NHS graph that could spell doom for govt


11:34 am - April 20th 2011

by Sunny Hundal    


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The big story today is the release of the quarterly NHS performance report by the King’s Fund think-tank.

The Guardian has already picked up on the fact that managers expect to achieve their efficiency targets through ward closures and job cuts.

What was that Mr Cameron, no front-line cuts to the NHS?

But the report also points to one particularly big area of danger for the government: waiting times.

The report says:

The latest 18-week referral-to-treatment waiting times data for February 2011 shows increases in the percentage of patients waiting longer than 18 weeks for inpatients and outpatients.

The proportion still on waiting lists and waiting longer than 18 weeks fell, as did the proportion waiting longer than 6 weeks for diagnostics. However, for all stages of waiting the trend since June 2010 remains upwards.

Update: Diane Abbott MP has slammed the jump in waiting times.

Alarm bells ringing anyone?

Here is the ITN news report

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About the author
Sunny Hundal is editor of LC. Also: on Twitter, at Pickled Politics and Guardian CIF.
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Reader comments


“Government led by party that took large donations from private medical insurers in hobbling NHS to tempt or force people to go private shocker!”

I really do not understand why Cameron made the promise of “no frontline cuts”. He has agreed to the McKinsey report that says that £20bn of “efficiency savings” must be made in the next 4 years. The report makes the following recommendation (p101):

Reduction in headcount equivalent to 35 FTEs from a clinical staff of 300:
– 2 Consultants
– 1 Registrar
– 10 Nurses
– 10 Healthcare Assistants
– 3 Allied Health Professionals
– 8 Non-clinical staff

So that means out of every 300 staff there has to be a cut of three doctors and twenty nursing staff, how can that not be frontline?

Does Libcon have something intelligent to say here? If so what?

Scrapping the targets allows clinical priorities to trump statistical priorities. Any comment?

We all know the NHS needs inflation + about 3% to stand still, and so inflation-only will be tough. But not as tough as under Labour who haven’t even promised to match inflation-only increases. Any comment? How much of the +3% is due to obligations under Labour’s giveaway PFI deals?

4. Chaise Guevara

@ 3 Joe Otten

“Scrapping the targets allows clinical priorities to trump statistical priorities.”

Or, alternatively, means wholesale failures go unrecorded. The trick is to deisgn it so that statisitical priorities reflect clinical priorities

@3. Joe Otten

Does Libcon have something intelligent to say here? If so what?

Are you in pain and on a waiting list for treatment to alleviate that pain? Yes there is something important to say, it is that, as always, when you have a Conservative government people are told to wait longer for treatment. There is no excuse to allow waiting times to increase, people need prompt treatment.

Scrapping the targets allows clinical priorities to trump statistical priorities. Any comment?

Huh? Keeping waiting times low is not “statistics” is is all about real people getting prompt treatment so that they are not left languishing in pain and fear not knowing when they will see their doctor. It is bizarre that you think that there are no clinical priorities with targets. The waiting time targets say that even if you are a low priority (ie you won’t die this week without treatment) the NHS still values you and still tries to treat you. A Conservative NHS removes that pledge, Conservatives say that people who cannot see due to cataracts are not going to die from them, and therefore are not worthy of treatment. Under the last Conservative administration we had 18 month waiting lists for cataract removal, under Labour there was a guarantee that you would get the operation within 18 weeks (the median time was 8 weeks).

Justify to me that someone should be condemned to a year and a half of virtual blindness.

We all know the NHS needs inflation + about 3% to stand still, and so inflation-only will be tough. But not as tough as under Labour who haven’t even promised to match inflation-only increases.

WHATTTT!!!!!! Fucking Tory Lies.

The last Darling budget said that

2010/11 would be inflation + 5%
2011/12 NHS funding would rise with inflation
2012/13 NHS funding would rise with inflation

Can you please do your research?

In fact we would be better off under Darling’s budget because after Osborne gave flat real terms funding he then took off £1bn a year to hand to local councils for social care (something that has always been paid from LA budgets since 1974). And then Lansley “top sliced” the PCT budgets by 2% to pay for his unnecessary and unproven re-organisation.

Under Darling’s budget there would not have been these two cuts in NHS funding.

How much of the +3% is due to obligations under Labour’s giveaway PFI deals?

Osborne signed off another 61 PFI deals this week. PFI is as much a Tory scam as a Labour one.

Have we forgot this from 2010?

EU rules push up NHS waiting time: Thousands more face 18-week wait for surgery
http://www.dailymail.co.uk/news/article-1300159/EU-rules-push-NHS-waiting-time-Thousands-face-18-week-surgery-wait.html

“Hosptial waiting times have begun to rise because of European rules limiting the number of hours junior doctors can work”

“Hosptial waiting times have begun to rise because of European rules limiting the number of hours junior doctors can work”

How about…?

“Fewer patients die in cock-ups by exhausted doctors working 70 hour shifts thanks to EU rule change”

Hmmm. I have a radical suggestion to reduce waiting lists, which is quite simple. Rather than have a monolithic, single organisation providing almost all treatments, why not allow other organisations to provide treatment as well, and pay them the same money.

This would create a market – and markets tend to get rid of long queues. I don’t know if anyone remembers the planned economies of the second world war or of Communist Europe, but there you had to queue for scarce food controlled by governement. In our market economy (apart from at my local supermarket when they forget that it might be busy in the week before Easter…) queueing is something of a rarity. Exactly the same happens with healthcare – you have to queue if you have effectively a single provider. If you have multiple providers, they will spot the queues and work to focus on getting their share of said queue, by offering treatment faster.

So I presume those of you bemoaning the long queues in the NHS (and to be honest, they are not the whole truth – there is queueing to get on waiting lists for example) are supporting the market-based reforms of the NHS? Otherwise, what would you suggest – throwing more money at the problem (you are aware of the law of diminishing returns I take it?).

9. Chaise Guevara

@ 6

“Have we forgot this from 2010?”

Do we have an informed source that doesn’t a) love the Tories, b) hate the welfare state and c) lie all the time?

“How much of the +3% is due to obligations under Labour’s giveaway PFI deals?”

Joe Otten, surely you don’t mean the PFI deals that the Tories promised to abolish but as revealed this week, have in fact decided to increase.

Chaise,

Do we have an informed source that doesn’t a) love the Tories, b) hate the welfare state and c) lie all the time?

No. Not sure we have an informed source that meets those criteria either mind you…

@8

Bad comparison. In supermarkets you don’t get to go to the front of the queue and/or get better service if you have more money to spend. You also don’t have to take out insurance to allow you to pay for groceries, and then have the insurers tell you that you aren’t covered to, say, buy that rice because your records show you already have a packet of rice at home that you bought last week.

Both of which happen in private, market- and insurace-oriented healthcare systems.

The NHS was set up on the basis that a population that by and large contributes to the well-being of the nation as a whole deserves to have their health looked after, regardless of how able they are to pay. Market fundamentalists consider this to be an archaic view, but I consider market fundamentalists to have misplaced their morals somewhere along the line.

Watchman, where have you been living for the past few years? La-La Land? Private providers were introduced by Labour precisely for the purpose of bring down waiting times. Big D’OH!

Richard,

Sorry – the sarcasm about radical could have been more obvious. I’m fully aware private providers are used – by going to one my wife’s knee got seen to in a week, not four months (a surprisingly common period of time on NHS waiting lists I’ve noticed – I can’t think why…). It works – and my wife can walk more happily – but it is limited. I am lost as to why people oppose expanding it.

bluepillnation,

Bad comparison. In supermarkets you don’t get to go to the front of the queue and/or get better service if you have more money to spend. You also don’t have to take out insurance to allow you to pay for groceries, and then have the insurers tell you that you aren’t covered to, say, buy that rice because your records show you already have a packet of rice at home that you bought last week.

Both of which happen in private, market- and insurace-oriented healthcare systems.

Who the hell suggested an insurance-based system. I would suggest a system where we all pay taxes and get free-at-the-point-of-delivery (FATPOD?) treatment. We could call it the National Health Service… Who provides the healthcare is a totally different issue.

You seem to be confusing free market in provision with the US system of healthcare, which I suspect everyone in the world regards as a bad model. It is either willfully stupid point-making or simply a failure to understand that there is more than two models on offer here – and that the stupid choruses of protest from many on the left are about what they believe the government intends to do, not what the government has proposed to do.

But anyway, you seem to forget that if you are rich enough you can employ someone else to do your shopping, or to cook your meals, or whatever – which is the same as having private medical insurance here alongside the NHS – you have
the choice of expending resources to free up your time from the system. That so few people do this in terms of shopping is because of the market – so if the NHS worked well, why would anyone want medical insurance anyway? The existence of that industry is surely an indicator that the NHS is not perfect?

The NHS was set up on the basis that a population that by and large contributes to the well-being of the nation as a whole deserves to have their health looked after, regardless of how able they are to pay. Market fundamentalists consider this to be an archaic view, but I consider market fundamentalists to have misplaced their morals somewhere along the line.

I am not sure who considers this an archaic view, but then I have never met anyone claiming we need to only have healthcare if we can afford it. Could you show me some examples? I fear this is the old political trap of deciding what your oppoents really believe rather than trying to understand them.

So, I am pro-NHS, but would like to see a better market in provision of healthcare under the NHS, because it is proven markets reduce lines, and the more perfect a market, the less inducement there is for people to try and use wealth (or connections – knowing the right person can get you a long way in the NHS nowadays apparently…) to jump the system – as you show with your extension of the analogy of the grocery market. Whereas you seem to think that we should stick with the same system because the US system of health insurance (I presume that is the model that influences you) does not work well. Hardly deals with my points does it?

Bugger.

Third paragraph from end of last post should be in Italics – it’s bluepillnation, not me.

You seem to be confusing free market in provision with the US system of healthcare, which I suspect everyone in the world regards as a bad model

Try telling that to Daniel Hannan.

because it is proven markets reduce lines

Sorry, I must have missed the memo there. If you could cite unbiased, scientific research which proves beyond a shadow of a doubt that markets always reduce lines (while, importantly, never harming the level of service), then I’ll take it as read, otherwise it is just more Market Fundamentalist dogma.

Comparing the Soviet-era state food stores with Tesco won’t cut it as scientific evidence, by the way.

Richard Blogger, apologies – I missed Labour’s alternative spending cuts programme. Can you give me a link to it? Thanks.

And I didn’t see anything about protecting NHS spending in the Labour manifesto…

On statistics, you miss my point of course, perhaps wilfully.

The question is whether somebody who has been waiting 5 weeks should be seen ahead of a more serious case who hasn’t waited as long. If you have a 6 week target then that target takes priority over clinical need.

It is precisely because waiting times are suffered by real people and are not just statistics that this is a problem.

A colleague had waited more than 4 hours in A&E once, and was therefore put to the back of the queue. One failure to treat in 4 hours is better for the stats than two, however long he has to wait.

I’m sorry but just as a humble man and worker I’d say Cameron is a liar and deceiver of the greatest degree.

20. the a&e charge nurse

[18] “A colleague had waited more than 4 hours in A&E once, and was therefore put to the back of the queue” – when patient’s are not called in time order it is usually because some unreasonable bugger has developed pulmonary oedema, or maybe a time critical condition like certain types of stroke – bastards, eh?

Watchman, if you don’t understand 97% of the public’s opposition, read the NHS Bill, you might learn something about what privatisation is actually proposed.

@20 no – it wasn’t clinical priorities. The colleague had to wait so that other people could be seen in just under 4 hours, thus meeting the target for nearly everybody.


Reactions: Twitter, blogs
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  69. sunny hundal

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  100. Chris Keegan

    Who else thinks that the Tories are running the NHS into the ground? Waiting times rise since June 2010. http://t.co/HQUCplp

  101. Philip Shorter

    RT @MustBeRead: From @Sunny_Hundal: Waiting times rose sharply after Andrew Lansley abolished NHS targets http://j.mp/gW2a0f





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