Costing the NHS

The BBC has a series of programmes on the Health Service available on “Listen Again” or iplayer.

This summer NHS England called for a public debate to find ways of renewing and revitalising the NHS. One of the widely reported claims in its report “The NHS belongs to the people: a call to action” was that continuing with the current model of care in England could lead to a funding gap of around £30bn by 2020/21.

In this special programme, Julian Worricker looks at the growing demands on the health service in the UK, the willingness of the public to fund a service that meets those demands and the scope for savings without compromising care. Can the UK afford a health service that follows the NHS core principles: one that meets the needs of everyone, is free at the point of delivery and is based on clinical need, not ability to pay?

Joining Julian are:

Prof John Appleby, chief economist, the Kings Fund, Christina McAnea, UNISON head of health, Don Redding, policy director, National Voices, Dr Mark Porter, chair of the BMA ruling council, Stephen Dorrell MP, chair, Health Select Committee, Tony Whitfield, director of finance, Salford Royal NHS Foundation and president of HFMA, Sandie Keene, president, Association of Directors of Adult Social Services, Andrew Dillon, chief executive, NICE, Karen Taylor, research director, Deloitte UK Centre for Health Solutions, Dr Clare Gerada, chair, RCGP, Anita Charlesworth, chief economist, Nuffield Trust, Chris Hopson, chief executive, Foundation Trust Network, Christoph Lees, obstetrician, founder of Doctors Policy Research Group, Andrew Haldenby, director, Reform and Sir David Nicholson, chief executive, NHS England.

Presenter: Julian Worricker Producer: Simon Tillotson

I was disappointed in the first as the panel never addressed the politically dangerous ground of rationing. Therefore rationing will continue covertly and post coded.

Costing the NHS – live page

Follow the debate, read the latest comments and find extra information about the topics.

The second link is to

NHS: Changing Culture

Lesley Curwen investigates cultural failings in the NHS. This is on Wednesday 18th September. It might be the most interesting as all interviewed consultants so far have agreed that the problems are with management.

NHS culture has been condemned as “broken” and as “insidiously negative”. Business journalist, Lesley Curwen, asks what NHS managers were doing when appalling patient care was happening on their watch.

In the first of two programmes, she tracks the initial introduction of managers into the NHS and explores the responsibility that NHS leaders now shoulder for creating both good and bad cultures.

Robert Francis QC spells out why he believes the primary cause of the scandal at Mid Staffordshire was management failure, and the clean-up executives, sent in to run the scandal hit Trust, describe the culture of denial that dominated when they arrived.

As the NHS adapts to the radical reforms of 2013 in the midst of unprecedented financial challenges, Lesley visits both struggling and thriving hospital Trusts to discover how their leaders and managers are trying to create positive and open cultures, where staff are supported to provide the very highest standard of care to patients.

Producer: Fiona Hill.

I listened to this carefully, and although the history of managerial inadequacy and incompetence is clear to hear, no potential solution is proposed to this cancerous and festering culture.

If you wish to see clips from

Surgical Cuts

Mukti Jain Campion investigates a pioneering Indian model of cut-price healthcare.

If I can record any of these digitally on Iplayer I will post as update.

You might also like the Kings Fund spoof:

And an update 25th September 2013 in case you dont think rationing is happenning..

The Daily Mail (Jenny Hope Medical Correspondent) on 20 September 2013 reports:

16,000 cancer patients a year to be denied vital medicine as Government’s  specialist drugs fund is wound up

  • 16,000  patients will be denied drugs when the fund is wound up
  • Cancer charities  are calling for the  Government to pledge it will not go back to days when  patients ‘had  to beg’ for life-prolonging drugs
  • Four out of every  five people believe Britons should get cancer drugs that are widely available in  other European countries
  • The £200 million  a year Cancer Drugs Fund which began in April 2011 has led to 30,000 patients in  England getting drugs banned on the NHS

At least this rationing is now overt.. I happen to agree with this decision.



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About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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