NEWS
Healthcare experts call for new direction for the NHS T
he NHS would become both more cost effective and equitable if it
were operated on its founding principle of co-operation rather than competition, a group of medical bodies, unions and healthcare experts have said.
In a joint statement – the result of a round table event to discuss alternatives to the market model for the NHS in England – academics and campaigners from the BMA, NHS Support Federation, NHS Consultants Association, Keep our NHS Public, Unison and others, call for:
• New mechanisms to allocate
NHS funding more equitably and efficiently: the document calls for funding to be allocated on the basis of population need rather than activity by trusts.
“It warns that the present payment by results / tariff system is “based upon narrowly defined episodes of care”, can “generate perverse incentives in patient referrals” and does not encourage “the pursuit of unmet need”
• An end to the purchaser- provider split: abandoning the purchaser-provider split in the NHS would be likely to generate substantial savings, the document says.
• A new vision of what ‘choice’ means: the statement says there is a distinction between choice as a lever for competition, and choice as the capacity for patients to make informed decisions about their own care. It says that unfettered patient choice as it has so far been conceived in the NHS is not what most patients want.
Dr Hamish Meldrum, chairman of council at the BMA, said: “The BMA, like many other groups, has long been concerned at the costs and perverse incentives resulting from the market structure that has been imposed on the NHS. Many of the reforms of recent years threaten to erode the principles of free
access, care based on need, and risk-pooling.
We need a democratically accountable, local approach to healthcare delivery, with funding based on the needs of patients, and providers encouraged to co- operate rather than compete.
“At a time of real economic challenge to the NHS, our proposals will maximise the effective use of scarce resources and help to ensure that patients get the services they need.
“We urge the coalition government to be true to their word and listen to the views of front-line health professionals.”
Employers set to help NHS staff blow the whistle E
mployers in the NHS are being urged to build a culture where staff are able to expose
bad practice in order to make the NHS the best health service in the world.
A new guide, Speak up for a Healthy NHS, will advise employers how to set up arrangements to ensure staff feel comfortable and secure if they want to report bad practice.
The guide, launched at the NHS Confederation’s annual conference, will also help employers to review current whistleblowing arrangements so staff can raise concerns about malpractice or potential risks to patient safety.
Secretary of state for health, Andrew Lansley, said: “Publication of this guide is an important step in developing a culture of patient safety. NHS
4 nhe
staff need to be free to raise concerns and shielded from any backlash. To make sure staff know about their rights, and are supported, the local NHS must champion this guide in their own organisations.”
The guide is designed to help employers, working in partnership with the trade unions, to achieve best practice when devising, implementing and auditing their whistleblowing arrangements.
It was commissioned by the NHS Social Partnership Forum (NHS Employers, NHS trade unions and the Department of Health) and has been written by the independent whistleblowing charity, Public Concern at Work.
The pack looks at what is expected of NHS boards and their executives, and publicises the availability of support for staff from the independent
telephone helpline run by Public Concern at Work with Department of Health funding. It sets out some simple steps to help employers ensure their whistleblowing arrangements work.
Gill Bellord , director for core services at NHS Employers said: “NHS Employers supports NHS organisations in promoting a climate of openness in which staff feel free to raise concerns in a reasonable and responsible way, without fear of victimisation.
“We believe that in most organisations there are effective systems in place in the NHS to allow staff to raise such issues however there have been a number of high profile cases where this has not happened.
“As such this guide has been launched to help ensure all employers are aware of what
they need to do to ensure their organisations have fostered the right environment for raising concerns.”
Karen Jennings, chair of the NHS staff side on the SPF, said: “Too often there is a climate of fear within the NHS that makes it difficult for staff to raise concerns about patient safety or malpractice.
“The NHS trade unions welcome this guidance as a tool that will promote a culture of openness so that everyone understands the process for raising concerns within their organisation.
“We strongly encourage local employers to work with the trade unions in partnership to promote this guidance so that staff will feel confident about raising issues of concern without fear of exposure.”
Jul/Aug 10
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