Posts Tagged ‘Waiting Times’
When I was referred for an MRI scan the two weeks wait was an anxious time. Even that seemed a cosiderable increase over the waiting times in force when I was chairing a NHS Foundation Trust hospital. I have since learned from Bill, a fellow chicken-keeper, that his brother who lives in Hastings has been waiting for six weeks. At first the news didn’t make sense because in my day (as fogies love to remark) we were summoned to London to explain even one target ‘breach’, and we used to travel in some trepidation. At that time, just a couple of years ago, every patient referred to us had to be in full treatment within 18 weeks, which meant that he or she had to be seen almost immediately after a GP referral was received and any required tests had to be dealt at once. Of course the tight timescale made life difficult for clinicians and managers alike, but at least all those suspected of having cancer were spared the stress of uncertainty and the clinical risks associated with delays.
It was only during the chat with Bill that I was reminded that Andrew Lansley’s first act on becoming health secretary was to abolish waiting lists. At the same time he imposed massive cuts to funding and it doesn’t surprise me one jot that hospital Trusts up and down the land found some of the savings by extending their waiting times. One of the first savings would be the amount of hours having to be worked on MRI scans.
Realising that Bill’s information could be dismissed as hearsay I did some checking of my own. Hastings, the home of his brother, had only 3 patients waiting in excess of the permitted waiting times in April 2010. In April 2011 it had 1255, an amazing increase of 41,733%. So Bill’s brother is just one of many worried sick about their referral. Checking the figures of other Trusts revealed a similar pattern. In Leeds for example, there were only 10 waiting at the end of 2010, the total for this year was 878. Lansley, take a bow!
Across the country the waiting times for cancer testing and treatment have at least trebled and the situation is worsening during the first months of this financial year. Amazingly all the focus on Lansley has centered o his bizarre plans for reform. Fortunately these seem to be heading for the scrapheap not least because Cameron has ruled that GP commissioning will only start when GPs are ready, at which point their commissioning body will include nurses, hospital doctors and patients. In other words Primary Care Trusts are being reinstated under a new name and costs of around £2billion have been incurred.
But all this is meaningless mumbo-jumbo with political point-scoring at the top of the agenda. The point is that massive damage has already been done and without question people who could have been saved will die as vital post-diagnoses weeks are lost.
This is too importat for childish arguments about the respective abilities of Labour and Conservatives. NHS people will tell you that they are both hopeless. Labour imposed 400 targets which was ludicrous, the Conservatives have scrapped the wrong ones which was equally ludicrous.
Our health is uniquely important and we should all worry that a blundering fool like Lansley is in charge. At the very least the minister should be a senior clinician with no political bias.
Unrealistic? If we settle for that we settle for disaster, we betray every individual whose life depends on a rapid response!
THOUGHTS FOR TODAY; FAMILY PLANNING; “Somewhere on this globe, every ten seconds, there is a woman giving birth to a child. She must be found and stopped”…..Sam Levenson ”Let me tell you a terrific story about oral contraception. I asked a girl to sleep with me and she said “No”……….Woody Allen “”I have 13 children. It’s not a burden. I love my husband” – “Lady, I love my cigar, but I take it out of my mouth once in a while”……Groucho Marx “I’m Catholic. When my mum found my diaphragm, I had to tell her it was a bathing cap for my cat”…….Lizz Winstead ”Condoms aren’t completely safe. A friend was wearing one and got hit by a bus”……..Rob Rubin “A friend of mine confused her Valium with her birth control pills. She had 14 kids but didn’t give a toss”……Joan Rivers “I practice birth control, which is being around my brother’s children”……Brett Butler
Another beautiful golden day! The optimists among the chicken-breeders are talking excitedly of a summer to beat them all. The rest of us remember similar delight at this time last year! But we live for the day and this one is brilliant in every sense of the word. However, at least one of our number is not entirely happy. He has been told by his GP that there are now restrictions on NHS orthopaedic referrals and his chance of a hip operation is now remote. I suppose we shouldn’t be surprised since the massive Lansley cuts are slowly but surely taking the NHS performance back many years.
In fact a survey of GPs published yesterday found that cuts are being made not only in areas deemed non-urgent. Over half of the 500 family doctors questioned said that waiting times had gone up for musculoskeletal work, and 42% reported a rise in waits for neurology treatment. Almost a third say that there are now delays in cardiology and one in ten say that waiting times for cancer treatments are rising quickly.
Interestingly the survey was carried out by Spire Healthcare, the second largest private hospital group in the country. And they are not in the least depressed by what their friend Mr Lansley is doing. Dr Jean-Jacques de Gorter, clinical director of Spire, said yesterday that the increased use of the private sector now being enjoyed is to be expected “as a result of health secretary Andrew Lansley’s measures and efficiency savings”. He reported that his group was already seeing waiting lists for elective admissions and diagnostics going up and patients are “likely to turn to the private sector”.
Spire claims from its survey that more patients are asking GPs about private treatment. It claims that a third of those surveyed plan to make more private referrals this year. Almost half (49%) are said to be asking their patients if they have private medical insurance.
The number of people with private insurance is actually flatlining or even dropping, as people are made redundant and lose the healthcare benefit that went with their job, but Dr De Gorter expects more to pay out of their own pockets as the NHS delays increase.
I honestly believe that, unless Lansley is stopped, the end of the NHS as we have known it is in sight. Private hospitals will lure top surgeons away from the NHS and will step up their GP-influencing campaigns. Of course this is one of the aims of the Conservative minister. Competition, he will argue, will lead to even better healthcare and higher standards. So far as the private sector is concerned that is correct but the massive flip side is that the NHS hospitals, starved of funding from basic work, will deteriorate and ultimately decline in numbers.
The end of the Lansley trail is plain to see. If you have expensive health insurance, or are relatively wealthy, you will notice little difference. If you don’t, you will probably die or at best suffer a lower quality of life.
If we regard that scenario as unduly pessimistic we will delude ourselves and betray generations to come!
THOUGHTS FOR TODAY; LUCK: “Everything went right for him until the day he was born”….Victor Borge “If it was raining soup, he’d be out with forks”…..Brendan Behan “Just my luck. I was at the airport when my ship came in” ………Henny Youngman “As one door closes another falls on top of you”…..Angus Deayton “It always looks darkest just before it gets totally black”…….Charlie Brown “Age does not diminish the extreme disappointment of having a scoop of ice cream fall from the cone”…..Jim Frieberg “What I’m looking for is a blessing that’s not in disguise”…..Kitty O’Neill Collins “I’m so unlucky that if I was to fall into a barrel of nipples I would come out sucking my thumb”……Freddie Starr
ANSWERS TO YESTERDAY’S QUIZ; 1. Shane Fenton 2. Gordon Sumner
TODAY’S QUESTIONS; 1. Where did troops fight for control of Islam’s holiest shrine? 2.Who went out to be Rhodesia’s last British governor?
The weathermen came under attack in Scotland yesterday but it has to be said that they got it right here. We had a respite yesterday from our now established thawing routine on the allotment but it was back to square one this morning. The surest way to kill poultry is to deprive them of water and we toiled for an hour using the age-old method of dropping ice-solid containers into a bucket of boiling water. It solved the chicken’s dilemma but did nothing for our blue digits. I should perhaps mention that Albert’s are black, the result of his once shaking hands with Lady Gaga and refusing to ever wash his mitts again. But the job is done and we are cheered by the forecast of above-freezing temperatures on Thursday. Everything is relative and after this ferret version of Ice Station Zebra, five degrees above will feel like the tropics.
One of our helpers this morning was retired GP Steven. Inevitably the topic as we thawed ourselves out in the shed was Andrew Lansley, the new disease afflicting the NHS as no other has ever managed to do. One of the first deeds of the new Health Secretary was to abolish waiting time targets. The view of Steven and his pals is that some targets were pointless and bureacratic but these were not amongst them. Demand huge efficiency cuts from hospitals and abolish their waiting time targets and guess what happens. Correct, the waiting times are already extending and thousands of patients are now facing the prospect of long waits to see a specialist. Things such as weekend ‘catch-up’ clinics have been dropped and the option of private treatment has crawled out from under the rock that was guaranteed waiting times. This is probably exactly what Lansley intended but what on earth is he trying to achieve with GP commissioning?
To Steven and several current GPs that I have spoken to ( as an ex PCT chairman I made many friends amongst the local GPs) the whole idea is a complete mystery. But today Lansley will announce the creation of the first 52 GP consortiums who will replace Primary Care Trusts and will assume control of commissioning. In other words they will decide how the £80 billion budget is to be allocated. According to the press releases millions of patients will take greater control of health care. How will they? In our patch none of the 130 GPs will be involved in the consortiums and no one seems to know who they will comprise. So how do their patients suddenly take control?
But the greatest mystery for all that Steven and I have spoken to is how the enormous unfairness of massive postcode medicne will be avoided. To an extent it has always been a bugbear but at least the Department of Health has co-ordinated the Primary Care Trusts. Left to their individual fancies the hundred or so eventual consortiums will opt for different priorities and the fate of some patients will vary accoridng to where they live. This cannot be right.
There is a suggestiuon that to avoid this, Lansley may impose a central body and encourage each consortium to recruit experts from the defunct Primary Care commissioners. But if he does that the poossibility of finishing back where he started is a real one.
The main medical authorities such as the BMA are refusing to have anything to do with the project which is therefore being driven by politicians supported by some GPs who prefer not to practice hands-on medicine plus a few who have an axe to grind. One suspects that the hidden agenda is to open the door to privatisation, something Patriciaa Hewitt played with with disastrous effects. But it won’t even achieve that. So far as anyone understands the revolutionary plan it will simply result in a giant mess and a situation similar to schools where people move home to be in a catchment area offering what they seek.
The NHS has made enormious progress over the past few decades but it had become choked with bureaucracy and red-tape. This needed treatment but what is happening is not treatment, it is slaughter. The one redemming feature is today claimed to be the transfer of power to patients. How will it do that? Greater minds than mine are completely bemused and simply cry it won’t!
I am rapidly coming to the view that the loner Lansley should carry a health warning on his rumpled coat!
WIKILEAK; WHAT IS REALLY GOING ON?
Various governments are now threatening all sorts of action against the whistleblowing website WikiLeaks and its founder, Julian Assange. It is inevitable that people around the world are wondering if the sudden appearance of charges of sexual assault on two women in Sweden is a co-incidence. Yesterday a district judge refused him bail
In truth we have no idea, but one thing is for sure. The Americans, who are the most strident in condemning the daily publication of embarrassing cables, are the people really responsible for this fiasco. A soldier was able to download thousnads of secret documents on to a Lady Gaga disc. Clearly the security in Washington is lax beyond belief. The people ultimately responsible are the American authorities.
The views of the website range from concern at the repression of information through to amazement that diplomats would be so stupid as to commit such nonsense to written form. And many abhor the activities of the website. But one common view prevails – the Americans should get their security act together!
ASHES; NOW COMES THE BACKLASH!
The Australian press is tearing Ricky Ponting to pieces in the aftermath of the thrashing by England. But it is hard to see what more he could have done with the bunch that he has, other than to score runs himself. Some Aussie papers are campaigning for the return of Shane Warne who still plays IPL cricket. That seems a retrograde step given that the wizard is 41. Certain it is that England would not be overjoyed since even at that age Warne is light years ahead of the present choices.
Looking back to my predictions I have to confess to gettimg most things wrong. My self understanding tells me that I should stick to the day job! I certainly didn’t expect to see Finn as the leading pace bowler with nine wickets after two Tests!
YESTERDAY’S QUIZ ANSWERS; 1 Argentina 2. Cyprus
TODAY’S QUESTIONS; 1. On which island did Noel Coward die? 2. Which was Roger Moore’s first Bond film?
Andy Burnham, the shadow health secretary, yesterday called on Lib Dem MPs to bring the coalition’s plans to reform the NHS to a halt. Of course we have to remember that he is campaigning for the Labour Leadership and was a member of the government that smothered the health service with layers of bureaucracy, but that doesn’t make him wrong on this issue.
He is right when he says that ” changes are being forced on the NHS with no consultation, no piloting and no evidence”. The failure to consult is leading the hapless Mr Lansley to the courts but the likelihood is that he will find weasel words sufficient to enable him to proceed with the rape of what is still the finest free-at-the-point-of-delivery service in the world. Amongst our allotment shed gang we have John, a retired GP, and he and I have a good deal of experience of life at the sharp end of the NHS. And we know what we are looking at here ; the privatisation of our health service.
The Lansley plan involves the abolition of waiting time targets and the introduction of GP-led consortia to take over the £80 billion commissioning responsibility from Primary Care Trusts. Many of John’s former colleagues assure him that there is no possibility of their taking on such a massive workload and the likelihood is that the task will be sub-contracted to American healthcare companies whose speciality is the provision of private medicine. Of course Lansley will rightly claim that those taking NHS treatment will still enjoy a free service. What he won’t be keen to explain are the implications of no waiting list rules combined with the option to ‘go private’. Remember that the surgeons and senior consultants that will provide such services are employed by the NHS. There will be nothing to stop them offering different waiting times according to the depth of a patient’s pockets!
Ironically it was Mr Burnham’s own Party that demonstrated the perils of introducing private healthcare providers into the NHS. Under the reign of the dreaded Patricia Hewitt – we endured endless Secretaries of State – the Labour government decided to trial the provision of a one-stop assessment and treatment centre using a South African company, Netcare. The trial was scheduled for Lancashire but local MPs and activists did their sums and quickly realised that if one took away the income from outpatients work, the hospital would be unable to fund the high-cost intensive medicine on which lives depend. In effect, take away the ‘easy’ routine income from a large hospital and the surplus it raises from that work is no longer available to subsidise the more complex work.
There was a massive public outcry and the government wisely decided to perform a U-turn of monumental proportions. Now the Chorley Hospital has the first NHS run centre. But U-turns are less likely under a Conservative government which, to be fair, makes no secret of its preference for private medicine.
So why does Burnham appeal to the Lib Dems? Mainly because their election manifesto opposed any form of privatisation and because the mass of those who voted Lib Dem at the election have told opinion polls that they are absolutely opposed to the planned NHS reforms. Senior Lib Dems are equally opposed, Baroness Shirley Williams has warned that ” if there is any sign of moving towards privatisation at lot of Liberal Democrats will not put up with it”. Senior backbencher John Pugh, co-chairman of the Lib Dem policy committee on health, has said that ” it would be “unthinkable” if the white paper was not extensively debated at the pa
rty conference. Lib Dem MP Gordon Birtwistle is “aghast” at the prospect of ward closures, the list goes on and on.
So the Lib Dems will heed the call of Mr Burnham? No! And the reason can be summed up in one word; Clegg. Nick Clegg is besotted with the high office that he never expected to gain and has become to Cameron what Blair was to Bush. He intends to hang on to the trappings of power whatever it takes. And that means a two-tier NHS service for the first time in its history!
In reality only the voice of the people can stop this irreversible change. Sadly few gardeners or ferret breeders can afford either fees or private health insurance so there is a united front in the shed. Our banners stand ready in the corner and our ‘I agree with Nick’ shirts are now used for cleaning out the hens. Given our advancing years, we are likely to be amongst the first victims of the Lansley madness but the man we will really curse is the one who appeared to be on our side!
WHY DO SO MANY LACK RESPECT FOR OUR TROOPS?
Over the weekend low-life scum with the self understanding of a louse, stole a brass plate from a Manchester war memorial, presumably with a view to selling it for scrap. That is how much the sacrifice of millions means to them. Now the grieving relatives have to fund-raise all over again.
There is something in our culture that leads some of us to show a lack of pride in our armed forces. Even in the second world war there were endless strikes in both the shipbuilding and aircraft industries at the exact time that out forces were on a knife-edge as they battled on with inadequate equipment.
Why this trait has dogged our country for so many years is hard to fathom but low-life seems a very apt term to use!
CRICKET- THE SCANDAL ROLLS ON!
It is nice for this cricket fogey to have an excuse to continually bang on about the game but I wish the excuse was something more paletable than the fcat that the game suddenly seems to have turned into a staged production.
One reader tells me that he has decided not to attend next week’s game at Durham. the reason? He feels that he will distrust any mistake or miss-field. there must be thousnda feelig the same way and this cannot go on. Michael vaughan probably spoke for many when he said that the forthcoming series should be scrapped until this whole appalling scandal is sorted.
ANSWERS TO YESTERDAY’s QUIZ: 1. Doris Lessing 2. Chancellor of Austria
TODAY’S QUESTIONS: 1.In which year did direct rule in Northern Ireland begin? 2. Jigme Singye Wangchuk became king of which country in 1972?
Amongst all the confusion and hoo-hah surrounding the Andrew Lansley proposed reform of the NHS, two items in the small print have slipped in almost unnoticed. Perhaps Mr Lansley is cleverer than we thought, admittedly not a difficult promotion. He is abolishing the cap limiting the proportion of income hospitals can earn from private medicine and, at the same time, abolishing targets for waiting times. Just pause and think it over. We could be back to the dreadful days of 18 months waiting times with the alternative of immediate treatment if you or your family can raise the cash.
Despite all the fairy tales about NHS funding being ring-fenced all leading Trusts are already facing crippling shortfalls and an ever growing volume of elderly patients. Suddenly they are offered a lifeline and already leading specialist hospitals are grasping the carrot. Manchester’s Christie hospital is Europe’s largest cancer centre and expects to treble its private income to £30 million within a decade by making a deal with HGA, the world’s biggest private hospital group. Caroline Shaw is quoted as saying that staff had voiced doubts but are reassured that ‘we are getting new facilities and a 50-50 split of income’. The Royal Brompton and Harefield, the UK’s largest cardio-respiratory centre is already offering patients a city guide and suggests trips to the ‘high-end shopping facilities of Sloane Street and Harrods.
Straws in the wind and other Trusts are busy planning a vast increase in their private practice. Until now most offered a few siderooms giving increased privacy but little else different to standard NHS treatment. Taking a private room could only be negotiated after an appointment was made. Once the few rooms become many it is inevitable that a distinct and seperate service will be on offer when your GP refers you. And remember that there will no longer be waiting list targets covering emergencies ( 10 days) or needed but not life-threatening surgery ( 18 weeks).
Already clinicians are under enormous pressure to meet those targets as a result of the reduced doctor’s hours ordered by the EU. Already operating theatres are short-staffed and a new survey of 980 consultants and trainee surgeons reveals that 61% of consultants are now having to operate without assistants and 66% of trainees are receiving significantly less training since they are having to stand-in on ward rounds. Now the very same surgeons are to be asked to provide private services giving immediate treatment and there can be only one outcome. NHS service waiting lists will grow longer and longer and the families of those who cannot afford what will undoubtedly be extortionate insurance payments will be faced with the moral dilemma of raising the money somehow or watching someone suffer and, perhaps, die.
For many years there has been a debate about the introduction of the private sector into NHS provision, indeed the Labour government made various attempts to do just that. But those proposals involved mainly the UK-based private hospitals, none of whom offer intensive medicne or care. What we face here is something far more draconian. The NHS hospitals themselves are being steered toward the provision of their own total services being available for cash if patients have the funds.
For weeks the arguments have raged about Lansley’s slightly bizaare plan to hand commissioning to GPs. Suddenly it is clear that we face something easier to do but far more devastating in its implications. It was quite one thing for the well heeled to be able to pay for immediate treatment, with all the trimmings, for a routine knee operation, quite another to tolerate the same back-pocket power to those whose priority will put other lives at risk.
When Angus Maude remarked at the weekend that this coalition government is being more radical than Thatcher or Blair he was right. It is turning the clock back generations to the day when how much you had determined whether or not you survived.
Of course we all know that as the popular song has it money can’t buy you love, but it has always been able to cover most things. Last week’s example was provided by Sky’s headline-grabbing deal with HBO which gave them the exclusive rights to the US channel’s archive as well as future shows and a first-look deal on all co-productions. Slowly but surely the pay-to-view media company is acquiring the exclusive rights to most things. That means that unless you can afford the monthly bills you are excluded.
But we have to live with this however unfair it seems, especially in the case of events such as Test Matches. Deservedly or otherwise one tenth of the population has the bulk of the nation’s wealth and whilst their money can’t buy them love it certainly can ensure access to most other things. Up to now that has not included acute medical treatment.
Soon it will and a poor diagnosis will take millions metaphorically back to a time when higwaymen cried ‘your money or your life’. To the extent that they have self understanding is this really what those who voted Lib Dem intended?
AND ANOTHER THING; Today’s Daily Express carries a front page story revealing that house prices are due to climb by a whopping 20 per cent with thousands lifted out of negative equity. It made a nice change from stories of Princess Di but is it true? Not according to the weekend financial pages which carried gloomy forecasts of sharp falls. We can only wonder who is right and pray that the experts variously referred to are not estate agents, the only profession keeping MPs from the bottom of the popularity league tables.
By contrast the Daily Mail carries a front page picture of Bill Clinton at his daughter’s wedding. It seems that Chelsea obliged him to lose 20 lbs before walking her down the aisle. Now that we really needed to know! And it isn’t cricket!