The government’s idea of compelling doctors to work for a period in the NHS…

The general public regards the NHS as something between a ‘sacred cow’ and a ‘national treasure’, despite all the pressures that it is under. For decades it has provided a universal service, largely free* at the point of use. The public may have a collective memory of the abysmal provision before it was introduced; to see just what changes it made, you have to look for ‘the short and simple annals of the poor’ — you could start by reading …

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Dr George O’Neill on the slow death of general practice…

The 2004 GP contract was the result of significant problems in English inner cities with recruitment and retention of GPs. The continuity of care the bedrock of general practice was lost when GPs no longer were required with the implementation of the new contract to provide out of hours medical services. As a consequence patient care is now the responsibility of the Trusts for the majority of the time.  The loss of continuity of care means the GP is no …

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We need to play our part in saving the NHS by taking responsibility for our own health…

Criticising our over stretched health and social care service is less of a public pass-time than it was five years ago.    This is good and perhaps reflects a growing maturity as we begin to realise that these vital services, on which we all rely, can only do so much.   In the social contract – the basis of the 1948 Health Service Act – there were two sides; (1) government agrees to provide a health service free at the point of …

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If Medics Treated Patients As Governments Treat the NHS, We’d All Be Dead

Another Secretary of State pushes determinedly, blindly on with NHS reforms, with the notion they alone can solve the great mystery of health. No matter how well intentioned, policy making is doomed to fail as before. I humbly suggest another way. The NHS is now into its 30th year of perpetual reform (perhaps we should hold an anniversary party?). Yet it is still in need of reform. At what point do the politicians wake up and conclude that, in the way …

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Real politics prefers a health service Status Quo…

The media hype on our latest could-do-better Health Service report Systems not Structures:  Changing Health and Social Care, was more positive than I expected.  BBC wheeled out the usual pundits.  John Compton welcomed the report saying it was good to say things over and over again until the public finally heard the message.   Dr George O’Neill was unusually positive but that seems to be because his Accountable Care System (ACS) approach got a good airing.  At least George understands …

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The NHS prescription: £22 billion of efficiency savings

At what point can an organisation which has undergone many years of reorganisations and “efficiency savings” actually create any more efficiencies and still comply with the regulatory regime? Leave aside the arguments about the £350 million lie of the Leave campaign, because it’s not actually relevant until Brexit is complete.  Even if every penny we actually pay into the EU were diverted to the NHS, apart from the inability to fund agricultural subsidies and infrastructure funding, that is a long …

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It is time to take politics out of the day to day running of the health service. A guest post by Dr George O’Neill.

  All of the party leaders, before the recent election, committed themselves to taking politics out of health. Is that realistic? I would suggest not. But what we can do is we can take politics out of the day to day running of Health and Social Care. That is an entirely different prospect. Bevan’s original idea of the Health Service was that it would dramatically improve the health of the population. Demand would decrease and cost would be reduced. This …

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Should doctors strike?

There is to be a further strike by junior doctors in England next week. They will not work between 8 am and 5 pm on 26 and 27 April. In previous strikes, cover for emergencies was maintained; this time it is ‘all out’. (The strikes, and the challenges of the new contract, don’t apply in Wales, Scotland or N Ireland.) The strikes come as negotiations between junior doctors and the Department of Health have broken down. The negotiations were about …

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NHS heading for a £2bn deficit, after #CPC15…

Anyone who knows anyone who works in the NHS, knows it is working at bursting point, not least because of the huge drain on recruitment imposed by the transfer to Foundation status. Now it seems the Conservatives are being accused of burying bad news until their conference is over: A report compiled by the health service regulator Monitor is understood to say the NHS is heading towards a £2 billion deficit. But a senior figure from the organisation told the Observer they had been ‘leaned on’ by Whitehall …

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How feasible is a 7 day NHS?

So, Jeremy Hunt, the Health Secretary for England and Wales, wants consultants to work a 7-day week, and is prepared to impose this. Simon Hamilton, the local Health Minister, agrees. This demand is based on there being 6,000 extra and unnecessary deaths (in England and Wales) when patients are admitted at the weekends. This assertion is questionable. Elective patients are admitted during the week, and not so much at weekends.  Ancillary services in the community may be reduced at weekends; A&E departments …

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Bloody foreigners coming over here and taking our medicines

Last night, during the party leader’s debate on TV, Nigel Farage was told that he should be ashamed of himself when he sort of said that people with HIV/AIDS come to the UK to get free treatment. But, of course, that’s just a part of his party’s xenophobic, keep the others out message. Firstly, his figures aren’t quite accurate. Secondly, the ‘foreigners’ refers to people born abroad. It’s not clear how long these people have been in the UK; and …

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Is Healthcare reform an unsquareable circle?

Two News Letter articles at the end of last week demonstrated the nigh on impossibility of solving the health services problems in Northern Ireland.  On the 14th February the new chief executive of the Health and Social Care Board Valerie Watts in response to the question “if people could expect to see smaller hospitals closing, with fewer but bigger hospitals remaining”. Ms. Watts replied: “That is my vision, yes, because that is the safest thing for Northern Ireland to have.” The same day there was a …

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The price of cancer for children in the Republic

More than 70% of the population in the Republic of Ireland have to pay to see their GP, as well as prescription charges and Health Care Costs. More than one in four sick people are deterred from visiting their GP as a result. Costs to see a GP range from anywhere between €45 – €75, to call out an ambulance can cost anywhere from €100, as can a hospital stay. Add to that prescription charges and illness can be a …

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Preview: Stitched Up (by Rosemary Jenkinson): a play asking how difficult is it to be moral in contemporary society?

With NHS cuts, closures and scandals never out of the news, health minister Jim Wells may need to cross his fingers that a piece of theatre by Rosemary Jenkinson stays on the Lyric Theatre’s stage and doesn’t end up on his desk in weeks to come. Directed by C21 Theatre Company’s Stephen Kelly, Stitched Up is a one act play starring Richard Clements as an NHS surgeon Aidan who has turned whistleblower in order to try to clear his name …

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Donaldson in review

It is a pity that coverage of the Donaldson review has focussed on his comments on the number of hospitals in Northern Ireland relative to its population.  It is true that he remarks on this, but his report is a lot broader than considering whether skills are being spread too thinly across too many hospitals – something korhomme discusses here, and I comment on briefly with regard to locations. What stands out is that Sir Liam considers the Northern Ireland …

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Does Northern Ireland have too many hospitals?

A recent report into health services in N Ireland has said that there are ‘too many hospitals’. The report also has a lot to say about the organisational structure of the NHS here. This isn’t the first time that hospital provision here has been questioned; decades ago, an MP in the old Stormont described N Ireland as having a hospital at every bus stop. So how many acute district hospitals (DGH) would be appropriate? It’s easy enough to calculate a …

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Terminating your care – The £600 million hole in the health budget

Writing exclusively for Slugger, the respected medic Dr George O’Neill gives his proposal to tackle the crisis in A & E. Dr George O’Neill qualified in 1971 and is a General Practitioner in practice in North & West Belfast for 40 years. He was for 6 years Chair of the Belfast Local Commissioning Group and he also Chairs Addiction NI. The extra £80 million additional funding this financial year to Health is approximately 50% of what is required and will still …

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From Napoleon to drunks in the Royal. The messy state of Accident & Emergency Departments.

Korhomme is a retired medical consultant. Pick up any newspaper these days, and you’re certain to find an article about the woes of A&E departments. Overrun with patients, the waiting time requirements have gone to pot. And here, in N Ireland, we are the leaders in the UK in terms of long waits, as described on Slugger here. The medics who work in A&Es aren’t happy, and neither would you be, for this story has an awful ring of truth …

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Why are GPs so unhappy?

Korhomme is a retired medical consultant. When I was young we lived in the University area of Belfast; out General Practitioner (GP) lived round the corner, and worked from home, as was usual in those days. To see him—and GPs were almost exclusively male then—you went in the front door, and waited. It was important to count the number of people in the waiting room, so you’d know when it was your turn. In his surgery, you were often met …

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Crisis? What Crisis?

As the NHS goes into meltdown once again both locally and nationally we asked NHS lobbyist and regular thorn in the side of Health Ministers and officials past and present HUGH McCLOY to give us his personal view on the latest crisis in A&E. You can follow Hugh on Twitter here and keep up to date with his campaign for the return of Acute services to the Mid Ulster Hospital here. This Winter Crisis of 2015 is not the same …

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