Jeremy Hunt, George Osborne, and the OTHER NHS shambles this week
“On 29 October, Jeremy Hunt’s department published a ‘consultation’ on what the government will tell the NHS to do for the next five years (the NHS ‘mandate’), and whether it can do it with the money George Osborne is likely to fork out.
And then… he didn’t breathe a word about it in parliament.
His department didn’t press release it. It doesn’t appear on their list of consultations online.
He didn’t say a word about the consultation in a major speech the day after it was released, even though this speech was all about an “inescapable, irreversible shift to patient power”.
Hardly anyone knew anything about it until last week – and it closes this coming Monday (23rd).”
https://opendemocracy.net/ournhs/caroline-molloy/jeremy-hunt-george-osborne-and-other-nhs-shambles-this-week
People who found out about NHS debate with days to spare blocked by government e-mail gaffe
“A row emerged today after critics claimed a consultation on the NHS Mandate – which helps set the health service’s direction and budget – had been swept quietly under the rug.” http://www.mirror.co.uk/news/uk-news/government-blocks-e-mails-people-6866634
This is the consultation the NHA Party informed us of recently. A post at GW drew attention to it a while back. It seems to have been fairly secretive up until about Friday. Over the weekend it seems that activists have suddenly caught on in such large numbers that the replies have now crashed the department of health’s mailbox. They didn’t expect many replies obviously. Now 38 Degrees is chasing it.
This is the MANDATE document and deadline for replies is 23 November 2015.
Advice from NHA Party about how to answer the questions.
Question 1: Do you agree with our aims for the mandate to NHS England?
- I don’t agree with the commissioner/provider model, the marketisation of the NHS.
- I think that it was wrong to remove the duty to provide a comprehensive, universal, health system from the Secretary of State for Health. I object in principle to the existence of NHS England as an ‘arm’s length’ body, and to competitive tendering.
- I absolutely do not endorse NHS England’s Five Year Forward View which appears to use the USA model of health provision as its blueprint.
2. Is there anything else we should be considering in producing the mandate to NHS England?
- The NHS used to base its strategy on the evidence of epidemiological data but now seems to base it purely on cost and ‘feedback from friends and family’: you need to get back to evidence-based strategies. The NHS is not selling commercial services, but caring for the health of the nation.
- ‘Yearly deliverables and metrics’: what is that supposed to mean, other than more admin and boxes to check? I want to see more investment in training clinicians, less in running a market with all its attendant overheads.
- Where does it say that your core aim is to provide a comprehensive, universal, accessible, high quality service, according to clinical need not ability to pay?
- Transparency between the NHS and the public is mentioned, but not evidenced in the way the mandate itself was distributed and publicised.
- Use plain English with clear and understandable terms and objectives at all stages of consultation.
3. What views do you have on our overarching objective of improving outcomes and reducing health inequalities, including by using new measures of comparative quality for local CCG populations to complement the national outcomes measures in the NHS Outcomes Framework?
- A good healthcare system should have objectives to improve outcomes and reduce health inequalities but the mandate is more concerned with scorecards than practical proposals.
- Reduced budgets in education, public health, social care and the NHS itself will not lead to service enhancements. In real life the NHS is struggling with basic provision in many areas. A mandate which is disconnected from reality is pointless.
- I do not wish to spend my time checking league tables of health services and hospitals, checking to see if my local area is better or worse than another.
- How onerous are the requirements of medical professionals to fill in questionnaires or report? What difference does it make?
4. What views do you have on our priorities for the health and care system?
- I think that the reduction in the budgets for social care (overall 25% cuts to local authorities, with disparities between them such as will lead to greater inequalities of health) and public health (£200 million budget cut) indicate that your priority is saving money, not prioritising care. It seems likely to me that combining the health and social care budgets is likely to bring in back-door charges for NHS services which were previously free to access.
- In times of budget restrictions taking more money out of the front line hospitals budget for the Better Care Fund, which appears to be about planning and management consultants, not about actual care, is incomprehensible.
- To focus on mental health provision when mental health services are being run down, underfunded at an even worse level than physical health, and their facilities closed, adds insult to injury. It should indeed be a real priority. As it stands that means increased funding. Reducing the use of management consultants and getting rid of the market should free up funds.
- Your obsession with a vision of a ‘seven day service working for everyone’ ignores reality: we already have a 7 day service in as much as access to GP provision and emergency care in hospitals is available at all times.
- It should be a priority in every mandate to ensure we have sufficient, fully trained professional clinicians.
- I don’t agree with moving to a ‘person-centred’ NHS in the way you use the term: it requires more administration and will be more likely to lead to fragmentation of services, except that it will of course make it easier to work out health insurance premiums.
- The statement that a strong NHS depends on a strong economy is nonsense. It is the other way round. Every penny invested in health repays society with better quality of life for all.
- Don’t set objectives for NHS England. Return the NHS to public ownership and get on with achieving those objectives yourselves.
- Stop the progress of the Cities and Local Government Bill before we lose our NATIONAL Health Service to even more fragmented and variable local service.
Advice from 38 Degrees
[1] The “NHS Mandate” was first reported by OpenDemocracy, and then by the Guardian newspaper
Open Democracy: Don’t want the government to let the NHS die? Here’s one crucial thing you can do right now:
https://opendemocracy.net/ournhs/caroline-molloy/dont-want-government-to-let-nhs-die-one-crucial-thing-you-can-do-now
[2]The Guardian: You’ve been asked to have your say on the NHS. You just don’t know about it
http://www.theguardian.com/commentisfree/2015/nov/19/nhs-mandate-england-consulation-deadline
[3] In a phone conversation with a 38 Degrees staff member, a Dept of Health official guaranteed that messages from 38 Degrees members would be accepted “until close of business on Tuesday”.
[4] See for example: BBC: NHS pressure worsens as key targets missed:
http://www.bbc.co.uk/news/health-34790100
[5] Government website: Open Consultation: Setting the mandate to NHS England for 2016 to 2017:
https://www.gov.uk/government/consultations/setting-the-mandate-to-nhs-england-for-2016-to-2017
[6] Open Democracy: It may not look like it, but Jeremy Hunt DOES have a plan for the NHS:
https://www.opendemocracy.net/ournhs/caroline-molloy/it-may-not-look-like-it-but-jeremy-hunt-does-have-plan-for-nhs-0
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