thu, 22 Jan 2009 20:54:27 +0000

This latest-of-many NHS constitutions differs not at all from vast numbers of similar documents written in that nauseatingly sub-standard form of English known as Managementspeak. Private companies, political parties, branches of all levels of the public services, the Boy Scouts, the Girl Guides and churches have been using it for many years. Such ‘constitutions’ are nothing but a thousand anile Mission Statements strung end to end. As Mission Statements always sound anodyne and fluffy, it’s extremely difficult to ridicule them without sounding like a reactionary curmudgeon. Calling it ‘vapid dross’ in fact flatters the drudges who employ it.

There must be a small army of scribes employed by the NHS and by the government in every other part of the public sector to compose this tripe. The amount of increasingly borrowed money consumed by their salaries must run to hundreds of millions or even billions of pounds.

By: adam

adam — Thu, 22 Jan 2009 17:11:31 +0000

Rights with responsibilities is a new federal citizenship idea, it comes from the European Union, Jack Straw among others has been promoting it.
It is very post industrial, post modern. Very Starship Troopers.
I think the idea is you need to earn your rights.

The New World Order is replacing the old 20th century idea of the public sector, the private and voluntary sectors are being used to fill the old role. Privatisation and PPP are coupled with an increase in corporate CSR, which leads to programmes like Orange Rock Corps, Npower climate cops, styled on global citizen corps, alongside an encouraged increase in charity and voluntary work. Many students in school are expected to chose either Combined Cadet Force, DofE or community service to complete, one can imagine how that will be linked with the new citizenship qualifications and pledge.
Obama is talking about similar ideas, increased sacrifice for the country, compulsory civilian security force for 18 to 25s.

By: A Griffin

A Griffin — Thu, 22 Jan 2009 16:46:14 +0000

The modern N.H.S. is run on business models with patient care episodes treated (ie. dealt with) and recorded. Hospital medical management has been fragmented by non-medical manager directed clinical systems that do not allow for continuity of care (speciallty wards removed, consultant team working replaced with medical shifts), added to by a dumbing down of medical training ( feminized and no longer based on science, which together with run-through training, now produces plenty of cheap but inferior”consultants.”) No one is in charge ( except the politicians), certainly not medical staff or managers,( who are just following orders.) When the present generation of senior docters retire in around 10 years time the system will explode due to it’s own lack of professionalism and some clever politician will probably blame it on the staff. Improvements in the N.H.S. have been largely due to advances in medical science, which has disguised the extent of loss of the plot at the frontline. Is the N.H.S. there to help people who are ill and what are their needs?, or is it some giant machine that everyone tinkers with, without knowing how it works? This new publication is just more glossy advertising by the government.

Reply: there are some very good female doctors – I don’t think the problem is “feminisation”