Europe needs to get real on defence; Britain needs to get real on Europe
13 February 2025
Welcome to new website
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Post
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26 August 2010
First of all, if you still can't read it on a blackberry or an iphone ... I give up.
Second, thanks to those who in the past few weeks have been sending me messages saying how much they missed my blog. It is very kind of you, but I think you need to get out more.
Third, thanks to those who sent kind messages about my daughter's double leg-ankle fracture whilst we were on holiday in France. It was not exactly the best way to spend a holiday, but she was pretty amazing once she got over the shock, and I have nothing but praise for the French emergency and health services.
We were staying at a modestly remote house in a fairly small village not very near to any large towns, but the 'sapeurs-pompiers' (the French double up on fire and ambulance duties) were there within twenty minutes, and had her in hospital within an hour or so. The first hospital could do the diagnosis but not the operation, which took place at a second hospital the next day. Good surgeons, a terrific anaesthetist (I had a bias in favour of him because he was a French player of the Scottish bagpipe) and wonderful nurses and support staff. We even had a view of Mont Ventoux from her room to remind me of the cycling I was missing.
But there are two other groups of people I should mention. Both tend to get a bad press most of the time, but they were really excellent. The first is our insurance company, Assistance International, who not only helped on the financial side but were regularly on the phone to tell us what should and should not be happening. The second was the dreaded 'health service bureaucrats' with their accounting devices and clipboards.
Grace was in hospital for almost a week, and whenever the surgeons did their rounds, there would be a manager alongside them as part of the team. The NHS spirit in you might summon up images of pre-Obama, US-style 'your dollars or your life' type treatment. But what was perfectly clear was that just as in our system, you need proper management and proper managers, so in an insurance type system, you need the same thing. They were completely integrated into the medical side of things, which were managed in the real sense of the word.
Since returning to England, and struggling at first to get her inside the system quite as well and as quickly as we had done in France, we have nonetheless had the chance to hear quite a few opinions about the planned Tory reforms, and in particular the idea that GPs should have far greater say in the actual running and management of healthcare beyond their traditional role.
The very strong sense I get is that very few GPs actually want it, and that for many services - not least mental health, and this is a real worry - they do not feel qualified to take on the responsibilities they look like being asked to.
And on the issue of managers, it is the easiest thing in the world - and doubtless I did it myself when I was on The Mirror - to say doctors and nurses good, penpushers and bureaucrats bad, but what has been very clear from recent experience of both systems is that the good of one cannot properly be harnessed without the good of the other.
There can be a debate about the quality of the managers and the systems they devise, on which we have had our own complaints in recent days. But that the managers matter, and that the NHS cannot function properly without them, is surely beyond doubt.
Anyway, it is nice to be back. I am still raising money for Rethink via copies of All In The Mind, and if I had listened properly when they showed me how to use the new website, I would be able to put a link in there for you to click through to. But I can't. One step at a time. If this is working properly, there should be something on the page to take you to Rethink. Many thanks to the Rethink team who organised the booksigning we did at Charity Towers yesterday, which went well.
My other big charity news is that Kevin Spacey no less has agreed to do an event for Leukaemia and Lymphoma Research, on which more later.
Meanwhile, if you have any comments on the new site, feel free.
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glad to hear all ended well re daughter..you do realise of course that the french health system though very efficient is extremely expensive….i pay far more in contributions than in the UK and also you pay a daily rate when in hospital of €20 per day (around £115 per week)…. in addition i have to pay a “complementaire” private health insurance as the ordinary national health insurance does not cover all the costs…
I assume you’re probably aware, but the links at the bottom (Twitter, Facebook, Youtube, et al) don’t work.
Nice site though, much easier on the eye that the old design.
Am reading on iphone … you listened!! Even if you took your time.
Good idea not to kick off with a blast at Cameron and Clegg … though I hope there will be some of those coming
I think that your new website is great.It’s eye-catching without being gaudy. Very easy to follow and easy on the eye to read.
An interesting array of topics from you on so many subjects.The links provided are good..I like how you give positive exposure to charities
As usual, the narrative in your blog is excellent.Your blogs never fail to raise a smile as well as provide thought-provoking matters to consider. All done in your own inimitable style.
Welcome back !
Kevin Spacey!! Keep me posted
Yes I like this new website, it’s well designed and easy to use. The links are dodgy though. An interesting round up of news and I hope to see some Tory bashing and some (brief) mentions of Burnley.
Welcome back.
To nitpick: over on the right where you have links you have Time For Change which I suspected was Time to Change
I loved the new site! Clean and easy to use!
Congrats!
GP Commissioning is not the issue. The issue is that the government wants to take away all public responsibility for healthcare provision. EVERY hospital will be a private business and taken out of public ownership (they are called “social enterprises” to make them sound more acceptable, but they are still private businesses). This will have a profound effect on healthcare provision in this country. We have NO indications of what it will mean. The dangers are huge. This de-nationalisation of hospitals will have serious effects on pay bargaining, pensions, job mobility, standards and training. These plans will plunge healthcare into chaos for five years.
Nowhere in the world has anyone ever done this on an organisation that has 1.4m employees. Imagine what would happen if every Asda, or Tesco supermarket became a separate, independent company, each one with a different recruitment policy, pay scales, opening hours, and each one needing separate IT infrastructure, procurement, legal and training. It is unlikely that Asda or Tesco will ever do this because the costs will be so high. Yet this is exactly what Lansley is doing to NHS hospitals.
Andrew Lansley is the Dr Beeching of the NHS.
I’m not sure all the Tory plans on this will actually happen … They must know too that very few doctors actually want or think they could run hospital services. But the backstory here is the desire to get more private sector involvement in the actual running of the NHS. Whether that is closer to France or America I don’t know
I would like to believe you. GPs are worried. They are worried that the white paper sections 4.4 and 5.12 “GP consortia will align clinical decisions in general practice ***with the financial consequences*** of those conditions” will mean that patients will see them as rationing healthcare. They are worried that as independent contractors, there will be an intrusion of the state in their businesses by the Treasury insisting that the Commissioning consortia are statutory bodies. They are also worried that PCT deficits will be transferred to them, so they will start by being responsible for a debt they did not create. (Yet section 5.14 says that the government will not bail out commissioners in debt.)
So yes, you can bet that some of the policy will change (expect Lansley to provide more money up front for GPs – pieces of silver, if you like). But he will not compromise on de-nationalising hospitals.
The involvement of the private sector is an interesting one. The private sector is too expensive. The ISTC programme was a failure because the private corporations charged more than NHS providers, cherry-picked patients (so difficult cases were referred back to the NHS) and even though they never fulfilled their contracts they were still paid 100% of the contract.
Further, Lansley’s plans to change the calculation of the tariff (the money a hospital is paid for each treatment performed) from being the *average* cost across England to the *lowest* means that hospitals will be paid less (one commissioner told me that the tariff will be regarded by GP commissioners as the *maximum* when negotiating, so the actual payment may be less). The private sector have said that they cannot do the work for the rates that Lansley is planning.
So how can he get more private sector involvement? Simple (and here is the connection to Alistair’s blog): co-pay. Expect some time in the next year or so for a law to be passed to allow co-pay and specifically for private providers to charge top-up fees on top of the NHS tariff. Cameron will finally have the big idea that he created for the 2005 election (Patients’ Passport) implemented.
Welcome back. Cyberlife gets more interesting again.
GP commissioners blew their budgets by a net 2.5 per cent last financial year, according to exclusive analysis by the Health Service Journal. Need one say more?
Love the new website Alastair, much easier to access. I’m one of those who missed your blog and admittedly do need to get out more!! Looking forward to reading more.
Nice site and welcome back.
I can not only read it on my iPad but can now express my technological smugness in comment form.
Hi Alastair.Nice Blog!. Keep up the good work for Leukaemia and Lymphoma Research 🙂
Andy Ward
http://www.scirocco2morocco.blogspot.com
Glad to have you back I was going into cold Turkey.
The diet of the current silly season rubbish is very depressing…too many lazy journalists who cant be bothered unless they can get the script directly from the Minister.
They work now 🙂
Great that the blog is back! And even better than before.
Much better. Clean, modern, uncluttered… and easily readable on mobile.
Well done and welcome back.
Site looks a lot better nice to have you back
Glad your daughter is OK
We all pay for health care ….you either pay in taxes or pay in insurance, their are no such things as free operations (sorry).
As an intensive care clinician I am concerned that a service which a GP may not have a patient using in a year will get lost and forgotten too.
And as an anaesthetist pleased we are just as good in France as the UK 🙂
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