Barefoot Doctors in the first world? Training cuts could harm patients, doctors warn. Health services are bust..

Sarah Bloch reports for BBC news 20th Jan 2015: Training cuts could harm patients, doctors warn

This regression towards the world mean is tacit admission that we may be training doctors to too high a standard for the population. Never mind that the individual patient benefits. The duty of government is towards populations and the duty of the doctor to individuals. The government has derelict it’s duty by poor manpower planning and failing to be honest. This report is the outcome! Do we really want to go back to barefoot doctors – in the first world? It’s another case of the BBC giving the News before any broadsheet gets a chance… so look for an update when the broadsheets have commented. Even Dr Sarah Jarvis is thinking of retiring early (Radio 4 interview 30th Jan 2015) .. she blames successive cuts and re-organisations along with a great increase in workload and shortage of GPs. She claims there is going to be a domino effect (she is part of it) and that over 40% of female GPs under 40 are leaving the profession.

In effect we are going bust, both financially and in manpower.

Dennis Campbell tells it as it really is in theGuardian 29th Jan 2015: England’s biggest hospitals veto NHS budget over patient safety fears

Hospitals that provide 75% of all NHS services refuse to sign deal, saying £1.7bn cuts involved will put patient care at risk

Chris Smyth in The Times 29th January reports: Hospitals revolt risks £1bn hole in budget

Hospitals have rebelled against funding cuts with a legal challenge that could blow a £1 billion hole in the NHS budget.

Patient safety will be at risk unless health chiefs back down on plans for extra efficiency savings, according to hospitals covering three quarters of NHS care. They say they are being asked to “achieve the impossible” and cannot cope with a 3.8 per cent budget squeeze due in April.

The unprecedented veto of the NHS payment plans for 2015-16 means that hospitals head into the general election period with no clear idea of their budgets for the year, throwing planning into chaos for a year which is meant start a crucial £22 billion efficiency drive.

If no deal is reached, hospitals will continue to be paid at this year’s rates, giving them about £1 billion more than planned. Health chiefs are adamant there is no extra money, meaning the cash would have to be found through a raid on GPs or other services.

Chris Hopson, chief executive of NHS Providers, which represents hospitals, said the move was a “last resort” move to force health leaders to listen. “[Hospitals] can no longer guarantee safe and effective care unless they are properly and fully paid for the patients they treat. We have now reached the point where patient care is at risk,” he said.

“Either we fit the money to the care provided; or we fit the care to meet the money available. What we can’t carry on doing is pretending that NHS trusts can achieve the impossible and then berate and criticise them when they inevitably fall short.”

For the past four years, hospitals have faced a 4 per cent annual cut in what they are paid for treating patients, as part of a £20 billion savings programme. With 80 per cent of hospitals now in the red, Mr Hopson said there were no more efficiencies to be made without harming patients.

“A month ago Circle, a private health company, announced it was handing back Hinchingbrooke Hospital to the NHS because it was impossible to run sustainably. NHS providers don’t have that luxury,” Mr Hopson said. “This is a similar statement that it is now impossible for all but the very strongest NHS providers to cope with rising demand, meet performance targets and achieve financial balance.”

Under powers in the coalition’s health reforms, funding plans can be vetoed if half the NHS reject them. Thirty-seven per cent of hospitals, ambulance services and mental health trusts responsible for 75 per cent of patient care have objected this year, forcing goverment to renegotiate. If no deal is reached, the Competition and Markets Authority will have to rule on whether the price-setting process was fair in a judicial-review-style process that could take months.

Richard Murray, director of policy at The King’s Fund think tank, said the move would throw NHS planning “into disarray” as the new financial year approaches. “The two main ways used to reduce NHS costs over the last few years -limiting staff salary increases and reducing payments to hospitals – have now been largely exhausted. With financial problems among hospitals now endemic, waiting times rising and staff morale a significant cause for concern, this once again indicates that the situation facing the NHS is becoming critical,” he said.

Big hospitals are also angry about plans which would see them paid only half-price for extra patients they take on who need complex, specialist care, claiming this is a mood to ease pressure on NHS England’s own overstretched budget.

Paul Baumann, chief financial officer at NHS England said: “Since the overall NHS funding totals for 2015/16 are now agreed, any changes to the proposed tariff would in practice just be robbing Peter to pay Paul – meaning less investment in other hospitals, mental health or GP and community services – the exact opposite of what pressures this winter show is now needed.”


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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.

1 thought on “Barefoot Doctors in the first world? Training cuts could harm patients, doctors warn. Health services are bust..

  1. Pingback: Doctors form new pressure group to prevent “marketisation” of NHS – Rationing by chaos | NHS reality. An NHS soapbox. Speakers' corner for the NHS.

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