I’ll start with the comments on the latest article. I’m too focused and passionate to get sidetracked, but not too dispassionate and curious to care.
I’m really surprised to see this published by the Fabians, which is nominally at least a democratic socialist movement, Whilst well written, turning healthcare further into a market commodity is something that even many Conservative voters aren’t comfortable with- and for good reason.
A basic look at global healthcare models shows that, excluding the admittedly successful French system, the majority of top ranking models have less private sector involvement than the perceived UK model. The poor performing US system shows that private healthcare is not necessarily more efficient than a nationalised state model. Private companies will provide the worst quality goods at the highest price they can get away with due to the centralisation of profit. The concept of competition is farcical as the heathcare market which will evolve in the private sector is likely to engage in mass collusion, as is apparent in most oligopolies globally. There is already competition from the private sector in the form of private healthcare which is forced to retain a relatively good economic model only due to the NHS’ fierce competition.So why then has this myth of the benefits of NHS privatisation appeared? Look at the number of Conservatives with a vested interest in private health care providers and it makes more sense.
I agree with Alex on this issue. Not only is it surprising coming from a young Fabian, but worryingly shocking as well. Healthcare is not a commodity and if the private sector wants to compete then it should be competing against a well run state healthcare service.
The British public pay less per capita and get more out of the NHS than most other healthcare systems, especially the American model. The private sector will try do less at a higher price. Already there are problems emerging at NHS Trusts that have privatised certain aspects of their services and the problems will only continue as it is carried out further.
The neoliberal approach to services has been shown to be a failure and we, as young Fabians and Labour voters, should be countering this vision rather than trying to make it less bad. Healthcare is about helping people and providing care, not profiting off of other people’s ill health and misery.
I have no problem with using private healthcare suppliers in the NHS. I think the key challenges are how they are managed effectively and how transparent this arrangement is to the general public i.e. us.
My problem with the Health and Social Care bill is that it will cost too much to do what could have been done by evolution rather than revolution. The NHS Outcomes framework would have been a step forward in the old structure. By wiping out the SHA’s and PCT’s a lot of knowledge and skill was lost. Whilst some of this is probably going to retained within the Commissioning Support Units and The National Commissioning Board it is a disruption we could have done without.
The jury is out on the Clinical Commissioning Groups and whether they serve the public or serve themselves.
By Adebusuyi Adeyemi.
In the latest installment of the Focus on Health and Society Series by the Health Network, Adebusuyi Adeyemi argues it doesn’t really matter who provides your healthcare.
A few weeks ago the Health Network held a debate around the ideology of private sector involvement in the NHS. The best compliment I can pay (and it isa compliment) is that I had such a massive headache afterwards. Rarely has my mind been so stretched, by so many sharp minds. Or maybe it’s all the daytime Judge Judy turning my brain into slush? Regardless, arguments for and against the motion of whether it matters if [more] private enterprise supplies healthcare were keenly exchanged, whilst the House of Lords voted for Section 75 down the corridor. Can you can guess what end of the spectrum I sit on…?
The NHS has always relied on private contractors. Many GPs are self employed and hold contracts, either on their own or as part of a partnership with the NHS. Dentists, Pharmacists and Opticians are nearly all privately owned. Similarly, it is private contractors who provide almost all of the IT equipment, build the hospitals and make the drugs. All our health related data is held on private companies’ machines. Heck, when the government tried to deliver a coherent IT vision, it failed. Admittedly because the private sector had already delivered on a lot of it and fought hard to maintain its share. Still, ‘privatisation’, strictly speaking should be viewed as what it is: the transfer to the private sector, of services which were previously provided by a struggling public sector.
Not sure where I stand yet? How about if we consider the hypothetical of owning a clothes shop. This is the only clothes shop in the city. Our clients/customers have no choice but to shop here, irrespective of the choice and quality of clothes we offer. If, however, we find that another shop is opening next door to us, providing nicer clothes for the same price or cheaper, with more choice, then that will force us to change the quality of the garments and the level of service that we offer; otherwise we’ll rapidly go out of business as our competitors will take customers away from us. If you haven’t figured it out yet, I support the idea that it doesn’t really matter who provides your healthcare, as long provided (and regulated) well it is.
Now, for all my spiel of corporate involvement, I don’t worship at the feet of the private sector, nor advocate the full disembowelment of the NHS. ‘Slippery-Slope’ arguments aside, regulating private providers properly in any sector is the responsibility of the government and this must be done, and done well. We can’t trust the Coalition Government to regulate private providers so that only people in the south are looked after, or that health inequalities increase. Still, we must give the principle of private-provider involvement a fair hearing.
The Health Network and guests recorded a draw for the motion on the night, which was in stark contrast to the votes counted from the wider community online. As a strong supporter for the motion, I was pleased to see a few people warm to the philosophy of increased private sector involvement, proving discussion is key to advancing thought in this space.
Introducing competition will mean the NHS will be forced to increase the quality of the work that it does otherwise an external provider delivering a better quality service may be appointed instead. From a business perspective (and the government’s perspective) this makes sense as it weeds out poor performing providers, replacing them with better ones (and if there are no better providers, then the current providers will remain in place).
There are many caveats to add to this piece that time (read word limit) doesn’t permit. From ensuring the principles of greater equality of power, wealth and opportunity are maintained, to detailing how our value(s) of collective action and public service do have a place alongside a more competitive NHS, there’s more I wish I could say. But this brief piece is only to stimulate thought, I hope it does.
What if only one chain of universities supplied doctors? Or only one drug company was allowed to make N-acetyl-p-aminophenol (paracetamol #Geek)? Unions, Socialist Medical Groups and others are right to assert the Health and Social Care Bill will result in increasing privatisation of the English NHS. In fact, this is in keeping with the “supply side” economic policies of this government, which promote privatisation throughout the entire public sector (Royal Mail, Urenco and the Met Office to follow soon).
However, there is an idea that needs to be considered seriously, that it doesn’t really matter who provides your healthcare.
Adebusuyi Adeyemi is Chair of the Health Network.
The debate was organised by the Secretary for the Health Network – Lauren Milden and chaired by Ivana Bartoletti of the Fabians Women Network.
Looking through my blog, a friend was surprised I hadn’t made any mention of my Young Fabians life on here. Well, that made the two of us. So before my next piece goes up or before I delete this blog (I genuinely don’t know which will come first), here’s a piece I wrote with one of our members:
By Richard Stebbing with additional comments by Adebusuyi Adeyemi.
In the latest installment of the Focus on Health and Society Series by the Health Network, Richard Stebbing looks at whether the NHS can become a successful business.
If the NHS were a normal business, then given its tumultuous performance so far in 2013, its share price would have probably fallen. Of course the NHS is a business, but given it is in the business of protecting the nation’s health, with its fortunes so closely woven to that of the Government it is a unique one. We know that the NHS is underachieving in terms of productivity and it is under pressure to be financially prudent in the face of ever increasing demand; whilst the recent findings of the Francis Report on Mid Staffs have underlined how factors of care and compassion cannot be discarded. Therefore we must consider how the NHS can be a more successful for its customers, employees and employers. Its shareholders, customers and investors, try figure out who’s who! Answers on the back of a postcard.
Making sure people are good at their jobs and doing jobs that are needed
So, considering the NHS is like a modern business. Considering it rewards key staff for good performance and it evolves, developing new areas of business. One glaring deficient area is in retraining or making redundant staff that are no longer required in their present roles. Now the premise of cutting necessary staff from the NHS is one that rightly fills many with dread. However cutting unnecessary staff – well that is something that makes good business sense – especially good business sense when it is us that is employing them, and that this is public money that can be used for ‘better’ things. Ask almost anyone that works in the NHS and they will tell you that administration is bloated and can be reduced. A solution is restructuring and reappraising NHS non-frontline teams and making staff reapply for these new roles if reductions in team numbered are deemed necessary. If we are serious about the NHS being a productive, successful business, then unnecessary staff is an opportunity cost that has to be considered.
Adapting GP surgeries for the 21st century
Most people now use the internet as the basis for all communication and arrangements in their social and professional life. Yet for most people the most advanced aspect of NHS services is receiving a text message reminder for that upcoming appointment or renewing their prescription online. Yes, yes, we know the more technologically savvy are messaging on other platforms like Whatsapp and Facebook. Still, there is significant inefficiency and wastage in not making adapting more services and logistics in the NHS to take advantage of internet technology.
For example, create a web-based GP booking as the default booking service. It is simply inefficient to have the default method of booking as phone-based when the technology for patients to complete web-based forms on their symptoms and select available appointment time slots exists online. Crucially this would mean that patients can book appointments 24/7 – i.e. when they fall ill – rather than when the GP surgery is open. This would reduce this burden for administrative and supporting staff in GP surgeries, especially in the 15 minute window when a GP surgery opens, and would mean that these staff are freed up to help the running of the surgery in other ways throughout the day.
Such a system could also be used to coordinate bookings with specialists and consultants, which if made more interactive, could help patients attend and cancel appointments they cannot make thus ideally meaning that these appointments could be allocated, say via email, to other patients in need at short notice.
Another simple idea is allowing patients to register with a GP online. When the process essentially involves proving one’s address via an official letter and completing a basic health questionnaire, why does this have to be done in the GP’s surgery? Doing this online would save time for the patient, who might otherwise have to take time out of the working day, and also GP surgery staff.
Using technology to aid patients in self-care
Another area where technology can be embraced is around patient self-care. In 2011 I (Richard) had the misfortune to contract Bell’s palsy for around 3 months. My GP at the time was helpful and gave me some printed information on the condition. However I received no information/advice around necessary items of self-care that I would need to undergo, such as taping one’s eye completely shut on a nightly basis.
I found useful information in this area, by a chance YouTube search after a few days, and research for this article demonstrates that similar information is also available for other conditions. Given that most patients do not master aspects of self-care on day one (for the record I was waking up each morning with my eye un-taped and open at first); technology here can help reduce patient follow-ups and can help them recover quicker and better. This also embraces technology; this form of advice needs to be more interactive than a piece of paper. So why not have health professionals email relevant self-care information to patients? I am not suggesting that patients are emailed arbitrary links, but why not have NHS-branded self-care videos either using actors or volunteering patients under supervision? It would be cheap and very useful to many patients. It would also save on GP printing costs! Isn’t the NHS in the business of being useful to its investors, shareholders and customers?
Richard Stebbing is a Young Fabians Member and Adebusuyi Adeyemi is Chair of the Health Network.
For more information on the Young Fabians’ Health Network email Adebusuyi: email@example.com.
Got thrown a surprise birthday dinner when I came back from my trip to Oslo. Which, I truly truly, seriously, this is it this time, hope is my last trip away by myself. As one grows more into themselves one becomes more and more confident to explore and do things. Maybe it manifests itself through social activism and awesome experiences when travelling, even more so this time around… But I really hope to be able to share these with someone. Maybe I’ve been hung up on the idea of trotting off on adventures with my future wife/soulmate/partner I’ve neglected to think she might be doing the same thing right now! And even if she isn’t, there are boyfriends I’ve grown up with that could be just as fun to travel with.
I unfortunately timed my trip with the international rock festival Inferno and… I’ll leave the stories off for now, but suffice to say, no more hostels for me. Like the branches of a tree, we all grow in different directions yet our roots remain the same. No friendship is an accident. Time to reach back and out and remember who the true friends are.
As I overlooked beyond to the new West Ham stadium. I remembered the many times I bump into people at our home games. I remembered the children I teach at the Sunday school at my church. The word ‘community’, like an obvious plot-twist exploded onto the screen and I remembered my personal statement in my application to study at business school. Some pretty lofty and ambitious words fell on that page. Words like community featured heavily. Busuyi, I thought. You might as well fully enter that renaissance attributed to most mid-to-late twenty year olds who start realising their place in this world. You’re right I said. You can’t stay in your corner of the Forest waiting for others to come to you. You have to go to them sometimes I said.
Consider our average lottery winner. Quite a few end up blowing their millions in a few years because their mindset is to spend everything they have on the most utility. When most people buy a house, they get the biggest they can afford. If they get a pay rise, they go out and buy a new car. And when that’s not enough, they take out credit to buy more stuff.
To the entrepreneur this is madness. All money is a means of making more.
Financial restraint. The budding entrepreneur delays their own gratification to maximise return. Develop skills that compound. Entrepreneurs even think of their own skills as an investment; whatever time they put in should have the greatest possible return.
Own assets that compound. The sweat of your own brow will rarely make you rich. As entrepreneurs soon realise, the most efficient vehicle is generally ownership of a company; your own efforts combined with others. Or spunk it all on trips around the world. It’s difficult to glean anything of value from the herd mentality, so I take a plane to Oslo for a quarterly review session of one. I went out with a group of people one night and could swear, I could swear I was in a penthouse apartment. Yet I woke up the next morning in a Norwegian suburb. I was too scared to find out how I got into the house so I grabbed a bread roll and ran out.
I sit down with executives of big drug companies and talk about white spaces they can invest in -That’s empty places filled with the promise of $$$. I ride up mountains to find white spaces of the mind, beyond the concrete jungles of east London. I worry every time the onslaught of Facebook on life continues as it weakens my position to avoid it. Who wants to consume other people’s thoughts and lives in such a forum all the time? So I climbed a mountain, or two, and almost got lost in a foggy hue on the way up. I was squinting so much, I wish I bought sunglasses with me. Its bright and lonely at the top, but who doesn’t like challenging their environment to figure out it’s secrets?
I met a girl who knew 6 languages, the daughter of a diplomat and a devil of an accomplished horticulturist.
And, well, a little while ago I read a study on sex trafficking that made my heart grieve. I remembered it and tried talking to them about their lives, but they wasn’t to trust a stranger. When you climb the ladder of success, be sure it’s leaning against the right building. One day it’ll all make sense
“I’m puzzled by people, loving isn’t easy, you can’t Google the answers to people’s feelings.”
Always providing the lyrics to whatever I’m feeling.
“Sometimes, you have to find out for yourself. Sometimes, you need to be told