The Health service underwrites your house values…. Undercapacity in staff, short termism and denial could mean house values will fall.

Yes, the Health service underwrites your house values….

And if the average couple had to pay £300 per month for Private Medical Insurance, (£500 for a “family”) it would certainly focus everyone’s minds on cash flow.  Undercapacity rationing in staff training, general short termism, and denial could mean house values will fall if citizens have to pay for health care. Perhaps this will be good news for first time buyers..

The decline in value of the £, according to our local Chief Financial Officer, has the implication of a £900m increase in costs for the 4 health services, but that has been updated by the BMJ “Brexit will leave NHS £19bn poorer” (BMJ2016;354:i3731) .( and of course “Brexit could worsen NHS staff crisis“.). That’s about £30 each man woman and child. At a West Wales BMA meeting the speaker, Steve Moore, enlarged on the dire circumstances of the Welsh Health Service. Coming from Kernow Trust, he has some experience of being on the sharp end. Whilst being frank about the finances, and the drivers for change, he was keen to encourage all Trust Staff to give “exit interviews”. He was unwilling to debate the fundamental beliefs and ideology of the original health service, and how they should change to make the system founded in reality. At the end he said he had ideas on rationing, if this becomes allowable…

The manpower planning deficit was ignored, but it is once again in the news:

Chris Smyth reports on 9th July 2016: Locum paid nearly £500k despite curb on agency costs

Britain’s highest pay for a locum doctor rose £37,000 to £478,000 last year as a government clampdown failed to cut the cost of the stand-ins.

Hourly pay for locums rose in 2015-16 despite an attempt to cap their rates to deal with a soaring cost of NHS agency staff. Not one registrar shift in A&E was paid within the limits, according to data from a third of NHS hospitals.

Doctors said the figures showed the futility of trying to solve a shortage of staff with a government edict, saying that many hospitals had given up attempting to enforce the caps.

Last November ministers capped hourly pay to help to rein in hospital deficits which reached £2.5 billion in the last financial year. NHS spending on stand-in doctors rose £100 million to £1.2 billion, suggests analysis of 56 hospital trusts by Liaison, the company which manages their staff payment systems. This was despite a drop in commissions paid to agencies.

The best-paid locum got £478,181, up from £441,672, with hospitals paying a further £25,856 in commission to book the doctor’s shifts. The medic worked an average of 84 hours a week.

Pay for junior doctors six years out of medical school is limited at £35 an hour, but the data shows no A&E shifts in 2015-16 paid below this, with an average rate of over £60. Dr Mann said it was naive to expect doctors to work in A&E units for such sums if they could earn the same in a less stressful department.

Mark Porter, chairman of council at the British Medical Association, said:

NHS officials insist that the caps have saved £300 million by slowing the increase in spending on agency staff.

June 4th 2016: Pension obstruction by bureaucracy for GP locums. Designed to frustrate..

December 14th 2015: Jeremy Hunt and the DOH attempt Stalinist refrain on locum pay in the NHS?

December 11th 2015: NHS locums get £36,000 pay rise – demand exceeds supply in a highly trained workforce

27th July 2015: Grieving for the NHS. The softer specialities and locums. Ration for higher earners, and where insurance could cover.

13th July 2016: Why not become a locum? Earn more, Standard hours of your own choice, no administration and control of your own life? Training bribes won’t work: undercapacity controls the rules

The chambers model is replacing the partnership model. There are so few barristers they control their pay – the same is happening for locum GPs. The primary care power will be in their managers/controllers.

Knee Jerk responses and short-term actions are not in the long term interest of health.. In a “free market” politicians threaten to cap agency/locum fees.

Agency and Locum fees reveal the extent of the undercapacity, and the political denial

Doctors quit NHS to work as £1,800-a-day locums

A&Es use locums to fill a quarter of senior posts

From Steve Moore’s presentation, a graphic from Roy Lilley explains the funding problem.

A bigger problem

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This entry was posted in A Personal View, Rationing, Stories in the Media on by .

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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