Lists within lists
Patients struggling with their mental health may be left stuck on "hidden" NHS waiting lists. New analysis by UK charity, Future Care Capital (FCC), reveals that 1 in 4 patients (24%) are waiting more than 90 days between their first and second appointments for NHS Talking Therapy treatment (previously known as IAPT).
Source: https://futurecarecapital.org.uk/digital-mental-health-tools-guide
Steady as you go
Catastrophism is running riot in the NHS and the advocates of switching to a health insurance system are increasingly vocal. Consider a headline from Bloomberg UK : Britain’s NHS Black Hole is Devouring the Whole Country. This is nonsense – health insurance systems are wasteful and bureaucratic and are best avoided. For some in-depth analysis of health insurance’s failings read Hugh Alderwick’s Health Foundation blog and Sam Friedman ‘s article in Prospect magazine.
Sources: Philip Aldrick Britain’s NHS Black Hole is Devouring the Whole Country Bloomberg UK Jan 24th 2023 Sam Freedman How the NHS crisis epitomises everything wrong with the UK’s political system Prospect magazine, January 25th 2023 Hugh Alderwick Rhetoric about NHS reform is misplaced Health Foundation 23rd January 2023
Number crunching
On February 25th members of the campaign group ‘We own it’ gathered in Parliament Square to mourn 557 people allegedly killed by outsourcing NHS work. This claim prompted a veteran NfN mole to ask the group some questions. “I have been involved in campaigning against outsourcing and privatisation in the care system for 40 years. I have written extensively on the subject and also led many successful negotiations to stop outsourcing. I hope you can provide answers to the queries I have in understanding your position.
What is a “fully public” NHS? How would it be different for patients and public? When was there a fully public NHS that can be restored? How did that alternative deliver better services? What impact analysis has been done into any transition to remove all non-public provision from the NHS? What advantages have been obtained in care quality or otherwise by Wales and Scotland which do not have any comparable level of private provision?
What credibility do you give to major studies, such as that recently published by David Hunter comparing health systems, showing that the extent of private provision does not determine much of anything? Other factors, such as funding level are far more important. In respect of the Oxford study that you cited, does it establish anything more than correlation? What evidence from elsewhere supports the claims of excess deaths? How do the Oxford results compare to multiple studies showing the avoidable death rate in the NHS to be around 6 – 8%? To date ‘We own it’ has not replied.
Source: Morning Star 25/2/23
Shutting down debate
One of News from Nowhere’s moles reported to their Integrated Care Board about a local listening exercise. A major concern from the public is not being able to get a GP appointment. Not news, you say. So our mole asked in a very gentle and diplomatic way what the system could do to support its General Practitioners. The GP representative on the board became defensive and said he was fed up with GPs being criticised. The Board tiptoed around the problem and promised support, without saying what that meant. Musing on this our mole concluded that the Board had a real problem being able to discuss the reality – that there is a problem with general practice. This is one example among many, we think.
Source: Integrated Care Board mole
Just keep trying
Feeling a bit poorly a mole of long standing went to her GP to book an appointment with doctor. “There are NO appointments available at all”, said the receptionist, who added that she did not know when there would be any. “Just keep trying” she said.
Source: wheezy mole
Policing & Mental Health
According to the Economist, in the last three months of 2022, Sussex Police spent more than 11,000 hours dealing with mental-health incidents. Bedfordshire Police are threatening to bill the NHS for the 53,000 hours they spend annually on mental-health call-outs.
None of this is new, but when health services are overloaded (waiting lists for mental-health services currently stand at 1.2m) emergency responders like police officers and paramedics end up taking more of the strain. That leaves police officers waiting for hours in emergency departments with psychotic or suicidal patients.
Some police forces are threatening to stop their officers from responding to mental-health call-outs altogether. Others are negotiating handover agreements with health workers. The best solutions involve police and the NHS working in tandem, as shown by rural Cambridgeshire’s Police Street Triage that attaches a mental health nurse to patrolling officers. This has reduced police detentions by half - risk-averse police lacking mental-health training are more likely to use their powers than not – and has reduced NHS costs too.
Source: Blighty - Recommendations and reflections on Britain The Economist 14/2/2023
Why is health reform so difficult?
The Centre-Right neoliberal think tank ‘Reform’ is back in business. On February 2nd it hosted a round table discussion between politicians who at some point in their career had held health portfolios, to answer the question why is health reform so difficult? Caroline Flint (Labour) argued that public distrust makes it difficult for enemies of the NHS to promote change, especially if NHS reform is framed around rationing, which is unpopular. A sense of crisis in the NHS impedes long-term planning.
Norman Lamb (Liberal-Democrat) agreed that NHS reform is seen as privatisation, especially when social enterprises were involved. In his view Wes Streeting is doing & saying the right things, but overall MPs are not really interested in the NHS.
James Bethel (Conservative) blamed public fatalism about health, political mistakes like “40 new hospitals”, the NHS’ lack of mission, professional scepticism towards reform and the economic barriers to major change – a strategic reboot (fundamental system change) would require a period of double running, which looked unaffordable.
No great breakthroughs, then. News from Nowhere is intrigued by the idea of MPs’ disinterest. Could this explain why Labour’s health policy has been so unimaginative?
Source: https://reform.uk/event/why-is-health-reform-so-difficult/
Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.health