COMMENT BLOGS
March 20 Quality, not quantity
Would guaranteed minimum numbers of nurses ensure adequate provision of care to elderly patients?
The RCN has stated that a lack of numbers is making it difficult to spend the appropriate amount of time caring for older people. But strict regulations on how many nurses must be working on a ward at the same time may not be the only way to deal with this issue.
More nurses, although a simple demand, is not always the best answer. Having a greater number of nurses who are not sufficiently motivated to provide good care, for example, would not bring any benefits to patients.
Making sure that the nurses who are recruited perform their job to the best of their ability would be a better place to start, and would make the most of the NHS’s current resources.
March 13 Backtracking
It is time to stop ‘polarising’ the debate on the Health and Social Care Bill, the RCGP has stated, just ahead of the legislation’s last stage before becoming law.
Despite its outright opposition to the Bill, and especially its elements of competition, the RCGP says it must now begin to work with the Government on implementation in order to move forward without harming patients.
This is a tricky manoeuvre to accomplish, as the organisation and its individual members will keep criticising the legislation, while needing to implement it effectively if patient care is not to be affected.
Many GPs do not think the Bill will succeed – and some commentators have suggested that doctors will actively sabotage the implementation to ensure it does not. But as Dr Gerada notes, doctors are not politicians – they must work within the framework set by the Government to the best of their clinical ability. Anything else could severely compromise public trust.
March 6 Over and over again
Detached observers could be forgiven for being confused. The latest batch of amendments to the Health & Social Care Bill are said to be to fix problems that we were told were fixed months ago when the Government accepted the recommendations of the NHS Future Forum report.
On the role of Monitor, and competition – and recently on the Secretary of State’s responsibilities too – we’ve been here before. The Bill is now a mess, with many of its former supporters walking away, and a good deal of those unhappy with it on competition grounds unlikely to ever be placated unless most of the Blair-era reforms are undone too.
Ministers say legislation is still necessary, in the face of calls to abandon the Bill and simply implement what they say are the key parts of it – around clinical commissioning and devolving power – using statutory instruments and departmental instruction.
The lack of a decent reply to this request, which the politics of the situation would seem to demand, does imply that the Bill was always more about the competition and private sector involvement than it was about ‘handing power to family doctors’.
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14 | national health executive Mar/Apr 12
Change is necessary in the NHS. Opponents can keep talking about the lack of demand for such change from the public, and the relatively good performance of the NHS according to many international measures, but these, crucially, do not address the future problem of limited resources but spiralling demand. The problem is that nobody now seems to know what this Bill is for, and how it addresses that challenge – which will be far, far harder to tackle if managers and clinical leaders in the NHS are still resentful over the botched reforms.
February 15 Plastering over the cracks
David Cameron’s forthcoming ‘pledge’ to tackle binge drinking is well-intentioned, but may be a sticking plaster approach to an issue which needs a deeper cure.
Cleaning up the mess once people have drunk too much is necessary, but until people learn to change their habits concerning alcohol, it will continue to cause expensive damage.
Using ‘drunk
tanks’
to allow
drunk people to sober up will mitigate some of the social costs that alcohol brings, in the form of violence, abuse, crime and antisocial behaviour. But it will not deter people from continuing to drink irresponsibly.
Neither will extra police patrolling the wards. Solving this problem must go much further, working with the drinks industry to restrict the availability of alcohol, and with the people who misuse it. Identifying who abuses alcohol and why would allow a targeted campaign to change their behaviour.
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