And it gets worse… Chronic Social Care cannot be fully funded and has to be rationed via a long term initiative. Nick Triggle gives 10 charts showing why health is failing..

The CEO of the Kings Fund, Chris Ham, has been at the cutting end of health philosophy and ideology for years. He writes to the Times 8th Feb 2017, but his words are anathema to the health professionals – who know that rationing is inevitable, and pretending that an adjustment by partial removal of universal benefits will save enough. Now it is covert, then it will be overt.. Chris Smyth in the same edition reports on another nail in the coffin of general practice. “GP surgeries that shut for half a day have funding cut“. Philip Aldrick also reports “Funding axe ‘will worsen care crisis’“. The conspirator theories are thus encouraged, and more doctors, nurses, and midwives decide to leave, or stay abroad. General Practice has been likely to follow Dentistry for some time now: Fears of ‘two-tier NHS’ as GPs allow patients to pay to jump the queue – MPs claim Dorset Private GP service, at up to £145 per appointment, will mean NHS patients without money will wait even longer for care (Dennis Campbell in The Guardian). Just like Health, Social Care cannot be fully funded and has to be rationed via a long term initiative…



Sir, Rachel Sylvester is correct to argue (“Social care crisis needs a Japanese solution”, Feb 6) that we need a national solution for what most people agree is a crisis in our social care system. The Barker Commission into the future of health and social care which reported in 2014 recommended putting health and social care budgets together and increasing spending to levels found in France and Germany. The commission proposed paying for increased spending by limiting winter fuel payments and free TV licences to older people on low incomes, increasing national insurance contributions for high earners, and levying national insurance contributions on people who work past state pension age. It also recommended increasing national insurance contributions for those aged over 40 to help pay for the more generous system from which they would benefit. Some funds could also be raised by reducing exemptions on prescription charges and reviewing the rate at which these are paid.

Incremental changes of this kind are not easy but are more feasible than a wholesale shift to a social insurance funding system of the kind used in Japan.

Chris Ham

Richard Vise in The Guardian September 2014 was full of hope: Barker report confronts injustices of long-term care

The Nuffield Trust’s response to the Barker Commission Report: The Nuffield Trust’s Chief Executive, Nigel Edwards, welcomes Dame Kate Barker’s report findings into how to adequately fund health and social care for the future.

Rachel Sylvester opines 7th Feb 2017: Social care crisis needs a Japanese solution

Walesonline reports: A staffing ‘crisis’ could hit midwifery unless more training places are created in Wales and the BBC reports:

Image result for long johns warmth cartoonIf we have to save money then Long Johns would be cheaper than heating allowances…

Kate BarkerWikipedia

This statement from the Barker Commission highlights their concerns about the lack of progress since their report was published, and calls on the Chancellor to take action on health and social care funding in the Spending Review.

NHS cash crisis in Kent halts non-urgent surgery until April – West Kent clinical commissioning group is trying to save £3.2m by delaying non-urgent operations until new financial year

Worcestershire hospitals trust ordered to urgently improve patient safety – Worcestershire Acute Hospitals Trust given six weeks to improve, after the deaths of two patients forced to endure long waits for care

Nick Triggle for the BBC today reports: 10 charts that show why the NHS is in trouble and The 10 ‘longest’ hospital delays exposed

Wales has the longest waiting lists in the UK and Owain Clarke tries his best to sell the failure as an opportunity:  £600m Arch bid to ‘transform’ west Wales NHS



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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