The long term trsaining implications of farming out arthroplasties (Joint replacements) may not have been considered…

There are issues arising from the under capacity for the 4 health services. In the long term this includes training standards: will all the juniors get the same levels of exposure and experience as when these operations were conducted in state hospital units? In the short term NHSreality expects a lower level of infections (Staph and Strep), and cross infections (Campylobacter, Norovirus, MRSA). This may affect through-put. as the least risky patients will be operated on in the private system, whereas those with multiple pathologies will be retained. In the long run, if we believe in only state provision, we need cold orthopaedic hospitals matching the private ones.  And it does not apply to all 4 jurisdictions….. Is there another perverse outcome: that training will suffer so that only those already doing these operations will get enough practice, thus self perpetuating private demand? We don’t know yet, but rest assured the managers making the decision will have moved on, and few Trusts have an “Educational Lead” who could report on the longer term implications.

This article is about England. It’s high time the Times and others stopped referring to the NHS when there is nothing “National” about the service we get (especially in Wales).

There will be no private option for the miners of Tredegar, but there will be for the bankers of London. Exactly what Aneurin Bevan wanted to AVOID IN 1948..

Image result for hip replacement cartoon

Rosemary Bennet reports 21st Jan 2019: Offer long-suffering patients private care, hospitals ordered

Patients who have waited six months for hospital treatment must be contacted by GPs and offered faster treatment elsewhere under NHS plans.

More than 4.15 million patients are on a waiting list, including more than half a million who have waited more than 18 weeks for treatment. Some 200,000 people have been waiting for six months or more, up by more than 45 per cent since last year.

Successive governments have pledged that patients referred to hospital should be offered a choice of provider, including private hospitals. Ministers have said that such policies give more rights to patients, while providing hospitals with an incentive to keep their waiting lists down, as they receive income for each case treated.

However, research has repeatedly suggested that many GPs do not offer such options routinely. The latest polls showed that only four in ten patients reported having been given a choice of hospital for their appointment.

The new promise, contained in NHS planning guidance for 2019-20, says that hospitals or local planning bodies will be obliged to contact patients who have been on lists for six months to advise them about quicker alternatives.

Professor Derek Alderson, president of the Royal College of Surgeons, said: “We are greatly concerned about the growing number of patients waiting more than six months for treatment. Any initiative to help reduce the number of people waiting a long time is therefore welcome. However, this option will primarily benefit patients in cities where it is easier to travel to another hospital, or those living in areas where a local private hospital may have capacity.” He added that different surgical teams would then need to become familiar with the patient, which could cause delay.

Professor Alderson said it was a welcome start but more needed to be done to reduce waiting times. “We continue to be engaged in NHS England’s review of performance standards,” he said. “While we accept that some changes to targets for planned treatment may be sensible . . . we could not support any revisions that leave patients in doubt as to how quickly they will be seen.”

If I pay for private treatment, how will my NHS care be affected? – NHS – 

In Wales if you start by seeing someone privately, but then elect to go to the Health Service, you should be put to the bottom of the waiting list. But we all know that if you have cancer or a problem that needs urgent attention the “rule” will be broken. The answer to the question is “You’re still entitled to free NHS care if you choose to pay for additional private care.”

Do I need a GP referral for private treatment? – NHS -Yes, but expect poorer communication.

What is an NHS Private Patient Unit? – NetDoctor

[PDF] Interface between NHS and private treatment: a practical guide … – BMA

[PDF] Defining the boundaries between NHS and Private Healthcare • The Warrington CCG…

Treating private patients in NHS hospitals – benefit or cost? — Centre for Health and Public Interest

[PDF] NHS treatment of private patients: the impact on NHS finances … – Centre for Health and Public Interest

As it gets worse, YOU are going to have to wait longer and longer – or pay up. A “grim reality”..

The evidence basis of all practice(s) needs to be challenged – continuously. There are perverse Incentives in private systems, but why do the UK health services still overtreat?

NHS rationing: hip-replacement patients needlessly suffering in pain on operation waiting lists

Orthopaedic waiting lists: time for more, and equal access to, non-urgent centres

2014 !! South Wales NHS: Plan to centralise services on five sites


This entry was posted in A Personal View, Consultants, Medical Education, Perverse Incentives, Post Code Lottery, 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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