Does Mark Britnell have the solution to the NHS 'crisis'?

[MrBates2]

The Foundation Trust Network has been gathering in Liverpool for its annual conference against a background of drift and crisis in the NHS. Like soothsayers in the dying days of a crumbling empire, the service is beset by reports and speeches predicting collapse. Harder to find are leadership and answers.

No week would be complete without another report telling us how many billions of pounds the NHS needs to save, how quickly it needs to do it, and how little chance it has of achieving it. This time it was Monitor's turn, with chief executive David Bennett warning that "the NHS must undergo radical change if it is to survive".

After many years of substantial improvements, mental health services are sliding into disarray. Research by the BBC and Community Care revealed average occupancy levels in acute adult and psychiatric intensive care beds of 100% – a crisis by any definition. Patients are in danger.

NHS England said this week that "London's hospitals are at breaking point". Just in case the message was unclear, it added that breaking point state of affairs was unsustainable.

Meanwhile NHS England chief executive Sir David Nicholson has been warning of the risk of a financial "cliff edge" as a result of the government's decision to establish a pooled "integration transformation fund" between the NHS and local authorities worth £3.8 billion in 2015-2016.

In a telling sign of his inability to control policy in the face of political interference, Nicholson was reduced to stating "my view" about what the money should be spent on – predictably light on social care – in a letter to NHS managers.

Just seven months after the reforms were put in place, bits of the system are already dying off. Another commissioning support unit is on the verge of collapse – this time Anglia – and more can be expected to follow.

Competition law is, predictably, playing havoc. The Health Service Journal revealed that the rules have derailed two major pathology organisations, trusts are being compelled to spend astonishing sums on legal fees to fight their way through the competition thicket in their efforts to respond to precisely the challenges laid down by Monitor and many, many others.

What is lacking is any sense of a way out of this mess. NHS England, after early signs that it would retain the "grip" personified by Nicholson, seems to have lost its way.

 

[oggbashan]

The 'Elephant in the room' of the NHS that cripples many NHS trusts but is rarely mentioned is the financial burden of PFI - The Private Finance Initiative.

Hospitals and facilities were modernised by borrowing money at high interest rates. Politicians of all parties jumped on the PFI bandwagon because they could announce new hospitals, modern hospitals, and better facilities by mortgaging the future.

The costs were and are enormous, so high that many hospitals cannot afford the staff costs to run their new facilities, so they sit idle but still cost the hospital massive sums.

Until those historic debts are removed from the current accounts of the NHS the financial crises will continue to occur. The debts are unsustainable - yet rarely mentioned.

PFI assumed that smaller, older, inefficient hospitals would be closed and specialist facilities concentrated in the new buildings. Yet every proposal to close a hospital is met with screams of outrage, often led by the very same politicians who signed up to the new builds.

We can't have our cake and eat it - unless we are a company that provided the finance under PFI. They are laughing all the way to the bank, getting returns that almost company would kill to get.

Sort out PFI - and the NHS would no longer be staggering from crisis to crisis.

 

[JAMESBJOHNSON]

I have a theory for government failure: Half of every dollar allocated for a task or program is lost to theft or malpractice. And every task and program requires twice the funds estimated.

 

[Beco]

and we have Obamacare...........