Friday, November 23, 2007

NHS News

Oh the General Practitioners complain too much. Always whingeing that the government is demanding too much of them, that the government wants them to offer Out-of-Hours (OOH) services when the government said the Primary Care Trusts would take care of OOH when it renegotiated the GPs' contracts etc etc.

Don't worry GPs – you are now not alone.

Now the politicians have turned on the hospital consultants (see the Guardian report here).

The House of Commons Public Accounts Committee has “discovered” that since the government signed a new consultant contract in 2003 (which surely Lord Darzi signed ?), average pay rose over the next two years by £ 23228. But at the same time their working hours fell from 51.6 to 50.2 hours per week.

These factors have led to a higher rate of recruitment and retention – and less private work (“oh fuck, we haven't got enough consultants for the NHS-contracted Independent Sector Treatment Centres”). And more patients are seeing consultants.

Good to see some explicit criticism of the government and NHS management – implementation of the new contract was “rushed” and “NHS managers did not take advantage of the intended advantage to introduce modernised working practices”.

Now I understand ... the DoH didn't provide the managers with Guidelines!

Will the government, after the GPs and consultants, now turn on the NHS management? Wishful thinking ...

Government: “You haven't got the private sector involved enough, and when you have, you've placed far too much emphasis on quality, so you've forced us to withdraw their contracts ...”

Managers: “But the private sector can't find consultants as the NHS now pays them far more than the private sector because you signed their NHS contracts and you signed the ISTC contracts ...”.

When will the government admit that (some) improvements in human resource management have led to (some) improved care through its increased investment in the NHS? When will it correlate reduced working hours for NHS staff, increased salaries etc with improved outcomes instead of always waving a stick rather than a carrot?

I predict Drs Rant and Crippen that you may sympathise with the NHS managers in the end (even if you only say “I told you so.”) ... because much worse may come ...

In other news, a survey commissioned by the Guardian newspaper from Medix, a public survey research company often used by the Department of Health, has found that GPs are reticent, in the extreme, to upload patient data to the planned national NHS database of patient records.

It is up to the GPs to give the choice and the patients to choose to not have their medical records uploaded to the national database. The Department of Health points to a trial in Bolton where less than 1% opted out – but I wonder how informed both the GPs and the public really were.

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