Aaaand 100k.

http://epetitions.direct.gov.uk/petitions/22670

Tomorrow's PMQT should be good chat.

Aaaand 100k.
http://epetitions.direct.gov.uk/petitions/22670

Wonder if Cameron will just repeat his line that opponents of reform should "grow up"...

The government's health reforms run a high risk of reducing levels of safety and patient care while leading to overspending, internal NHS reports have warned.

The potential for conflict between NHS organisations in the new system and upheaval during the transition is high, according to risk assessments drawn up by the four English NHS regions. There is also a high chance the reforms will fail to achieve hoped-for management improvements and budget cuts, they say.

Some of the anticipated problems are rated at the highest risk category, "significant", and many others are considered "high risk", even after mitigation measures designed to tackle the issues raised, and despite all actions taken after previous risk reports last autumn.

The warnings – dated January and not due to be updated for three months – will be in place when the controversial health and social care bill becomes law, provided the government succeeds in getting it passed before Easter.

According to the report for the north of England, risks rated 15 or higher are considered "significant" and coded in red; those from 8 to 12 are judged "high" or amber risk. In the north of England officials warn the risk of achieving "productivity gains at the expense of quality", defined as "safety, clinical effectiveness and patient experience", rates as 12 – a possible event with major impact – even after the mitigation actions so far chosen are taken.

The same report warns of a similarly high risk of "organisational and system instability" damaging management and governance, and uncertainty caused by the changes that could reduce the capacity and capability of staff and organisations.

Lower rated problems – still considered high risks – cover a wide range, again after existing mitigation, including a "loss of grip on current performance", that "safety is compromised by lack of clarity on accountability, poor morale, and loss of knowledge", that the benefits of the reforms are not achieved, and there is a loss of public confidence in the NHS.

In the Midlands and east of England, officials are most concerned that a combination of targets to reduce spending, and the management changes, will cause upheaval during the transition, and similarly warn of worse quality and safety, conflict between organisations, neglect of primary care, overspending, and failure to meet key targets such as limiting the number of patients who wait more than 18 weeks for treatment.

Moderate risks in the region include loss of key personnel, staff working in "silos" and so not co-operating as they need to, a rising risk of fraud, lack of clarity about structures for commissioning treatment for patients, staff distracted or overloaded by the upheaval leading to worse service and higher sickness levels among health service staff themselves, confused and unclear accountability leading to "organisational and system failures", culture clashes, "mission critical" staff leaving, lack of leadership skills among key staff, and loss of confidence among clinical staff leading to the reforms failing.

Allyson Pollock, professor of public health at Barts and The London School of Medicine and Dentistry, said the Health and Social Care Bill had "a hidden purpose" which amounted to privatising health services in Britain.

Writing in The Lancet, she argued that ministers were intent on creating "a system that permits alternative funding sources for services currently provided free as part of the NHS

The Department of Health has apologised after documents sent to the Guardian showed that contrary to assurances given to parliament, more than 25 senior staff employed by the department are paid salaries direct to limited companies, with the likely effect of reducing their tax bills.

In some cases, the documents show the named individuals are being paid more than £250,000 a year, as well as additional expenses. The payments amount to almost £4.2m in one year.

The department claimed the 25 were not civil servants, or technically even staff, although a large number have been employed by the department for many years and hold very senior positions. It said the arrangements will be subject to review by the Treasury.

One Whitehall source said: "We cannot defend these arrangements, but it may be it is very common in Whitehall and this is just the tip of an iceberg."

Danny Alexander, the chief secretary to the Treasury, set up a cross-Whitehall review this month into the extent of the pay arrangements after it was revealed the Department for Business, Innovation and Skills had sanctioned a similar salary deal for Ed Lester, the chief executive of the Student Loans Company.

At the time it was presented as a rare practice.

The single largest payment was £273,375. Nineteen of the staff are paid more than £100,000.

In the majority of payments at the DH, the fees were paid to companies with the same address as the home address of the staff.

It seems to me there are seven reasons that can be put into plain English that wavering MPs, jobbing journalists and the public will understand.

1. The Bill replaces three levels of management (DH, SHA, PCT) with Seven; (DH, NCB, 4 Clustered SHA, 50 Commissioning Support groups, 300-ish CCGs, Clinical Senates and HealthWatch.)

2. GPs cannot 'do commissioning'; it is too complex, they can't fit it in part-time and look after patients. They can and should influence local commissioning decisions.

3. The complexity of buying healthcare is recognised by the DH who have invented Commissioning Support Organisations (not in the Bill), to help. They are intended to be private companies who will decide what healthcare we can have and pocket any savings.

4. The Coalition has not saved millions in bureaucracy; they have shifted costs by sacking really experienced people who are now being re-hired to commission care on behalf of GPs.

5. No one is really worried about the 'private sector' per-se. But, if you spend £100 on healthcare in the NHS you get one hundred quid's worth of healthcare less about 5% management costs. In the private sector you'll get a hundred quid's worth less 3% management costs, 5% profit, 12% to pay bank loans and charges, plus a chunk for bonuses, dividends and return for investors. And, no provision for what happens if they go broke or get fed up.

6. There is no increase in patient choice; we are all stuck with our local GP who is stuck with his local CCG who are stuffed into CSO's who will decide what we can have and when we can have it. All the decisions about us are being made without us.

7. The NHS will function perfectly well without the Bill; it is performing pretty well now and can coalesce around what it is doing. But, waiting times are on the way up and we are getting fatter and older. The Bill does nothing about any of that and the Service should be allowed to concentrate its efforts to meet those challenges.

Seven simple, uncomfortable, irrefutable truths you can pass on if you are of a mind to!

Now, what happened upon David Cameron's entry into the hospital itself, was until now, difficult to publicly confirm. 4 staff members have made their stories known privately but all are reluctant to come forward because they fear for their jobs. However, we do have the public account of a visitor to the hospital that day, and the account of a patient whose brother contacted me to give me an update on what went on at the hospital. It makes for interesting reading. My private sources tell me the Prime Minister got a bad reception. Much of the staff ignored him for his entire visit and he had to be closely guarded by police security. A young visitor Alexander Hay, who can be followed at @Alex_Hay tweeted about the Prime Minister's visit real time. He stated that he heard a nurse say to the PM "'I am vehemently opposed to reforms they're bad for patients and bad for care". Alex also confirms that the Prime Minister simply ignored the nurse and refused to reply to her. This cannot be verified by a journalist because they were locked in a room. But two further sources further reveal that the PM received a verbal volley from one staff member who had to be 'led away'. I am told that that staff member is facing disciplinary action. A senior NE Health Source was contacted last night by a health campaigner for an update of events that day, the reply stated the following, "I heard it went badly, that is all I can say".