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The New NHS?

tinto
Grafter
Posts: 262
Registered: 21-11-2010

The New NHS?

I watched an item on BBC News earlier this evening which came as a bit of a shock.
A practice  somewhere in Yorkshire alleges the local health trust has stopped financing certain minor procedures and is offering its clients the opportunity to have them carried out in selected private clinics. Prices shown varied between £50 and £250 and one of the touted selected clinics is coincidentally, (aye right) owned by the practice. The item included an interview with a patient who had been taken advantage of taken advantage of the service, and seemed to think it was acceptable
The health trust denies the allegation, but Yorkshire folk have a reputation as hard headed and it's unbelievable that  patients should meekly accept such a situation.
13 REPLIES
Community Veteran
Posts: 18,545
Thanks: 191
Registered: 12-08-2007

Re: The New NHS?

Certain procedures at both primary and secondary care level have been blocked for some time.  As I am away from home at present I cannot put my hands on the list of procedures but they include many cosmetic procedures as well as other ones that are deemed to be of little benefit to patients.
Here is a general guide from one of the Essex areas. 
Restrictions
tinto
Grafter
Posts: 262
Registered: 21-11-2010

Re: The New NHS?

@ Artmo
Your link to the Essex health trusts makes  sobering reading; you have to ask though, why did they wait until they were  £35 million in debt before they decided to take action?  Don't they have auditors? What proportion of their annual income does this debt represent?.
I can't comment on factors such as population density, demand on medical services, etc., and I can just about accept  some of the things they're cutting out or cutting back, but from my own experience, others seem to me to be false economies, for instance, cutting back on knee and hip replacements.  My wife suffers from arthritis, has had both hips and a knee replaced, with the  remaining knee likely to  need replacing fairly soon, but the joint replacements have meant that she can still enjoy some hillwalking with me and gives her a better, fairly painfree quality of life, which we're sure sure makes a huge contribution to her otherwise general good health. (we're both in our seventies)

The same can be said of other relatively inexpensive treatments where they are making economies: nagging, so called trivial things like a hernia or gallstones, or even ear wax are debilitating, and can discourage people from participating in social activities which might otherwise help maintain their wellbeing and keep them away from doctors or hospitals.
For what it's worth, I visited the Scottish Government website to check our NHS financial status.
In brief for financial year 2009/10, the latest figures available, their allocated budget was £10,387 million and their expenditure was £10,345 million, an underspend for that year of £42 million. The capital expenditure budget was £497 million, ie new hospital building etc., with an underspend on this item of £1 million.  Without wishing to reignite the fairly recent debate on prescription charges, I extracted this paragraph below, from the Chief Executive's Annual Report, so that any interested parties could make their own comparisons.
REVENUE EXPENDITURE
NHSScotland's revenue expenditure of £10,345 million in 2009/10 represented almost £2,000 for every person living in Scotland. Around 52 per cent of this funds staff costs for NHSScotland employees. A further 11 per cent goes on prescription drugs; 11 per cent on general medical, dental and ophthalmic services; with the remaining 26 per cent funding buildings and associated running costs, equipment, supplies and services.

the full report can be found here http://www.scotland.gov.uk/Publications/2010/11/09154028/7
pierre_pierre
Grafter
Posts: 19,757
Registered: 30-07-2007

Re: The New NHS?

the South Essex situation has turned up on the BBC  News with a slightly different slant to it
http://www.bbc.co.uk/news/uk-england-essex-15184912
Quote
NHS chiefs in south Essex have outlined how they intend to make savings of about £300m over the next four years.
Efficiency savings have been agreed by two primary care trusts as well as hospitals and GPs covering Southend, Basildon, Thurrock and Castle Point.
Plans include treating more patients away from hospitals, allowing fewer referrals and cutting management costs.
Chiefs said job cuts in front line services would be minimal and come through "natural turnover".
Hospital admissions would also be cut, community services strengthened and more people treated at home.
pierre_pierre
Grafter
Posts: 19,757
Registered: 30-07-2007

Re: The New NHS?

NHS  Con/Dem ed?
http://www.bbc.co.uk/news/uk-politics-11583648
Quote
20 October 2010 Last updated at 13:56 Help
The Chancellor George Osborne has confirmed that health spending is going to be protected from spending review cuts.
During the announcement he told MPs that his government had chosen to protect the National Health Service and that savings will be made in other ways.
He said "By 2014 we are aiming to save up to £20 billion a year by demanding better value for money."
Community Veteran
Posts: 18,545
Thanks: 191
Registered: 12-08-2007

Re: The New NHS?

@ Tinto, posted the Mid Essex info just to give you a guide to the procedures that are being restricted.  I will post fully details when  I can access my papers which are at home. 
You mention hip and knee replacements.  These are not being stopped but it has been found that many patients were having these operations without really needing them  There is now a clear check list to determine if a replacement is needed or if it can be postponed.  Level of mobility is obviously one criteria to be taken into consideration.
pierre_pierre
Grafter
Posts: 19,757
Registered: 30-07-2007

Re: The New NHS?

Party my fault in telling the truth, but I had a hip operation that was delayed by the hospital for four years from when I was first sent to the orthopedic specialist..
Four weeks after I eventually had the operation, (Just after we had new double glazing and double lock doors) SWMBO had gone to the Gym early morning and left me in an arm chair.  My hip dislocated, luckily I could reach the phone, couldnt phone the gym as no staff on to answer phone, Contacted Police, could they go to gym and get the wife to come home.  They in their wisdom called out tthe Ambulance, who got to my house before the wife.  They could not get in and were doing their nut.
Got taken to the hospital, it popped in as I was getting in the ambulance, had X Ray and sent home.  Inquest next what the hell had I been doing, nothing.
12 hours later in same chair, wife on phone, but looking at me and it popped out again- she then believed me that I had not done anything.  This time it did a real job, X Ray showed it out by 6 inches, tooke three people to pull it back.
Next time I saw the surgeon who did the op was not amused said it was probably as I had been left to long before the op
Net result, I have permantly damaged Ham String and Quad muscles and a Blue Badge to get me free parking on double yellow lines
Community Veteran
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Registered: 23-09-2010

Re: The New NHS?

Efficiency in hospitals as politicians see it doesn't work. Here in my home town we used to have a separate eye hospital, children's hospital, and a general hospital. Used them all personally and had nothing but praise for them. All were easy to park nearby at no charge. Nothing remains of the first two as blocks of flats now occupy their original space.
All we have is one big hospital with all the extra bits stuck on. More like a big factory. And just like in a big factory some of the staff walk around all day with a clipboard in their hands doing little else.
The last time my dear old Mum was in there they failed to regularly put her eye drops in or even feed her properly. I ended up feeding a couple of other older patients as their food just got cold on the ends of their beds. She actually needed time to recover from just being in hospital.
So if this is all the NHS, as it stands, currently have to offer then maybe the billions might be better spent somewhere else to get a higher standard of care and better value for our hard earned taxes.
Community Veteran
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Registered: 01-08-2007

Re: The New NHS?

Nothing would surprise me. I lived in pain for 4.5 years after being told by my Doctor to live with it. Life was an absoiute misery and it caused other physical health problems too.
Eventually I went back and demanded they do something. Several referrals, scans and appointments later they finally decided to operate and put me right. No pain since.
When they first denied me any treatment they said there was nothing they could do. A subsequent FOI request after my op revealed the procedure had been available since 1981. What makes it worse is the op was only about 40 minutes with a local anaesthetic (yes i was awake and watching a stent wriggling inside me on an x-ray screen) and i was on my way home 3 hours later. Thats was it. 4.5 years of severe pain and misery to save them a few hours - hardly seems fair does it  Cry
I need a new signature... i'm bored of the old one!
Community Veteran
Posts: 18,545
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Registered: 12-08-2007

Re: The New NHS?

The list of procedures on the restricted list has been drawn up by clinicians and not admin personnel. Some procedures are no longer available whilst others are graded to decide if a patient needs to be treated and how quickly.  A GP can override the criteria if he feels it is in the patients interests.
Community Veteran
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Registered: 21-03-2011

Re: The New NHS?

#Artmo, I beg to differ. In the case of my daughter her GP was recommending surgical treatment of a life threatening condition, but the local administrators turned down the application twice. That cost us over £8,000 from our retirement savings. to get the treatment, money we could ill afford to release. We've since discovered patients in neighbouring Primary Care Trusts did not have the same rationing of treatment.
Now Zen, but a +Net residue.
Community Veteran
Posts: 18,545
Thanks: 191
Registered: 12-08-2007

Re: The New NHS?

@AlaricAdair, this is possible. At present PCTs can make different rules and this is different to the list of restrictions I referred to.  There is an appeals procedure.  Did you use it? It may not be too late to do so.
tinto
Grafter
Posts: 262
Registered: 21-11-2010

Re: The New NHS?

Quote from: artmo
@ Tinto,
You mention hip and knee replacements.  These are not being stopped but it has been found that many patients were having these operations without really needing them  

My reading of the Essex Link was that hip and Knee replacements were to be restricted not cut, and I can't imagine anyone undergoing what is quite radical surgery unless they really needed it. Restricting such surgery is a false economy.
I can only speak from personal experience, and I still maintain that the improvement in quality of life for my missus after three replacements has proved to be value for money.  Without these operations she would now be immobilised, so she'd require full time care, possibly residential because by now I might not be able to care for her, we all know cases where older people's health has failed whist trying to care for others.  
Community Veteran
Posts: 18,545
Thanks: 191
Registered: 12-08-2007

Re: The New NHS?

This is a judgment call by the surgeons.  Take hip or knee replacement.  In recent years the number of ops have gone up.  It has been the case where patients get a replacement that allows them to get back to sports for example.  The new criteria would not allow this until the patient finds walking difficult and is suffering a level of pain that can't be controlled with painkillers etc.  Other factors that would be considered are living conditions, home assistance etc.
@tinto, I am not saying I agree with all the restrictions.  I am simply reporting the situation as it is.  Some restrictions, however, make sense such a fertility treatment and cosmetic treatment to name just two.