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Sunday, August 29, 2010

All bluster and no substance

The moment that the English Health Minister mentions that he is considering replacing NHS Direct with the new non-emergency number 111 the internet goes mad. Accusations of Thatcherism and of destroying the NHS have been flying around all day, whilst Lord Prescott has even started a petition, which he says is to force a debate on the issue.

Well I have some news for you, your Lordship, Labour have opposition days whereby they can table debates of this nature in both the House of Commons and the House of Lords, and if they make a good enough case the Speaker may even grant an emergency debate in Government time.

Nobody is expecting Andrew Lansley to avoid questions on this issue. He may even to table his own debate and/or legislation when he needs to do something. So the only conclusion I can reach is that this petition is about closing down debate by creating a hysterical knee-jerk reaction and by misrepresenting the proposed reform.

We should not think that this is about an attack on the NHS either. As Olga Ivannikova says on her blog: according to the BBC, ‘GPs urged the government to get rid of NHS Direct, claiming it was not cost effective.’ and according to e-health insider ‘NHS Direct has never been popular with doctors.’

From my own conversations with doctors and A&E staff, NHS Direct seems to have a reputation for either saying: take some paracetamol or go to hospital, with not much in between. I am sure that there are many people working hard and genuinely saving lives but why not replace this with something more cost effective and with a number which people can actually remember? Nick Chapman, chief executive of NHS Direct himself said: “The new helpline will be better and more cost effective than NHS Direct“. Because the NHS budget is being ringfenced, resources saved can be redirected to other frontline services, which no doubt can help patients and save lives.

The 111 service is more based on the emergency doctor service, which is very effective. Also unlike NHS Direct, NHS 111 could book appointments with GPs and other services, and dispatch an ambulance without callers having to dial 999, amalgamating several services into one.

But Labour's hypocrisy runs deeper than this. On page 35 of the last Labour Party manifesto they say:

"A new, national 111 telephone number will make non emergency services far easier for people to access and book."

So the idea was their's all along. Oops! Lord Prescott really has got egg on his face now.

During my stint as health spokesperson for the Welsh Liberal Democrats I rarely heard anything good about NHS Direct. It clearly needs reforming, not so much to save money (though that would be a consequence) but to make it more effective and better integrate it with other services such as Ambulances, local doctors and Accident and Emergency for example.

One last thought from the Labour-leaning blog Inside Out Swansea. They say that criticism from Labour in Wales about government plans to scrap the NHS Direct helpline in England will be unusually muted:

Assembly chiefs are known to be deeply unsatisfied with their own call centre service which has consistently proved to be an expensive and irrelevant flop.

Despite several re-launches and marketing ploys, A&E departments throughout Welsh hospitals have yet to record any sort of decline in non-emergency arrivals. This is attributed in part to anecdotal reports of patients arriving at emergency rooms with minor ailments after being told by NHS Direct staff that it is the quickest way to receive treatment.

The view among officials is that ministers in Cardiff Bay will quietly close down the service before the end of the year and replace it with a national version of the 101 non-emergency number currently being piloted in Cardiff.

So over to you, Lord Prescott. Are you going to organise a petition to save the service in Wales as well, or is opposing commonsense measures by a Labour-led Government just one step too far?
"NHS Direct seems to have a reputation for either saying: take some paracetamol or go to hospital, with not much in between."

Many GPs have the same reputation. Oops, there I've said it - many of our GPs are making a fortune from pushing pills or passing the buck to hospitals.
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