English NHS doesn’t need polyclinics, study shows

So, will New Labour’s plans to open up GP services to big business be halted by the facts? Obviously not, but it is worth noting who the victims will be in this case (aside from the patients who might suffer worse services) it will be middle-income professionals.

Consider also that the English NHS is controlled by the British government. Would an English parliament make it easier to resist corporate takeover of public services? Who knows? But it is interesting that polyclinics are not being considered in Scotland or Wales…

From the BBC:

Average-sized GP surgeries are just as good as “super-surgeries” at providing extra services, a study suggests.

Ministers in England have asked health chiefs to create a network of polyclinics to provide extra care, such as diabetes clinics and minor surgery.

But a Kent-based GP’s study of 384 practices found no difference between the range of extra services offered by standard surgeries and polyclinics.

The government said polyclinics would provide a valuable service to patients.

Every NHS trust in the country has been told to set up at least one polyclinic, with a whole network being created in London.

Ministers believe the super-surgeries are the best way of moving care out of hospitals and into the community.

But the study by Dr Hendrik Beerstecher, who specialises in research, found large surgeries already operating were no better at providing the specialist care the government is so keen on.

He looked at the range of extra services, beyond the average package of GP care, being provided by a range of different-sized practices up to ones serving a population of more than 30,000.

He found small surgeries – classed as having fewer than 6,300 patients – tended to provide less diverse extra services.

But once the threshold of 6,300 was reached – the average size for a practice in England – there was little difference no matter how big the surgery was.

On average, these had between 10 and 11 extra services.

‘No evidence’

Dr Beerstecher, who is not a member of the British Medical Association, the doctor’s trade union body which has campaigned against polyclinics, said: “I am not sure why the government is pushing ahead with polyclinics.

“As the study shows, there is no evidence that they provide more services so why are we having them set up all across the country?”

Dr Richard Vautrey, the deputy chairman of the BMA’s GPs committee, said: “This proves what we have been saying all along – that we should not be rushing headlong into setting polyclinics up.

“GPs have always been innovative. You do not need a big surgery for this to happen.”

Church leaders in Christmas criticism of “free” market

Credit is due to Cardinal Cormac Murphy-O’Connor, leader of the Roman Catholic Church in England and Wales:

“Christianity neither condemns nor canonises the market economy – it may be an essential element in the conduct of human affairs.

“But we have to remember that it is a system governed by people, not some blind force like gravity.

“Those who operate the market have an obligation to act in ways that promote the common good, not just in ways that promote the interests of certain groups.”

Admitting he was “no expert” in economics, he said he was unable to “ignore the damaging consequences of volatile financial markets” on his fellow human beings.

The Cardinal is clearly not an expert, as he freely admits, but his sincere comments are welcome.

To stop the deepening economic crisis and ensure it is not repeated, we need to extend democratic control into the economy, empowering workers to make decisions within and between enterprises. This means an reversal of privatisation, and a proliferation of worker co-operatives in place of joint-stock corporations. it is apparent to people that the super-rich have no morality, and they must give up their power over our economy.

And credit is due to Archbishop Rowan Williams, leader of the Church of England, who has also been critical of the market madness. He urged solidarity with victims of the recession in his Christmas message:

“In the months ahead it will mean in our own country asking repeatedly what is asked of us locally to care for those who bear the heaviest burdens in the wake of our economic crisis – without waiting for the magical solution, let alone the return of the good times.”

Drop the dead dogma – privatisation isn’t efficient or cheap!

Two items from Tribune on health and education show that New Labour are far from burying the failed neo-liberal model.

First, healthcare:

UNISON has urged the government to rethink its whole approach to NHS reforms in the wake of a damning new report on the cost of commissioning and outsourcing in the health service.

The public sector union has called on the Secretary of State for Health, Alan Johnson, to concentrate on giving NHS patients the care they need and deserve – as well as ensuring the taxpayer gets real value for money – rather than using health service reforms as a smokescreen to outsource or privatise services and “throw precious money away to the private sector”.

The call comes in the wake of a hard-hitting new report – called Driven by Dogma – from the Office for Public Management. In a damning verdict it says outsourcing in the NHS has failed to deliver value for money, proper patient involvement or improved working conditions for staff.

The Government’s pre-Budget report made much of the potential efficiency savings to be made by the NHS from shared service operations with the private sector. But first hand evidence in the new report, examining the experience of those commissioning and delivering services, reveals that promised cost benefits have failed to materialise and quality has suffered.

Unison general secretary Dave Prentis said: “At a time when finances are increasingly tight, the NHS cannot afford to be throwing precious money away to the private sector and wasting time and resources on the complexity of the commissioning process.

“Patients want more involvement in decision-making and staff want to spend more time on providing excellent patient care rather than tendering for contracts.

“Unfortunately, this report shows that the various reforms to outsource or privatise parts of the NHS are working against these goals.”

The union says there are realistic alternatives – Scotland has recently announced it will no longer permit any contract cleaning and Wales has done away with the purchaser-provider split in favour of a more sensible and user-friendly integrated system.

Second, education:

TRADE unions have hit out at plans by the Office for Standards in Education, Children’s Services and Skills to privatise parts of the schools inspection service.

According to a leaked memo, Ofsted intends to outsource inspections of early education and childcare provision early next year.

It says privatising early years inspections – which ensure nurseries, pre-school provision, summer play schemes and childminding services are safe and secure and meet educational standards – will “provide better outcomes and save money” but Unison, the PCS and the FDA senior civil servants’ union say the idea is wrong is principle and bad in practice.

Unison national officer Jon Richards said: “It is outrageous that Ofsted is privatising early years inspections. Parents need to have confidence in the inspection system and know their children are safe and will be well cared for.

“There is a very real danger that jobs will go and the quality of inspections will fall if the focus shifts from raising and maintaining standards to cutting costs and making a profit.

“The decision to privatise inspections has serious implications for staff, parents and children.”

PCS national officer Neil March said: “Introducing the profit motive into inspections, combined with the naive belief that ‘the market’ has all the answers, will end in failure and further demoralise dedicated staff. It will lead to corners being cut and a loss of expertise.”

The unions think Ofsted wants to “wash its hands” of staff. Mr Richards said: “It has hundreds of equal pay cases outstanding and this is a crude attempt to deal with the problem as the workers pursuing these claims will be the ones to go.”

Devolution for England, a modest proposal

Here’s my submission to Compass’s How To Live In The 21st Century project:

Devolution for England

“It’s worked in Scotland and Wales!”

Contrary to the opponents, an English parliament would provide constitutional balance within the UK; an English parliament would have a progressive majority.

2. How does it fit with Compass’ core beliefs of equality, solidarity, democracy, freedom, sustainability and well being?

An English parliament would give England the same kind of representation that Scotland and Wales were granted in the late nineties and put an end to the anomaly of England-only laws being voted on by MPs whose constituencies lie in Scotland, Wales, or Northern Ireland.

It would allow the articulation of a civic conception of English national identity – based not on race and exclusion, but on place and participation – as has happened to some extent in Scotland and Wales.

The arguments against: it would make no difference to ordinary people; it would encourage the break-up of the UK; and it would reduce England to Tory domination.

3. How does it build the institutions of social democracy, like social groups and collective and cooperative forms of ownership and control?

An English parliament will provide a focus for those issues that are currently decided by the British government – which is comprised of MPs from across the nations of the UK – issues such as healthcare and education.

The establishment of devolution involved referenda in both Scotland and Wales; there is every reason to expect that there would be a public vote within England on the question of a national parliament and this will reinvigorate a sense of popular soverieignty, perhaps leading to more decisions being made through the use of plebisites.

4. How much will it cost or raise and where will any cost come from?

An English parliament could sit in the Commons at no extra cost.

5. Which groups in the electorate are likely to support or oppose this measure? Is there any polling evidence you have on this?

In November 2006, an Ipsos Mori poll for the Sunday Telegraph found 68% support. In January 2007, a telephone survey conducted by ORB (Opinion Research Business) for the BBC last year found that 61% of people in England were in favour. In April 2007, an opinion poll conducted by ICM for the Campaign for an English Parliament found 67% in favour.

Opponents have long suggested that an English parliament would lead to the break-up of the UK, but polling suggests greater support in Scotland and Wales for an English parliament than for either nation’s idependence!

6. Is there a place or country where it’s worked? Please provide some information.

As above, it has worked in both Scotland and Wales.

7. What are the three main arguments in favour/against it?

The arguments in favour: it’s popular amongst the general public who have seen the benefits in Scotland and Wales; it would allow decision-making on issues specific to England; and it would lead to the transformation of the UK into a federal republic.

English water, anyone?

The Stonemason has blogged about the eagerness of the Adam Smith Institute to see Glas Cymru (which owns Welsh Water) subjected to the “disciplines of private sector ownership”.

While it’s no surprise that they are calling for a successful publicly-owned company to be used as a cash-cow for shareholders, I feel I must unpick this particular assumption.

The issue of “discipline” relates to the principle-agent problem. How can those running a company be held accountable to its owners?

The Adam Smith Institute may argue that privatisation has been a wonder – but this is only true for shareholders. And some of these shareholders are ordinary people who are facing huge bills because of prices that go up when costs go up and stay up even when costs go down – yet they cannot as shareholders demand this of the company.

Because Glas Cymru is a company limited by guarantee its purpose is not to maximise the dividend paid to shareholders but to meet its objectives of providing high quality water and sewerage services to customers. This year each customer of Glas Cymru will recieve a dividend of £21.

Now, I’m not saying that it has the most socially-just model of ownership.

The company’s workforce – and the employees of contractors – should be regarded as stakeholders just as much as consumers. The objective of high-quality service cannot be met if workers are disempowered; good wages, working hours, and democratic representation ensure that high standards are maintained.

The remit should also include efficient use of energy and minimising any negative effects on the environment or natural wildlife.

Though Glas Cymru may not be perfect, it looks a damn sight better than what we have in England! We are being told that the only way to lower our bills is to have the profiteering water companies competing with each other. We have this with our gas and electricity suppliers – but do our bills come down? No, they compete with each other to squeeze as much money out of customers!

Privatisation has been a disaster. Public assets sold off at knock-down prices to the friends and sponsors of the governing party (Tories, now New Labour). Prices have been allowed to skyrocket -natural monopolies are milked for profit by colluding suppliers in gas, electricity, and railways. Rather than seeing greater private investment in our railways, more public money is invested in rail than ever before!

The likes of the Adam Smith Institute can try all they like to convince the public of the benefits of handing public resources over to big businesses. Their nonesense is only heeded by those politicians hoping to get cushy non-jobs in business after they leave office.
We need to return the privatised utilities to public ownership and democratic control, with the involvement of workers and consumers in the process of management.

Surveys of public opinion have never found a clear majority in favour of privatisation – and with the credit crunch being perceived as resulting deregulation and demutualisation, more and more people will begin to see the necessity of reversing the neoliberal era.

Privatisation of water and sewage services did not take place in Scotland or Northern Ireland. Scottish Water is owned by the Scottish government and both the incumbent nationalist party and the opposition Labour Party are committed to the company remaining in the public sector. The Scottish Tories are for privatisation, but are at pains to point out they don’t want what has happened in England! Northern Ireland Water priovides water and sewage services in the six counties; like Scottish Water it is still part of the public sector.

So, there’s Northern Ireland Water, Scottish Water, Welsh Water – how about English Water?

England needs a health minister

Oh god. Ben Bradshaw again, knocking the Welsh Assembly Government’s policy of booting profiteers out of their health service, something far more popular than flogging bits of the NHS off…

Note that the BBC wrongly reports that he’s the English Health Minister. Mr Bradshaw is English, but he’s a minister in the British government – there is no devolved administration in England, unlike Wales. (Sadly, the absence of an English parliament is not pointed out) Note also that Labour shares power with Plaid Cymru in Wales – Bradshaw is attacking the policies of his own party!

Cardiff-London tensions re-ignite

An English health minister who criticised health policies in Wales has returned to the attack.

Ben Bradshaw told a conference the English NHS provided a better service despite spending less per patient than the health service in Wales.

Mr Bradshaw attacked Welsh policies of free prescriptions and free hospital parking again and said ruling out using the private sector was “dogmatic”.

The Welsh Assembly Government said it was “putting the patients first”.

Earlier this year, Mr Bradshaw sparked a row between the assembly and UK governments by saying the money spent on free parking would be better spent on improving patient care.

His keynote speech to a CBI conference on health in London on Thursday threatens to re-open tensions between Cardiff and Westminster.

He told delegates the benefits of the English approach would become clearer in time.

He said he was “fed up” with being told that England suffered from health apartheid “because millionaires in Wales get their prescriptions free or Scotland plans to allow anyone who wants to park in busy hospital car parks for free.”

Mr Bradshaw said: “What about the fact that in England you can get your operation much more quickly, you don’t have to wait for more than four hours in A and E any more and it is easy to see a GP when you want?

“These things matter more to the public. We are already delivering them in England and we have been doing so while spending less per head on health than in Scotland and Wales.”

‘Widely welcomed’

Responding to the criticism, an assembly government spokesman said: “Devolved government means that each administration is free to pursue its own priorities.

“Mr Bradshaw is entitled to his views.

“Free prescriptions and parking reforms have been widely welcomed by patients in Wales.

“We are putting the patient first and removing barriers to accessing healthcare.

“We see prescription and car parking charges as a tax on the sick.

“Investment in improving access to healthcare will improve the health and well-being of the people of Wales.”

At the Plaid conference this weekend, Adam Price called on Welsh Labour to break free from Westminster. Certainly, at the moment it’s path is leading away from New Labour. If only English Labour would do the same…

On your bike, Cameron

He’s had his bike nicked, of course, but that’s beside the point.

Here’s the point(s).

Dave’s trying to convince us he cares about working class families by promising to fund a 100,000 apprenticeships if he wins the next election. ‘Cause, like, they’ve done a lot for the unemployed in the past… (Cameron and his “New” Tories were on the scene when the Old Tories were in office. The economic policies haven’t changed, and won’t change under another Tory administration.)

He’s so committed to saving the discredited centralised British state that he’s working on a merger with the Ulster Unionists – well, it’s not as if the Tories are having any luck in Scotland or Wales. Since the UUP is the second-largest unionist party in the North of Ireland, it would appear the Tories are not having much luck in Ireland, either.

And despite his talk of empowering people, Cameron is said to have overruled the Welsh Conservatives‘ support for a petition on the Welsh Assembly becoming a full parliamentary body.

And don’t worry, I’ll give Gordon Brown a literary kicking on the morrow.

Follow

Get every new post delivered to your Inbox.