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Author Topic: Darzi Constitution replaces public provision by an "NHS constitution"  (Read 2793 times)

roger

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Looking at the Darzi endorsement of an NHS constitution he has outlined it as an alternativie arrangement to the present day NHS. Endorsing the NHS as a system of increasingly commissioned private and public providers he claims that his constitution propsoal is the safeguard.

He says "As the NHS evolves, a wider range of providers, including those from the third and independent sectors are offering NHS-commissioned services. Patients expect that wherever they receive their NHS-funded treatment, the same values and principles should apply. All organisations are part of an integrated system for the benefi t of patients. That is why we will set out the purpose, principles and values for the NHS in the Constitution. We propose that all organisations providing NHS services are obliged by law to take account of the Constitution in their decisions and actions."   

In a nutshell this is an endorsement of the anti-social direction for the NHS to continue down the road of turning the NHS in to competing "Trusts" and big business whilst claiming that consitution will safeguard the interests of the people.  This one very big dangerous illusion in Darzi's propsoal. Are US and European Health monopolies, even now, let alone once they get a bigger foot hold in the poly clinics and services they are bidding for going to "take account of the consitution in their decisions and actions".   Just as the oil and military monopolies are driving the anglo-US foreing policy to launch wars against the people of the middle east does one think for a minute that the these health monopolies will not drive the agenda emptying the coffers of the treasury and dictating to governemnts how things will be. Providing for the needs of all is not the way of market competition among the monopolies, such markets thrive on shortages, price rises and findin every and which way to extract maximum profits for the rich. 

I think the question of the NHS constitution presents itself in a different light for health workers.  It cannot have anything to do with paying the rich but onthe contrary only move forward by stop payin gthe rich. It is not the NHS that should have a constitution that moulds it to the interests of the marketisation of the NHS with its sham "patient commissioned NHS" but instead the people should have a modern constitution for the nation that safeguards the future of NHS with modern arrangements that empower the health workers  and people to make the decisions, that outlaw the involvement of the private sector and take back into public ownership all the assets that have been sold off or franchise to the monopolies from care of the elderly homes to Private Finance Hospitals. 
« Last Edit: July 02, 2008, 10:06:22 pm by roger »
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roger

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In one part of the draft consitition it says this

"You have the right to receive NHS services
free of charge, apart from certain limited
exceptions sanctioned by Parliament."

But in the staff guide to the draft constitution it says this about the right to health care.

"1. Access to health services:
People have the right to receive NHS services free of charge (except
where sanctioned by Parliament) and without discrimination, to expect
their local NHS to provide necessary services, and to seek treatment
elsewhere if delays are excessive."

"Certain limited exceptions sanctioned by Parliament" now become "except where sanctioned by Parliament"    What kind of guarantee is this to the right to health care?
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roger

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Re: Darzi Constitution replaces public provision by an "NHS constitution"
« Reply #2 on: September 27, 2008, 02:17:48 pm »

NHS Constitution: More privatisation, less accountability

http://gillgeorge.wordpress.com/2008/08/09/nhs-constitution-more-privatisation-less-accountability/

From Defend the NHS Gills Blog

The consensus view seems to be that a constitution for the NHS is a good idea. Gordon Brown wants one; Ara Darzi thinks it’s the best thing since sliced bread; the Tories want one; the BMA wants one; an awful lot of health campaigners agree that an NHS constitution is by definition a good thing.

The New Labour intention is that the constitution goes through a bit of fake consultation now, it gets reviewed in ten years time, and in the meantime - so we are told - the future of the NHS is assured.

Does a constitution protect the NHS? It’s worth some careful thought.

The constitution now out for consultation sets in stone the current drive towards the fragmentation and privatisation of the NHS. So we are told ‘all NHS bodies and private and third sector providers supplying NHS services will be required by law to take account of this constitution in their decisions and actions’. We are told ‘the NHS is an integrated system of organisations and services…’ - rather than the single public organisation that many campaigners believe it should be. We are told ‘The NHS is committed to working jointly with… a wide range of other private, public and third sector organisations at national and local level to provide and deliver improvements in health and wellbeing’.


Darzi agrees. His Final Report concludes that one of the reasons for the constitution is because ‘as the NHS evolves, a wider range of providers, including those from the third and independent sectors are offering NHS-commissioned services’.

If this constitution is nodded through, privatisation is part and parcel of the NHS for the next ten years. How much of the NHS will be left in ten years time if the current gallop towards privatisation continues? By the time the constitution is reviewed, the NHS could well be reduced to a logo at the top of the appointment letters (and even the logo now seems to be subject to a ‘rebranding’ exercise).

This is perhaps the most important element of this constitution. An unwanted and damaging process will become irreversible. The NHS gets taken apart - and the Government (Labour or Tory) says, ‘Well, it’s nothing to do with us. It’s in the constitution’.

And that’s the second reason why a constitution is such a bad idea. Accountability disappears.

Conventional wisdom is that a constitution is a good idea because it stops politicians interfering with the NHS and using the NHS as a ‘political football’. The challenge is that the football is already sailing through the air, and a constitution simply allows the Government to duck responsibility for where it lands.

The reality is that an NHS constitution will result in less accountability. The Government continues to determine the overall direction of travel of the NHS - in this case, a sharp drive towards privatisation. The Government determines the funding available for the NHS. The Government in practice sets the political context in which ‘local decision makers’ make their decisions. (Any NHS Chief Executive with half a brain knows that you opt for privatisation of local services if you want to keep your job).

There is a strong risk of the Government effectively hiding behind a constitution that is updated once every ten years and denying responsibility for the management of the NHS. Where’s the accountability in that?

Local campaigners will already be familiar with the grotesque lack of accountability of many PCTs, and the privatisation of commissioning and service provision will reduce accountability further. A constitution that lets politicians off the hook makes things even worse.

There are fundamentally different political philosophies when it comes to healthcare. Socialists believe that looking after sick and vulnerable people is just part of what we do in a decent and caring society. Parties of big business - Labour or Tory - believe that healthcare is a great opportunity for their mates to return a hefty profit. Nothing could be more political than this. I want the opportunity to challenge the privatising politicians who are destroying the NHS. A constitution is a nice idea - but it makes it that much harder to point the finger of blame.


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roger

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Re: Darzi Constitution replaces public provision by an "NHS constitution"
« Reply #3 on: September 27, 2008, 02:52:37 pm »

An NHS constitution could be beneficial, but only if drafted correctly, says King’s Fund
17.01.08
There is a case for an NHS constitution but there are pitfalls to avoid when drafting one, according to a King’s Fund report published today.

The Prime Minister has indicated that he is considering plans for a new ‘NHS constitution’ as part of Lord Darzi’s review of the NHS.

Niall Dickson, chief executive of the King’s Fund, said: ‘A constitution could provide real benefits but there are dangers if it is not thought through with care.

‘A detailed list of patients’ rights could become caught up in endless legal wrangling. On the other hand, a constitution which simply reiterates core principles or restates existing targets, such as 18-week waiting times, without any enforceable rights for patients would lack credibility.’

Yet the report goes on to argue that a constitution that sets out lines of accountability, as well as the roles and relationships in today’s more devolved health care system, could help clarify what the NHS is designed to do and how it is governed. It could also place appropriate legal checks on ministerial and departmental decisions.

The report also concludes that as recent reforms have begun to increase the autonomy of health service organisations and reduce central government control, an independent board to manage the NHS would be unnecessary. Foundation trusts, GPs with new commissioning powers, regulatory bodies such as Monitor and the Healthcare Commission and NICE, who make decisions on acceptable treatment costs, are all examples of autonomous bodies involved in the running of NHS services.

Co-author of the report, Anna Dixon, acting director of policy at the King’s Fund, said:

‘People have legitimate concerns about excessive central control and the “politicisation” of operational decisions in the NHS. There will always be short-term political pressures on whoever is making decisions, whether it is politicians or members of an independent board. However, recent reforms creating autonomous NHS providers, patient choice and devolved commissioning and delegated responsibility for regulation have shifted power over the day-to-day running of the NHS away from central government.’

Anna Dixon added:

‘Those who propose an independent board to manage the NHS believe it necessary to reduce politicisation and micromanagement, but our assessment found those arguments unpersuasive. A board would be under the same pressures now faced by Ministers, especially media scrutiny, and it is hard to accept that decisions about such a large chunk of public spending should be made by an unelected, unaccountable board. The fact is that control of operations is shared among many bodies in the modern NHS meaning the Department of Health is no longer the sole, or main, source of rules and regulations that govern NHS organisations.

‘This report sets out constructive ideas to help ensure that future decisions about health policy are more transparent, strategic and focused as much as possible on outcomes.’

The authors suggest some other measures that might be considered to help secure operational independence and ensure that decisions about the NHS are as free from short-term political pressures as is possible. These include:
an explicit commitment to local decision-making where possible
a stronger role for parliament – giving MPs more opportunities to debate health service reforms
promoting better understanding of when responsibility lies with local managers rather than national figures
improving transparency by requiring Ministers and the Department to make information on policy decisions, and the evidence underpinning them, available to the public
strengthening local accountability – by increasing the clout of local authority oversight and scrutiny committees.
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