Letter in The Times re ME and NHS reforms

[currer]

The network of CFS/ME clinics which were set up in 2005 across Britain represented a hard won advance in the recognition of CFS/ME as a disease. I say this despite recognising the problems in treatment and care in these clinics which still need to be resolved.
The problem is not the clinic service as such, but that once the service had been commissioned, the only specialist who wished to apply for the new posts running the service were psychiatrists. This simply reflects ignorance among immunologists, infectious disease specialists etc. that their specialty may be relevant to this disorder.

The CFS/ME service was not commissioned as a psychiatrically led service. The difficulty is the battle going on in the medical profession about what ME is and which specialty it belongs to!

I too, as a patient am not happy with the way the local clinics view ME and are managing their patients.
But to go back to the days when the ME patient could only rely on the understanding (or lack of it ) of their own GP and the days when there was no separate recognition of ME as a disease entity with specific needs which need to be addressed, will be a disaster and I hope the current proposals for further destruction of the NHS can be blocked by the BMA.

 

[orion]

Quite right. It's such a sick situation, that the services we pay our taxes for will do nothing to help us, and we have to spend our own money on the therapies that do help, and manage and investigate what works for us, taking over responsibility for our own healthcare. Some kind of revolutionary voucher system would be much fairer, for us, at least. It would be a rational and reasonable response to all kinds of problems that the mainstream healthcare has no answer to: let patients spend vouchers on their experimental and alternative treatments of choice.

It seems to me that this sort of model is exactly the sort of thing that a Conservative government would seem more likely to introduce than a Labour government, so I actually still have some optimism that we might get something more positive from them than we ever would from Labour. It's a brief opportunity though: the Tories will probably never see power again after what they're going to do to us all in the next few years! The Tory 'reforms' are going to be awful for everyone else, but with our unique situation, it's just possible we might get something good out of it all - and we have absolutely nothing to lose.

I'm sorry, but I find it hard to get motivated about the pain everybody else is going through these days in relation to stuff like healthcare. If the rest of the population showed a bit more interest in those who have never been offered any healthcare at all, I might feel a bit more sympathetic about the plight of people who are about to be brought a step closer towards our level of service, but selfish as it may be of me, it's just nice to know that there's at least one area of cuts where there's nothing that can possibly happen to make my situation any worse than it already it is. Even the Tories can't find a way to give us less than nothing, surely? I guess the situation is very different if you've managed to get sickness benefits though - there really could be some horrific scenarios coming down the track for those of us in that situation.

I think we're pretty much on the same page here. I was initially sceptical. However, the more I read about these reforms, the more I warm to them. On economic matters, I've always been very left of centre, and I never thought the day would come when I would actually support Tory reforms of the NHS. However, as you point out, the current system has treated ME patients so disgracefully, what have we got to lose?

Your observation that these reforms could only have been implemented by a Conservative government is an interesting one. Certainly the last labour government was far too authoritarian for my tastes. They talked the talk when it came to things like "patient choice" but they didn't walk the walk. Indeed their actions actually led to significantly reduced choice. It's all very well promoting the idea of "evidence based medicine" but if the only evidence you're willing to accept comes from unaccountable self-serving cliques within the medical profession, then the policy just becomes a tool for unscrupulous doctors to further disempower patients.

So I think you may have a point. However, I'm also going to give some credit to the Lib-Dems. Despite their recent betrayals, I do believe they possess a libertarian streak that the other two main political parties lack. If this had been a purely Conservative government then I think it's likely we would still have had all the negative aspects of the reforms (i.e cutbacks, outsourcing, and privatisations) but without the measures designed to increase patient autonomy and choice.

 

[Bob]

Hi Bob

Your last comments about GPs like Myhill are telling and alarming, In so far as her case goes ( didn't she win a High Court appeal? ) I think it high lights Orions point nicely

**What was the end result of Myhills case?

** Not to worry...found the thread in the forum

I thought it might be helpful to post a link to the Dr Sarah Myhill thread on this thread, as it's very relevent:
http://phoenixrising.me/forums/showthread.php?9427-Dr-Myhill-wins-back-her-licence-to-practise

 

[orion]

The NHS spends too much of its time and energy on implimenting reorganisations every five years. When are the doctors and healthcare workers going to be allowed to get on with their vocation - the care of patients?
Too much of the energy of NHS employees has been wasted by being diverted into these politically led, bureaucratic white elephants.

Hmmm. No doubt bureaucracy is part of the problem (as it is in any large organisation) but that's definitely not the full picture.

A few years ago I saw one of those Troubleshooter type programmes where a "Business Guru" visits a struggling business (in this case an NHS hospital) and offers facile solutions to complex problems. As you'd expect, the programme was pretty superficial. I didn't like the businessman or agree with any of his solutions. But what was fascinating was the insight it gave into how the NHS is actually run.

Our media and most of our politicians are continually spouting out the same old tired cliches to explain the NHS's failings - too much bureaucracy, interfering politicians, too many managers, managers not allowing doctors to do their job, too much centralisation, a "post code lottery" (i.e. too little centralisation!), blah, blah, blah.

No doubt there's some truth to all of that. But what's interesting is that the one group that always manages to escape all blame is the doctors. However, the troubleshooter programme clearly demonstrated something I have long suspected - it is actually the doctors who are running the NHS.

In the programme the hospital consultants came across, without exception, as arrogant, entitled prima donnas. In contrast, the hospital's CEO came across as a decent guy trying to do an impossible job under very difficult circumstances. His role was essentially that of a fall guy, someone who could be blamed for all the hospital's many failings, without having any real power to change anything. The consultants appeared to have such watertight contracts that they were essentially untouchable. Nothing happened in the hospital without their say so.

That's another aspect of these reforms that I'm quite liking. The government has essentially called the medical profession's bluff. For years doctors have got away with blaming bureaucracy, managers etc. for the NHS's failings. So the government is essentially saying to them - "OK, so you think you can do better? Fine, we'll put you in charge then!"

At the moment doctors secretly run the NHS from behind the scenes. However, these reforms will put them in charge in a highly visible way, and consequently they'll be forced to accept their share of the blame when things go wrong in future.

I can see why the doctors are so terrified. They're being lead into a subtle trap, and they know it.

 

[Bob]

Something I've recently thought about is, if they are getting rid of PCT's, then who will oversee setting up new local health services?
At the moment, if a new hospital, clinic or doctor's surgery is needed in a local area, then the PCT is in charge of setting them up.
If doctor's are going to commission services from any provider, then who will make sure that there are proper services in a local area for them to chose from?
Does anyone happen to know about this?

 

[Bob]

Hmmm. No doubt bureaucracy is part of the problem (as it is in any large organisation) but that's definitely not the full picture.

A few years ago I saw one of those Troubleshooter type programmes where a "Business Guru" visits a struggling business (in this case an NHS hospital) and offers facile solutions to complex problems. As you'd expect, the programme was pretty superficial. I didn't like the businessman or agree with any of his solutions. But what was fascinating was the insight it gave into how the NHS is actually run.

Our media and most of our politicians are continually spouting out the same old tired cliches to explain the NHS's failings - too much bureaucracy, interfering politicians, too many managers, managers not allowing doctors to do their job, too much centralisation, a "post code lottery" (i.e. too little centralisation!), blah, blah, blah.

No doubt there's some truth to all of that. But what's interesting is that the one group that always manages to escape all blame is the doctors. However, the troubleshooter programme clearly demonstrated something I have long suspected - it is actually the doctors who are running the NHS.

In the programme the hospital consultants came across, without exception, as arrogant, entitled prima donnas. In contrast, the hospital's CEO came across as a decent guy trying to do an impossible job under very difficult circumstances. His role was essentially that of a fall guy, someone who could be blamed for all the hospital's many failings, without having any real power to change anything. The consultants appeared to have such watertight contracts that they were essentially untouchable. Nothing happened in the hospital without their say so.

That's another aspect of these reforms that I'm quite liking. The government has essentially called the medical profession's bluff. For years doctors have got away with blaming bureaucracy, managers etc. for the NHS's failings. So the government is essentially saying to them - "OK, so you think you can do better? Fine, we'll put you in charge then!"

At the moment doctors secretly run the NHS from behind the scenes. However, these reforms will put them in charge in a highly visible way, and consequently they'll be forced to accept their share of the blame when things go wrong in future.

I can see why the doctors are so terrified. They're being lead into a subtle trap, and they know it.

Interesting thoughts orion.

I remember the program you're referring to... I saw it advertised and wanted to watch it, but I never got round to watching it.