THE DE-SKILLING OF THE NHS

Closing hospitals and shoving their work onto GPs

Minor surgery such as hernia repairs and varicose vein removal will be carried out in family doctors’ surgeries instead of in hospitals under plans to be announced by Patricia Hewitt, the health secretary, this week. Ministers believe that up to half of the 45m hospital outpatient appointments can be dealt with by GPs and nurses in local health centres. It will save the National Health Service money by freeing up hospital beds which cost about 300 pounds a day. Ministers say surgery in local health centres will make better use of highly trained GPs and be more convenient for patients.

Lord Warner, the minister for NHS reform, said: “The rationale behind providing care closer to home is to make better use of highly specialist skills . . . this will involve (having) GPs who are as skilled with the scalpel as they are with the stethoscope.”

Hewitt will also announce plans to free up hospital beds by discharging patients early with a telephone number for a nurse in case they have a relapse. The health secretary will say patients are likely to make a speedier recovery in the comfort of their own homes. A trial of the dial-a-nurse plan has already been carried out at the Royal Hampshire county hospital in Winchester. Bowel cancer patients have been discharged from hospital early and told to call if their condition deteriorates.

Cancer patients will be given chemotherapy in their own homes as part of the drive to reduce the amount of treatment carried out in hospitals, which are expensive to run. The changes will also reduce the risk of patients catching hospital-acquired infections such as MRSA. Hewitt pledged to move treatment out of hospitals in the government white paper Health Outside Hospitals, published in January. The plans may prove controversial when some hospitals are either downgraded or closed.

David Nicholson, chief executive of the NHS, warned that some hospitals will need to close. Last month he said that there would be up to 60 “reconfigurations” of NHS services, affecting every region in England.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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