Care for those who are denied treatment costs more than if the procedures were carried out.
Hands up those amongst you who know anyone who underwent a joint operation and didn’t greatly benefit afterwards?
Hands up those amongst you who know someone who has been denied this treatment and has found themselves largely housebound and in need of care?
The cost of the procedure would be less than the average long-term cost of care and the rollover impact on the lives of carers.
National Carers Week ably demonstrates the myriad ways in which a carer role impacts on families – including reduced earnings capacity.
It is clear thousands across the country are being consigned to pain and discomfort and unable to lead their lives.
In reality, given the actual wording in the Health and Social Care Act, which amounts to the government heavy breathing down the necks of PCTs and CCGs ‘to liberate’ services at any cut price, managers have clearly gone about it another way by introducing very restrictive new eligibility criteria in lieu of caps and have at the same time moved at the speed of a roadrunner to cut services quickly and without debate in a very crude efficiency drive.
Crucially, these policies are impacting people’s lives – they could lose employment due to loss of essential function and find themselves cast into the world of welfare reform.
Shadow health secretary Andy Burnham is the first to acknowledge this level of stress and loss will also impact on the mental health of these patients – even if no such condition existed before.
In a debate last week when MPs broke with Parliamentary stiff upper lip tradition and engaged in an open discourse about the complexities and prejudices which surround mental health disabilities, several MPs revealed they too had past or ongoing challenges. This, then, is surely the time for empathy.
• The NHS crisis: A spotter’s guide 18 Jun 2012
Burnham remarks that this is a government that only “pretends to listen to doctors”, and urges the medical profession to “pull back even at this late stage” in a challenge to the random chaos of localism.
He also stresses patients “need to invoke their rights”, which is never an easy route. He also calls for a public debate on what should be deemed essential treatment.
We already know about the Haxby practice just outside York which tried to pre-empt the Act by deceiving patients into thinking a range of procedures would only be available at a charge, as well as the Kent practice which disclosed patient data to a private company in line with our prime minister’s behest.
Yesterday, Royal College of General Practitioners chair Dr Clare Gerada noted Local Commissioning Groups are outsourcing the GP Local Enhanced Services (LES) to Any Qualified Provider (AQP), which she fears will result in a fragmentation of patient care, destructive GP practices – by which she presumably means conflict of interest – and the risk of cherry picking.
Gerada had earlier noted there are no clinical representatives on the new National Commissioning Board, which only goes to paint a picture of the health secretary sticking his fingers in his ears.
Voicing genuine concern about the loss of a national standard, the Labour team are taking action: Burnham is now challenging the government’s commitment to a universal health service free at the point of need and an approach which he says is “clearly in contravention of patients’ rights under the NHS Charter and indeed their basic human rights”.
The shadow health secretary is calling on the government to:
• Order an immediate review of rationing in the NHS, and act immediately on new evidence showing treatment restriction on cost alone. It should produce clear national guidelines for PCTs/CCGs.
• An immediate reversal of rationing decisions that leave patients in severe pain, restrict mobility, limit their ability to live independently or have a major psychological impact, pending the outcome of the review.
• For all other treatment the government should initiate a public debate on whether or not they should be provided by the NHS rather than allowing them to be restricted in a random fashion.
• A call for urgent clarification of the government’s policy on minimising potential conflicts of interest and for reassurance that commissioners’ restricting or decommissioning of services in the NHS are not opening up private markets from which they can benefit. Failure to do so undermines public trust in the NHS.
In response to a prime minister who once said he would “cut the deficit – not the NHS”, Burnham vowed:
“This attack on the N in NHS demonstrates to the public Cameron’s lack of commitment. For a politician who promised that the three letters of NHS would be his priority Cameron has quickly been shown up as having betrayed this commitment he needs to get a grip and turn these words into action – this is HIS challenge.”
Meanwhile a letter has apparently been sent from the shadow office to the secretary of state – we await his response with interest.
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