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Readers' letters

Letters to Health Service Journal's editor.
  • Falls prevention: how to slash the NHS's £2bn bill

    31-Oct-2014 11:00 pm

    Agreed. We must get the NHS to once again share and sustain best practice and deploy evidence-based ways of improving the quality of patients' lives, and save money to boot!

  • Roundtable: Where should Care.data go from here?

    31-Oct-2014 10:51 pm

    Does not sound like this round table had any robust discussion, merely seeking consensus. What gives the DH/NHS the right to give or sell information about me to anyone not directly treating or caring for me? Yes, we might expect clinicians & medics to know what we need & what we have had, but that does not necessarily mean we want academics or insurance companies having access to our records. And, even when things do get out of hand, there are no consequences for anyone who was trusted to safe guard our privacy. The ONLY way the public can be expected to accept the risks & to support the potential benefits of this scheme is informed consent to opt-in. Anything less would be unethical if not illegal.

  • Why no one is responsible for ensuring best practice in hospitals

    31-Oct-2014 10:28 pm

    If the roles of CEO or MD are corrupted as described in the above comments, then we must ask how good is the Chairman? And, if the latter is complicit or inept then we really do need to get NHS organisations that are more publically accountable via more powerful Councils of Governors. Then, there will always be "someone you can go to" who does not have a career to protect & is passionate about the quality of care their hospital provides [or CCG commissions].

  • Majority of HR managers would support imposing a contract on doctors

    31-Oct-2014 9:41 pm

    Very very bad experience with the BMA. Not only did not support me but was acting when the Trust was calling them up and repeated requests from me went unheeded. I actually thought of suing them at one point. I still might ! On HR Managers, will be interesting to know how many of them would like a contract imposed on them. I would really also like access to their diaries to see exactly what they are doing.

  • Hunt: NHS has 'responsibility' to help councils

    31-Oct-2014 8:55 pm

    This is so silly. Hunt talks of "celebrating the success" of the Better Care Fund, when it is only just beginning. Based on what? Predictions of half a billion savings. says who? Fantasy economics. Council budgets have been cut by 25 -25% forcing them to employ companies that employ carers at less than the minimum wage with little training and support. And this fund - which is just moving money out of the NHS and which will destabilise the NHS further - is meant to do what? Make up in some way for the cuts to levels of care? Bring the quarter of a million no longer eligible for care back into care provision? Stop people being admitted into hospital? Yeah, right. What we need is a few more zero hour carers to diagnose and treat people at home. Or perhaps Hunt doesn't mean that. He thinks district nurses will do it - even though their numbers have been depleted by 40% in a decade, or maybe GPs will do it - even though they are already at breaking point. Plus there is no evidence that community based care is cheaper, or that it prevents hospital admissions, so where he thinks half a billion will be saved is anyone's guess. And that is probably what it is - a guess. The reason that the NHS and Councils argue is not because of some "clash of cultures" but because they are both incredibly cash strapped so are desperate to pass costs on to the other. Hence the dreadful arguments about whether something should be counted as health or social care. There is no hope for integration of either commissioning or provision of health and social care until personal social care becomes free like health care (as in Scotland). That is the only basis for integration - otherwise the arguments will continue. Hunt talks about the funding settlement for local authorities as if it is some act of God and nothing to do with him or his party. Yet it is a political decision to cut funding for local authorities and one he should take responsibility for as a member of this government. We are one of the richest countries in the world and the rich are getting richer, despite austerity. We spend less on health and social care than many countries spend just on health care. We could spend more - it just takes political will.

  • Burnham fills in the blanks on 'reform without reorganisation'

    31-Oct-2014 7:26 pm

    Problem with NICE guidelines are two fold at least: 1. They do not del with situations that arise when one has worked through them (sounds obvious but the question of what to do when one has worked through them is salient here). 2. Can't get them funded in child/adolescent mental health... often would love to implement the NICE guidelines but do not have the resources....

  • HSJ Live 31.10.2014: Ministers take first steps to imposing a contract deal on doctors

    31-Oct-2014 7:20 pm

    Re: The seven day per week contract. The difficulty appears to me to be that there are simply not enough senior medical staff to cover the system as it currently exists. If the 7 day per week contract is imposed is imposed presumably most people will have to come off the EWTD. Will there not be major problems in getting back up from other services? What will happen to investigations etc? For once I think the medical negotiators are right about an issue. This is about patient safety rather than the doctors being unreasonable. It may be possible to have 7 day normal working in all hospitals but it is difficult to see how. As far as imposing contracts is concerned I thought that this had been done a long time ago... Who is ngotiating the main substance of their contracts currently

  • First foundation trust takeover approved

    31-Oct-2014 5:08 pm

    the £100m is incorrect- its closer to £300m

  • Exclusive survey: HR managers back end to pay restraint

    31-Oct-2014 5:05 pm

    HR staff will of course support a course of action which gives them an easier life. Unless the Government changes its position we should look to break up A4C giving key clinical staff more and other staff, who tend to be easier to recruit, less. Otherwise the concept of any pay award is simply not affordable.

  • BREAKING: Ministers take first steps to imposing contract deal on doctors

    31-Oct-2014 4:52 pm

    Anon 4:30 I disagree that private practice is fine. To me it is private practice which is the root cause of waiting lists in the NHS, there is a clear and unambiguous correlation between the Private income earned by the private practice to the size of an individual consultants NHS waiting list. It cannot be right that an NHS consultant can reduce his work rate in an NHS Trust, knowing full well that to meet RTT targets he will be paid far more to either treat that patient in his local private hospital, or be paid considerably extra to treat in the NHS hospital. As you say their NHS salaries are pin money when compared the amounts they earn from private practice. However, no private hospital will allow a consultant to practice there without either having or recently held an NHS contract, the reason being this is their governance process to ensure competent surgery. For most of these private hospitals, if anything does go wrong then the patient is transferred straight to an NHS one. I am sorry, but I do not agree that major teaching hospital consultants earning millions of pounds from private practice each year is comparable to other professions. Especially when consultants like yourself, presumably with a similar amount of training and dedication accept the NHS salary is sufficient.

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