Private sector growth

The latest data from the Private Healthcare Information Network (PHIN) shows that insured private medical admissions hit a post-pandemic high with 134,000 treatments in Quarter 3 of 2022 as the crisis in the NHS drives growing demand for private healthcare options. Despite a drop-off in self-pay procedures (albeit still above pre-pandemic levels), since Quarter 1 2019 total private patient admissions have only in one quarter (203k in Q2 2021) surpassed the procedures in Quarter 3 of 2022. 

Source: https://www.phin.org.uk/news/phin-private-market-update-march-2023

Trojan Horse trading

In a recent article in the Morning Star MP Claudia Webbe claimed that “The Tories’ so-called Integrated Care plan is the Trojan horse for the Americanisation of the NHS”. The article was widely acclaimed in some quarters and accepted as if it were restating established facts.  Webbe asked why nobody was doing anything about this threat. The article is but the latest in a whole series of attempts to portray threats to the NHS which have no basis in fact, and are part of a conspiracy theory involving American healthcare companies taking over the NHS. 

The claim is that the NHS is being broken up into Accountable Care Organisations modelled in the US in the 1970s and designed to cut costs and to deny patients access to treatment. 

Webbe argues that “For the past 30 years, by degrees and with little debate and with varying levels of stealth, the same system has been rolled out in Britain.” And “Nationally mandated reductions in services are conceived and designed to bar and discourage patients from accessing services, running the NHS on minimal capacity — like a business instead of like a public service, always aiming for the maximum profit for the minimum outlay, which in healthcare means less treatment.” 

If there is this plot it is very well hidden. The current architecture of the NHS is about as far from the US system as is possible, the US being an outlier on most  observable health measures. The allegation also applies to Wales, which has a NHS that is similar in many ways to England but managed very differently, with little private involvement or competition and which also has joined up Health Boards (which Webbe is arguing must be bad). The idea of Wales as a bastion of neo liberalism and a participant in this plot is laughable. Scotland too has a different, more joined- up approach and a different government. The NHS in England is far from joined up, as would be required for ACOs. Primary Care and Secondary care are as far apart as is possible. Commissioning and delivery are separate. 

Looking back over 30 years the multiple reorganisations in England hardly suggests some underlying plan. Seen in the light of actual NHS history, the Trojan Horse is an illusion.

Source: Claudia Webbe Morning Star Monday 27th February

I am a robot

In 2022’s Autumn Statement, the Chancellor announced that NHS England would receive an additional £3.3 billion of funding in both 2023–24 and 2024–25.  A significant portion of this funding has been invested in surgical robotics, and the UK now has well over a hundred of the newest. fourth generation surgical assistant robotic systems, known as the ‘Da Vinci System’. This four-armed robot was designed and built in the UK. Robots may not be the solution to all surgical problems, but they probably represent the future of ophthalmology as a discipline, improving precision and reducing human error in eye surgery.

Source: shurleyokelly@sapiencecomms.co.uk

Nimble or not?

Fans of Matt Black, acerbic commentator at the HSJ, will be pleased to see him promoted to columnist Steve Black. In a recent rumination about NHS management he was particularly sharp, arguing that, “instead of delivering a clear, focussed set of objectives, NHSE has set an unfocussed plan with too many unclear objectives containing so much detail that the overall goal is obscured. NHSE does not trust the local leaders and managers to solve problems and denies them the autonomy, capacity or flexibility to make their own decisions. And it has failed to establish sufficient well-trained expertise in local leaders and middle management. Added together, these failings make for a deep cultural and organisational failure that cripples the whole system’s ability to take action and solve problems.

Steve Black The myth-buster: The NHS leadership needs to stop thinking like the Russian army Health Service Journal 13 March 2023

Waiting times have got worse and we have more staff 

The A&E medical workforce has grown by almost two thirds since 2016, exceeding the growth in other specialties. Despite this, waiting times in A&E have deteriorated significantly over the same period. In the 12 months to November 2016, the emergency medical workforce in England averaged 5,635, compared to 9,241 in the year to November 2022, a rise of 64 per cent. Over the same period, A&E attendances increased by only 4.8 per cent, whilst performance against the four-hour target declined from 90 per cent to 73 per cent..

Source Matt Discombe NHS warned ‘cramming’ A&Es with medics is not working Health Service Journal 17 March 2023

Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.healthmatters.org.uk/