Protect the NHS, part 2. Reduce avoidable hospital admissions.

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Phaeton

Grumpy Old Barstool
Location
Oop North (ish)
That's not *quite* true.
But like a lot of untruths it is build on facts & experiences
It is argued that this system delivers best value for the tax payer.
It could also be argued that the services provided & the method of delivery is done to maximise the profit of the partners in favour of what is best for it's clients, customers, or whatever buzzword they want to use instead of patients.
 

DCBassman

Going up hills, very slowly...
That's not *quite* true. What *is* true is that when Blair was in charge, funding got changed a *lot*. Instead of just being commissioned by the NHS to provide medical services, Practice based commissioning was introduced. This meant that GP practices could bid to provide Primary Care Services in addition to their core functions. Then in 2010/11 under Cameron, this was enhanced even further allowing GP Partners to essentially become self-employed and take "drawings" from their businesses out of profits, thus allowing GP partners to earn more than salaried GPs. To ensure profitability the role of Practice Manager has been somewhat changed in function to be more like a business manager.

So, providing healthcare is still the primary function of a GP practice as that is the key source of funding. It's just that Practices can negotiate to provide additional services which carry additional funding, and if they can deliver healthcare more cheaply then the partners can make more money.

It is argued that this system delivers best value for the tax payer.
And, from a great deal of personal experience, at more than one practice, it also delivers worst service for patients. I am certainly one who would remove ALL private enterprise from the NHS. Money anywhere in the equation means patients are not the first priority. Jeez, it's why the whole thing was dreamed up in the first place...
 

Mike_P

Guru
Location
Harrogate
Problem in the public sector it is now seemingly compulsory to review services every x years resulting in interview show ponies getting promoted beyond their competence, and consultants then brought it to work out how to improve the service as the review has resulted in exactly the opposite to its aims, with outsourcing or public private partnership being promoted.
 

SkipdiverJohn

Veteran
Location
London
Private enterprise has failed to universally deliver reliable, quality services, or value for money, in local authority outsourcing. That being the case, I cannot see reason beyond blind ideology and avaricious self interest why any politician thought things would be any different in the NHS.
As a capitalist I'm all in favour of people making profits. but not when it comes to public services. Those should be run by the public sector, but without the dead wood, and public satisfaction with the service should be the performance benchmark, not "efficiency" against some arbitary yardstick.
The problem with introducing private enterprise into public services is you end up incentivising the wrong behaviours, which means things get done to maximise bonus payments or other rewards, rather than just giving the punters the best service that their taxes are ultimately paying for.
 

BurningLegs

Über Member
But like a lot of untruths it is build on facts & experiences
It could also be argued that the services provided & the method of delivery is done to maximise the profit of the partners in favour of what is best for it's clients, customers, or whatever buzzword they want to use instead of patients.
Opportunities??
 
As a capitalist I'm all in favour of people making profits. but not when it comes to public services. Those should be run by the public sector, but without the dead wood, and public satisfaction with the service should be the performance benchmark, not "efficiency" against some arbitary yardstick.
The problem with introducing private enterprise into public services is you end up incentivising the wrong behaviours, which means things get done to maximise bonus payments or other rewards, rather than just giving the punters the best service that their taxes are ultimately paying for.
Here we have a lot of services provided by private or NGO organisations, which in the UK would be provided by the state, including a lot of healthcare and organisations like the one I work for in long term mental and psychological health provision.

I'm a bit ambivalent about this to be honest.

There are certainly advantages in healthcare: the structure of the system makes it a good investment for a local government to finance healthcare provision, because the wages of staff are paid by state or private health insurance, so once the hospital is running then theoretically it is a net gain to the local area.

My field is a bit different: local authorities have a legal obligation to finance it, and they licence organisations like my employer as providers. There are several large providers mainly connected with the Catholic and Lutheran church.

In theory, this means there are several providers with several different concepts working in an area and clients are customers who have the right to a place in the organisation of their choice, so they get to pick what works best for them.

On the other it can have exactly the result that you describe: as long as the upper management can sell their concept then they get finance and the usual cost cutting, paring down front line staff, and exploiting of loopholes exists here just as elsewhere.
 
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