UK Healthcare Reform: 25 Proposals Towards Real Effectiveness – John Gelmini

Chief executive of the NHS

Chief executive of the NHS (Photo credit: Wikipedia)

I thank Dr Alf for reblogging the article entitled “NHS waiting list at five-year high as cost-cutting reforms strike – Health News – Health & Families”  , published in the Independent. I empathize with Dr Alf’s conclusion, namely:

Thanks to three years under David Cameron‘s leadership, the NHS is beyond reform and must be replaced

Let me try to pick apart the ineffectiveness of David Cameron’s reforms of the NHS and then offer twenty-five policy proposals towards real effectiveness.

The so called NHS reforms to date are nothing of the kind and what has been done is too limited, too late and done in the wrong way.

In addition, NHS reform cannot be done in isolation but must look more widely at prevention and other actions in wider society which have a direct bearing on the number of people needing treatment.

The original Lansley reforms were scuppered by Sir David Nicholson, the eminence grise, behind the Staffordshire Health Trust debacle and David Cameron caving in to pressure from the BMA, the consultants, the Health Care Unions and saying “We have to listen to the healthcare professionals” whilst leaving Lansley swinging in the wind.

Sir David Nicholson, after receiving a huge payoff in the form of rewards for failure, was said by one wag to be “A tough act to follow”.

This sort of elevation of useless performance and praise for a man who should have been dismissed for incompetence and sent packing empty handed needs to stop forthwith but, of course, when these people” know where the bodies are buried” in the form of Ministerial incompetence, civil service bungling etc.,  they only go AFTER their silence has been bought.

Requirements for Effective Reform of UK Healthcare?

1) A preventative health care strategy, plus variable taxes on foods, zoning laws to discourage the opening of fish and chip shops, fast food outlets, burger bars and any establishment selling cigarettes, rolling tobacco and fizzy drinks

2) Limits on sugar and salt content in food

3) Banning Bisphenol A, e numbers,Sodium laurel sulphate, aluminium, aluminium derivatives and other dangerous chemicals, elements and substances from the food chain, food packaging and cooking utensils.

4) Improving hospital food, and compelling the NHS and civil servants to treat food as part of healthcare

5) Reduce NHS management layers to 4 and impose an 80% reduction in overall manager numbers

6) Merge the NHS and Adult Social Care budgets, clear out unnecessary local authority staff

7) Centralise and improve purchasing with rotating panels of providers operating to global best in breed standards

8) Use Kaiser Permanente Health Care Apps to encourage diet and exercise amongst the population

9) Renegotiate the BMA out of hours contract with GPs, sack and replace dissenters

10) Expand the number of expert systems in areas like surgery so as to weaken the power of consultants to create waiting lists and thus enrich themselves via their private practices

11) Pay GPs on the basis of the number of people they keep well and clear out malingerers and people trying to extend their holidays from GP surgeries so that the genuinely sick can be attended to

12) Stop building houses near aircraft flight paths where Antimony from the aircraft fuel causes dementia

13) Stop building houses within 1 kilometer of electricity pylons as is the case in Russia where the practice is banned because of the cancer producing properties of electronic fog caused by high voltage power lines

14) Promote traditional marriage in the tax system (evidence shows that traditional marriage is the key to long life and decreased morbidity)

15) Put Rife Machines in all cancer wards as happens in Germany where cancer treatment outcomes are far better than ours

16) Make food manufacturers put vitamin B17 into all processed foods and reduce fat content to minimum levels

17) Build an NHS target operating model on French,German and Italian lines borrowing the best features of each to best in breed standards(say Lean /EFQM) coupled with TOC/OODA LOOP and independently audited customer satisfaction measures

18) Limits on the use of gagging orders and proper protection enshrined in law for whistleblowers who expose corruption, malfeasance and bad practice in the NHS

19) A new PHI/PPP profitability formula which allows reasonable profits to be made but which is transparent and fair to taxpayers

20) Curtailment of the revolving door which allows senior NHS managers to leave on Friday with a large payoff and reappear days or weeks later as a consultant for the NHS often doing the same job for much more money

21) NHS interims and managers to be drawn from sectors OUTSIDE of the NHS to stop them “going native” and accepting what they are told by insiders

22) The Big 4 consultancies and major systems integrators only to be used on parts of the NHS too large to be dealt with by smaller less expensive practices, rather than being given carte blanche by lazy civil servants engaged in back scratching and with an eye to a future in one of those consultancies when the time to return the favour draws near

23) Train NHS doctors to American standards and intensify the regime of CPD and peer review to improve diagnostic capability

24) Plant minimum numbers of trees along motorways around industrial estates,power stations,airports and cities to clean the air

25) Back our farmers with lite touch regulation and move towards food self sufficiency rather than importing food which because of freezing, long food miles, handling and warehousing, is neither fresh or of high nutritional value

Unless NHS reform is taken seriously, as a matter of urgency, I fear that Dr Alf may be right in that the the NHS will need scrapping and replacing with a completely new twenty-first century public healthcare system.

Any thoughts?

John Gelmini

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A Hard Look at the Politics of the UK’s NHS – John Gelmini

Second Life: National Health Service (UK):

Second Life: National Health Service (UK): (Photo credit: rosefirerising)

To be fair the decline of the NHS started under Gordon Brown with the inception of the Wanless Review which injected £7 billion gbp into the NHS, none of which produced any productivity improvement and any benefit that might have ensued was eaten up by increased wages and NI contributions.

The rot continued under David Cameron when instead of backing the Lansley Reforms he started a process of “listening to the healthcare professionals”.

This “listening process” was to yield to pressure from Sir David Nicholson the disgraced NHS Chief who allowed the terrible events in Staffordshire and needless deaths elsewhere to occur on his watch.
The satirical magazine Private Eye ran a story before Andrew Lansley’s removal as Health Secretary demonstrating how Sir David Nicholson was deliberately undermining the reforms particularly to the “commissioning ” processes.

Instead of backing his Minister David Cameron sacked him and replaced Lansley with the more telegenic Jeremy Hunt and then continued to have complete faith in Sir David Nicholson a man who should have been dismissed for incompetence and bungling without any compensation and personally surcharged.

The NHS does need complete reform starting with the removal of all but 4 layers of management and continuing through to the merger of the Adult Social Care and NHS budgets.

It does not need to be privatised but does need hard commercial focus in procurement particularly in the area of purchasing drugs which are up to 2000% too expensive (See article in the Independent).

Some things like printing, cleaning, parking, the typing of patient notes,grounds maintenance,IT and administration can be outsourced and strategically in-sourced and hospital consultants cannot be allowed to create waiting lists to build their private practices.

This last objective can be achieved through the use and application of “expert systems” to enable more specialist work to be done at lower cost and with fewer people.

The NHS needs to focus more on stopping people from getting ill in the first place so measures here would include:
–Variable taxes on foods
–Teaching people how to cook
–Encouraging people not to drink on an empty stomach
–Promoting exercise and vitamin supplementation
–Reintroduce Vitamin B17 into our diet
–Opt out of Alimentarius Commission directives on food and supplements
–Forcing the NHS and civil servants to see food as part of a person,s treatment
–Refusing operations to those people who are smokers or morbidly obese until they stop smoking or reduce their weight
–Paying doctors for keeping people well not the size of their patient lists
–Teaching people a Stoic philosophy ,Zen,meditation and NLP so that they are better able to cope with the vicissitudes of life
–Tax breaks for PMI policies
–Promoting traditional marriage in the tax system and discouraging bizarre and unusual lifestyles which produce dangerous health outcomes and lead to greater mortality at an earlier age Note:In this regard traditional marriage leads to the longest and most healthy lives,stable cohabitees live the next longest along with spinsters and single men especially if they are out of work die the fastest.
–Stopping any further moves to make divorce or cohabitee breakup easier ,cheaper or faster and sacking /retiring early those judges in the Family Court Division who want to bring in American style “No fault divorce”
–Using work scheduling software in hospitals to roster nurses and doctors to meet peaks and troughs in demand
–Weeding out malingerers in GP surgeries
–Making people more responsible for their own health
–Removing, as far as possible salt, sugar, additives and harmful chemicals from food, drinking water, air and the environment
–Banning the use of amalgum containing mercury for dental fillings
–Planting more broad leaved trees around roads,motorways and industrial areas
–Putting air cleaning FICA plants in offices and factories
–Stop building any houses within 1 kilometer of an electricity pylon or sub station(banned in Russia because it causes cancer)


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