Saturday, 5 February 2011


I was speaking to my GP last week, and she mentioned the English Health Service reforms, saying that all her practice colleagues were hoping that they would never come to Scotland. I feel the same way. I want her doctoring, not managing, and even more so now that she told me she was pretty useless at admin, but I know she’s a smart cookie when it comes to healing.

It seems that many people in England feel the same way about the English health secretary Andrew Lansley's plans. His scheme has united doctors, health think tanks (and the right-of-centre think tank Civitas), unions representing the 1.4m-strong NHS workforce, health academics, MPs on the health select committee, the NHS's major employers, and patients' representatives in opposition.

Even David Cameron's brother-in-law, an NHS cardiologist, thinks the government has got it wrong, but predictably Mr Lansley and Mr Cameron intend to press on regardless, certain as they are, that they know best.

I’d be interested in finding out what other people think about this, particularly if you are English and are going to have to live or die by the totally new NHS that will emerge, and in any case, is this the right time to start messing about with something that will certainly cost a vast amount of money to set up?
But also if you are Scottish. The NHS has been carefully protected by the current government in Scotland. Is this a good thing? Do you think that it is fit for purpose in the 21st century, or has this government ignored the facts, as explained by Cameron, that in its current state, the NHS will simply not be able to survive? What do Scottish Tories think about their English colleagues' plans? And if you are Welsh or Irish, what kind of NHS do you have, and should it change?

These are extremely important issues for the whole of the UK, lives being dependent upon them. I have no idea what Labour’s proposals would be for the Health Service, but I feel that this will be an important issue in the debates leading to our General Election.


  1. Yes cast iron is fully qualified and experienced to transform the NHS in England. What with his background in PR and his penchant for watching 'Casualty' and being chased round the nursery by matron when he was a nipper.

  2. I knew he would have the experience from somewhere. it's good to know that it is all for the benefit of the health service and nothing to do with ideology though.

    Winston, step lively with the physical exercises. 1-2, 1-2, out, in....

    Oops, did I just let something out there? Did you not know we were watching you?

  3. Tris, as someone who has used NHS Scotland quite a bit ow years for one or two things and who also has recent knowledge of care in the community and hospice care, it is my belief that all the services are fabulous. I further believe that it is the mark of a mature society that it looks after it's sick and old.

    No one complains about the cost of the NHS when they are being wheeled into theatre after having a heart attack.

  4. Good points well made DL.

    I too, for the first time a couple of years ago, had experience of the NHS. I make no bones about the fact that my stay in Ninewells Hospital was a complete nightmare, with dirty wards, dirty cleaners, and surly, dirty and unpleasant nurses. Not to mention some half wit doctor whose cack handedness has left me with horrible pain which will never go away, BUT when I was transferred to Edinburgh, I can't describe how much better it was. Wonderful staff, clean wards, agreeable doctors, edible food... and only a few mistakes. And that happens when staff are as rushed off their feet, as they were.

    When our health service is bad, it is very bad; when it is good, it is fabulous.

    What I don’t get is this “choice” thing. What you want when, as you say, you are on a trolley, is “good”, not bloody “choice”.

    Hope you don't have to go back though DL. However good it is, it's not like home.


    A good article here on some of the dangers in Cameron's plans.

  6. winston ( no not exercising try again ) smithFebruary 06, 2011 12:45 am

    " What I don’t get is this “choice” thing. What you want when, as you say, you are on a trolley, is “good”, not bloody “choice”. "

    Yeah it's a scam. How do we know what we want ? It's like a car mechanic asking you if you want the bosch or the ngk spark plug. Most folk ( who aren't sad like me) wouldn't have a scoobie. It's all done to make us feel like we're getting something special.
    A bit like the MSP's expenses are 'all online for us to peruse'. You would need a PHD in dodgy databases to find out what the weasels were scamming from us.
    They take us for fools basically.

  7. The problem with the NHS is that it's helping too many people with their illnesses, but it's just not making enough money off of them. Hopefully the Tories will really lay into the NHS and make sure that those doctors rake in the cash off the sick, being that they're so well-off, the benefit cheating, lower class immigrant paedophile scum.

    Oh wait, no, that was my Daily Mail voice. I would like to know, really, what sensible person suggested 'hey, you know doctors, those people that study medicine for years, we should put those guys in ADMIN!' Clearly they're wasted in politics, and should be writing edgy comedy for Channel 4.

  8. Yes, absolutely Winston Lazy Git You're Coming to a Bad End Smith :)

    Don't give me a list of hospitals and the relative benefits, or downsides...just get me to the nearest one, and please I hope it's not a really dirty one....before I die.

    Dead right, even if it is elective surgery, or out patient treatment who really just want a good hospital. If they were all good there wuldn't be anything to choose from....

  9. Daily Mail readerFebruary 06, 2011 1:02 am

    We could harvest our prisoners organs like they do in China. That would make a lot of money. Especially for fat arabs needing liver transplants after drinking the infidel ales and spirits.But our lazy sod prisoners lie about all day eating pies and watching tv so would be full of fat and useless so that wouldn't save eff all.
    Could get the buggers out jogging and cleaning the streets and when they pass their basic fitness test we could stun them and cut them open as required. Make a bloddy fortune.

  10. Lordy Laz, for one horrible moment I thought melanie Phillips was writing on the blog...

    Smart huh, 7 years study about bones and blood and organs and all that, then a two hour course on admin and related computing and you're off.

    And can you imagine how these semi-private hospitals will stick it to the doctors when it comes to fees?

    The whole idea really is Pythonesque

  11. " Smart huh, 7 years study about bones and blood and organs and all that"

    And my GP still logs onto google to find out what's wrong with me !

  12. Dear Daily Mail Reader,

    I think what we should do is round up all Daily Mail readers and then all the Daily Express readers and...put them on a conveyor belt into an electricity generating plant. The money we save on coal, we could put into the NHS.

    Oh yes, and politicians on Sundays...

  13. Who needs Google?

    I could tell him Monty...

  14. Daily Mail readerFebruary 06, 2011 1:41 am

    My mum gets the Express ( for the crossword).
    Wait until I tell her what you said !

  15. Oh, and if you're wondering about the state of the NHS in Northern Ireland, it's generally the same as in the rest of the UK quality-wise because of stupidity about quotas, but also has a simply lovely exacerbation of the rural/urban divide thanks to the fact that only the major hospital in Belfast has the equipment for anything serious (and in fact a lot of really critical patients have to be airbussed across the sea to other areas of the UK)... and let's not even mention the startling divide between green and orange :P

  16. What worries me is if labour get in here in May then we will go down that road. It takes responsibility and accountability away from government.

    Also the thought that my GP would want to be sitting in meetings all day. She hates them. She's young and says they'd emigrate to Australia if there was the slightest whisper of this in Scotland. We're already losing far too many of our brightest young medics.

  17. The NHS is a fine national asset which serves those who need its services very well in almost all cases.
    It really is simply that seeing such a big organisation with so much funding - the private sector want to eat that particular cake. That is all there is to it.
    That's why you're never short of NHS attacks in the press, but when talking to people you know, you usually find it almost universally respected.
    That's why the privateers running the country keep having to push the big lie that Cameron and Lansely feed us.
    Ben Goldacre debunks Lansley's 'evidence' lies here -

    One last thing - this is why I'm keen to see the NHS protected at this particular time - if it isn't soon we'll find the narrative that drives any further decision making on the NHS straight framed by the English model. This is being attempted with the higher education debate, and such efforts should be resisted everywhere (the media won't do it) - it's the eternal slippery slope of unionism.

  18. Of course we don’t know what Labour will do here, other than put up the council tax. Their programme so far is rather thin on....well content!

  19. I think the NHS is coming to a terminal end the fact is Cameron is only carrying on a process which was being pursued under Labour.

    In ten years from now it will not exist at all
    just a version of American style medical care
    and far more seriously ill UK peoples.

  20. MR Mx

    Just goes to show that only morons would even think about voting Labour after all the harm they have done to the NHS, the Economy, and just about everything else in the UK.

    Thank god Brown was not Scottish, these North British bas***ds will do you down every time.

  21. Dear Daily Mail Reader,

    Obviously your mum is the exception. Duh!

    Yours sincerely


  22. LOL Laz, I did wonder about that. Green and Orange nurses!

    I thought that they might have escaped the quotas having been free of Labour rule, but I forgot that they were ruled from London for a while, so they will have had English Labour targets foisted on them.

  23. SR, I'm glad to hear that my GP isn't the only one. Like yours, mine is young, and her husband is a doctor too. The loss of young medical talent to Australia is a very serious problem. They seem to be able to sit back and leave Scotland to do all their medical training for them.

    We must press Labour to tell us what they would do with the NHS if they were elected in May. It could be crucial to the vote. So far, as on most things, we have no idea what they stand for. I suppose that they are waiting for Ed to bed in and then give instructions to that little bloke with the grey hair they have in charge here.

  24. anon(or yellow dog coward as we say)

    Don't denigrate the moron vote there are a vast amount out there and a lot vote snp/conservative

  25. Pap: I suppose that there is always the danger while we are joined at the hip that we will have to follow the English model, because out funding depends on their model. Now of course this could be a good thing, because, if, as I suspect, all of this messing with NHS England costs a fortune, it should reflect in higher Barnet consequential funding. But, as the privatisation proceeds and people feel obliged to take out insurance to pay for certain medical procedures (as many of us do for dentistry now), the Barnet consequential will lower. Of course this is dependent on how the Barnet formula will adapt to take cognisance of the tax powers devolved by Calman.

    We are a different country, and our wants and needs are different from England (look at the result of our UK General Election voting), and being tied to them, financially, stops us from organizing our services to our needs. I agree that we need to do something very quickly to establish the Scottish way of dealing with public services, but not knowing from year to year what the English government will decide to dole out to us makes any forward planning rather difficult in massive projects like Health and Education.

    The solution is obvious.

  26. BTW Pap, I've added that Blog to the blogroll. It's a very interesting piece. Lansley really is a prune.

  27. Munguin. When I've seen Gray asked about his policies, all he has done is mutter something about trying to create new jobs for young people, which is admirable until you find that this is dependent on the Tories giving Scotland extra money to do this, and upon business making a financial contribution. It's a bit pie in the sky.

    Apart from this, and for all the fuss that Gray has made about university funding and the lack of a direction from the government, we still don't have a policy on that, on schools, on alcohol, drugs, health, etc, etc, etc.

  28. tris -
    you let him off light calling him a prune! you're too nice.
    Yes, Goldacre's blog is very good - you'll no doubt be aware that it is focused heavily on debunking spurious scientific claims and bad reporting of science, but gems like the Lansley article pop up outside the strictly scientific arena.
    Critical thinking FTW!

  29. Niko: I think you're right as far as England is concerned. That won't do for Scotland, and a party which tried to bring that in here would have big trouble from a Scottish population which, as everyone on here so far has said, values their NHS (despite individual criticisms, including from me).

    (Incidentally, I do realise that my case was pretty isolated to one ward, in one hospital, and particular the night staff on that ward, which seems to have been allowed to slip out of control. It is not typical of the NHS Scotland at all.)

    As a Labour supporter, can you say what Labour in Scotland would do with the NHS?

  30. Anon: Yep North Britishers are a real pain and they do us no credit.

    Sometimes you look at political parties and wonder why the hell anyone votes for any of them.

    They all seem to be pretty crap, interested in boot filling and personal betterment.

    If we are talking the London parliament, the laws pass from a house that is much more interested in its expenses than in the poverty that afflicts the rest of us, where they are, in any case, whipped to vote for what a few people at the top of the party tell them, then pass to an historic house of gold and fairy tales, and deeply disturbing, cheating and lying and stealing, from whence these laws go to the palace, occupied by a family that tried to steal funds, put aside for the very poor, to heat their home, where the inhabitants are above the law and have the right of complete secrecy, even when disclosure is in the public interest. It’s like something out of Grimms’ Fairy Tales.

  31. Pap: I was, but I have a bad habit of being too nice. It is, however, my only fault! :)

    I certainly found the article interesting, and I'm looking forward to reading the comments at leisure.

    I don't think that anyone ever suspected otherwise than that Lansley is following an ideological path here, and that even Cameron is having difficulty following him all the way.

    Polly Toynbee's piece throws all sorts of extra problems into the spotlight. Commissioning on a commercial basis is a matter for EU competition laws. So you may find that your bunions would be better, or rather cheaper, treated in Bulgaria than Brighton, and your rheumatism would be cheaper to cure in Romania than Ramsgate.

    The problem is that of course the coalition will be whipped to vote for this, and the opposition whipped to vote against it, so it is likely to go through... but it’s the most illiberal thing they’ve done so far

  32. ....with the exception of Cameron's multi-culturalism speech yesterday. What on earth do the real Liberals think about that?

  33. Good old “call me”, I’m amazed he did not suggest a national “British” day. Oh no Gordon Brown suggested that and we all laughed ourselves silly in the devolved areas (or non English countries) about that!

    Britain and Britishness is, and always was an artificial construct that suits well enough when there are common interests at stake such as the British Empire to run or the defeat of Napoleon or Hitler, but it does not work at all well when these catalysts do not exist and in a climate where national and regional differences are flagged to the fore, that has never been more apparent than at the moment.

    What “call me” really means is that the ethnic Muslim population of England do not want to fit into his way of doing things. This may go down great guns in Royal Leamington Spa with the blue rinse brigade and his natural right wing support but it wont go down so well with his Lib Dem colleagues support in places like Sheffield Hallam. So as they say what the Tories gain on the swings the Lib Dems will lose on the roundabouts.

  34. It'll be a bloody long time before Call Me makes an Englishman, or a Britishman out of me Munguin.

    I'll wear my kilt, eat haggis and learn Gaelic and he can take his boat song and Ascot and the sound of cork on willow and his spinsters cycling to church along with his overbusy garish flag and stick it....

    IM SCOTTISH NOT BRITISH. Live with it Dave

  35. Now, now chaps, aren't you even a little bit grateful that the mighty and oh-so cultured English rescued you from all that bally barbarism? Really, it's just poor form chums.

    Is it any wonder than England is such a fucked up place when every aspect of its culture is grounded in an outdated class system?

  36. You're dead right there Laz. I'm sure that's the problem. It's all class.

    Cameron wants us all to be the same, all British, just like Brown did. But we're not all the same. Some of us have never been to Royal Ascot, or worn a top hat, or had lunch at the palace. And some have never had a proper sit down meal, or been in a room that you could take more than 4 steps without turning a corner.

    Some people live on £4,000 a year, and others have a bonus of £9 million on top of their salary. Some worry all day every day about bills, some fly to Dubai for a party on a Saturday night.

    But we’re all supposed to feel part of the same country.... PFFFFFFFFFFFFFFFFFFFFFFFFFFFF

  37. Tris, do we have to electrically reeducate you, you ungrateful little prole?
    We're all the same, and even Call Me has had to make cuts.

  38. No, I'm sorry; you're right. I understand that Call Me gave up his holiday in Thailand with his old Eton chum, the Thai prime minister, and in doing so upset the good Mrs C, her indoors what as must be obeyed.

    This was on the recommendation of Mr Coulson, who, with his prole ear to the ground, told his boss that the rest of the prole class wouldn't like it, what with them all having to have an austerity Christmas in the snow and the cold, if he flew off to the warmth and luxury of the Thai prime ministers summer residence and had himself a non utility Christmas at a vast cost, and of course a substantial cost to the tax payer, what with him being a VI like and having to have loads of security. (What with him being a very unpopular VIP.)

    Still, look what happened to old Essex boy Coulson just after that... huh... He got the push didn’t he?

    So that won’t be happening again.

    Never mind what the proles say dahling. We can have them all tasered....