Call for major shift in health funding

MAJOR changes on the way to health funding next year should pave the way for a radical shake-up of care for older and vulnerable adults, according to a leading regional care leader.

April sees the introduction of GP-led clinical commissioning groups who will manage NHS budgets and replace primary care trusts.

And the Independent Care Group says the moment should be seized as an opportunity for radical new thinking on care.

York and North Yorkshire chair Mike Padgham said: “We are hearing of huge financial problems for NHS North Yorkshire and York and nationally hospital trusts are struggling to cope with full beds.

“This doesn’t come as a surprise as far too many older and vulnerable people are in hospital when they could and should be getting cared for at home. Care homes also have a vital role to play in helping to keep people out of hospital.”

He added: “The creation of the new clinical commissioning groups provides a once in a lifetime opportunity to take a fresh look at how we provide care for one of the most vulnerable groups in society.

“If you switch the emphasis and the funding from treating people in hospital to social care, you not only slash NHS hospital spending, you also give people a better quality of life and their independence.”

He said such action needed a mind-set change and a desire to divert funding from other parts of the NHS into social care, enabling more people to receive the care they need either in their own homes or care homes, freeing up expensive hospital beds.

“Instead we have a situation where, through a lack of money, people commissioning social care are actually cutting back on the care they provide, which is only going to make a bad situation even worse.”

Comments (3)

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2:58pm Thu 27 Dec 12

hullgodfreyshire says...

What do they intend to do when they have finished privitising this service, move all the old people into tents to save money? talk about one move forward and ten backwards. the reason there is a lack of money will is because the tory party dont want the NHS to survive, so handing the reins over the a private concearn will only make even LESS money available because lets face it there has to be some left for the share holder to put in their fat bank accounts.
What do they intend to do when they have finished privitising this service, move all the old people into tents to save money? talk about one move forward and ten backwards. the reason there is a lack of money will is because the tory party dont want the NHS to survive, so handing the reins over the a private concearn will only make even LESS money available because lets face it there has to be some left for the share holder to put in their fat bank accounts. hullgodfreyshire

12:01pm Fri 28 Dec 12

voice for logic says...

The messenger brings the same old news, with the same old unplanned, without any detail, there “VISIONARY” proposals.

Let us stop and recap:-

There is not and never has been a detailed set of plans for the NHS.

In 1992 the TREASURY announced ALL government departments were only about 66% efficient and proposed cuts in budgets across the board of 30%. I have not come across any detailed report of assessment of all departments prior to that statement.

The government appointed a CEO – a surgeon with limited planning skills to take charge of the “VISION” of the NHS.

He is on record that he did not produce a plan because he could not instruct the staff how to achieve the changes. That is direct from the horses mouth.

Instead he and his colleagues embarked on the biggest ever change on the back of numerous documents misleadingly entitled NHS PLAN – issued at least one every year.

These documents were no more than verbal diarrhea of some fanciful set of “VISIONS” - in other words DREAMS that had not been thought through structurally, financially or in practicality. And at no time had been set out in detail in any critical path format.

One of his counterparts said in one of these “VISIONARY” documents, that after FOUR YEARS research they discovered that if you involve your staff and value them, sickness and absenteeism falls and productivity improves.

Well, the first thing one has to ask is what the hell is this guy doing running the NHS ? Clearly he had never had any experience of direct man management.

They then impaled themselves on this stupid idea of “NO top down management”

Then they did away with Region Offices, so now there is one office for thousands of individual units.

The they announce they are turning the service on its head and giving it to the GPs.

Then they were FORCED into realising they needed to reinstate staff they had made redundant.

They spent a fortune on increasing the number of beds, nurses and doctors only to now make them redundant. What a waste.


The result a total shambles, WHY? - because NOBODY sat down and drew up a set of detailed plans fully costed and programmed to see if their “VISIONS” would work.

There is only ONE good thing to come out of this diabolical farce and that is – the service is in such a mess from top to bottom that nobody can reassemble the broken pieces so somebody needs to sit down with a clean sheet and draft detailed plans for a totally new service.

At the same time EVERY department from the porters to the general managers should have to draft a report on their department – identifying :-

ALL codes of practice, laws etc that they are charged with fulfilling and identifying any shortfall.
The reason for the shortfall and any cost implications.

The cost of their services and cost of comparable locally available services.

Only then can one see which existing services can be incorporated directly into the new plan and which can be improved / modified to incorporate and which need to be totally overhauled and which services would be best farmed out to other units or private providers.

The NHS is charged with providing a health service as specified by the government, be that best served by in house or private provider.

You cannot put a financial cap on the service without specifying which services will and will not be provided.

At the same time we the public have to accept that there is no such thing as something for nothing. So we MUST take responsibility for our own health and if government funds do not increase in line with the changing service costs then we are going to have to look at how the gap can best be filled.

There are many options but none popular – never is when you are told to pay more.

Why do patients and GPs wait until a patient is grossly obese before taking positive steps to correct it. And more to the point in most cases obesity is self inflicted – so why should the NHS pay and not private servers as a direct charge to the patient. Why should the NHS pick up the tab for self-inflicted health problems.

Any private insurance would charge extra for self inflicted problems so why is it not considered for the NHS? At the end of the day if we are not prepared to help ourselves then why should we expect the NHS to do our job ?

There is also the fact that about 65% of our demand on the service is when we are over 65 but we then pay nothing as a direct contribution.

On the other side of the coin we have to FORCE the government to take steps to ensure funds are not being wasted on the services which exist. For example some years ago I think it was Phillips who had to reimburse some Yorkshire hospitals for overcharging on call out repairs to some of their machines. Look at Scarborough hospital catering as seen on TV; there are countless more examples like them including a body scanner being installed at considerable cost only to stand idle for years, by which time it was out of date. Then there is the scandalous IT program.

Plus we are told that 20% of taxes is spent on the NHS. At the same time we can see that large companies and their directors pay little if no tax, which means that us commoners are financing the NHS through high taxation; meaning those with the least are paying proportionately the most.

So we need:-

A stop to abusing staff – learn from your 4 year research.

**** within a month, each and every department in the service.

Draw up a Critical Path Analysis fully costed and fully programmed for the entire service from top to bottom. Such that it can self adapt to the ever increasing developments in the service, without having to resort to major restructuring every few years.

Then draw up a similar program of integration of the existing services.

Establish a head of each individual department at national and in the 5 regions to ensure all local departments are fit for purpose; managed efficiently; are up to date ; cost competitive; see quick use of best practice and oversee speculative developments.

Abandon Post Cod Services and reestablish a NHS.

Ensure ALL individuals and companies pay taxes according to their earnings.

What would you have thought if you discovered that they had started to build the London Shard or the A380 or some similar project without planning it in every minute detail. I suspect you would have split your sides laughing or been in total shock. Bu that is EXACTLY what they are doing with the Health Service!!
The messenger brings the same old news, with the same old unplanned, without any detail, there “VISIONARY” proposals. Let us stop and recap:- There is not and never has been a detailed set of plans for the NHS. In 1992 the TREASURY announced ALL government departments were only about 66% efficient and proposed cuts in budgets across the board of 30%. I have not come across any detailed report of assessment of all departments prior to that statement. The government appointed a CEO – a surgeon with limited planning skills to take charge of the “VISION” of the NHS. He is on record [in print] that he did not produce a plan because he could not instruct the staff how to achieve the changes. That is direct from the horses mouth. Instead he and his colleagues embarked on the biggest ever change on the back of numerous documents misleadingly entitled NHS PLAN – issued at least one every year. These documents were no more than verbal diarrhea of some fanciful set of “VISIONS” - in other words DREAMS that had not been thought through structurally, financially or in practicality. And at no time had been set out in detail in any critical path format. One of his counterparts said in one of these “VISIONARY” documents, that after FOUR YEARS research they discovered that if you involve your staff and value them, sickness and absenteeism falls and productivity improves. Well, the first thing one has to ask is what the hell is this guy doing running the NHS ? Clearly he had never had any experience of direct man management. They then impaled themselves on this stupid idea of “NO top down management” Then they did away with Region Offices, so now there is one office for thousands of individual units. The they announce they are turning the service on its head and giving it to the GPs. Then they were FORCED into realising they needed to reinstate staff they had made redundant. They spent a fortune on increasing the number of beds, nurses and doctors only to now make them redundant. What a waste. The result a total shambles, WHY? - because NOBODY sat down and drew up a set of detailed plans fully costed and programmed to see if their “VISIONS” would work. There is only ONE good thing to come out of this diabolical farce and that is – the service is in such a mess from top to bottom that nobody can reassemble the broken pieces so somebody needs to sit down with a clean sheet and draft detailed plans for a totally new service. At the same time EVERY department from the porters to the general managers should have to [in one or two months only] draft a report on their department – identifying :- ALL codes of practice, laws etc that they are charged with fulfilling and identifying any shortfall. The reason for the shortfall and any cost implications. The cost of their services and cost of comparable locally available services. Only then can one see which existing services can be incorporated directly into the new plan and which can be improved / modified to incorporate and which need to be totally overhauled and which services would be best farmed out to other units or private providers. The NHS is charged with providing a health service as specified by the government, be that best served by in house or private provider. You cannot put a financial cap on the service without specifying which services will and will not be provided. At the same time we the public have to accept that there is no such thing as something for nothing. So we MUST take responsibility for our own health and if government funds do not increase in line with the changing service costs then we are going to have to look at how the gap can best be filled. There are many options but none popular – never is when you are told to pay more. Why do patients and GPs wait until a patient is grossly obese before taking positive steps to correct it. And more to the point in most cases obesity is self inflicted – so why should the NHS pay and not private servers as a direct charge to the patient. Why should the NHS pick up the tab for self-inflicted health problems. Any private insurance would charge extra for self inflicted problems so why is it not considered for the NHS? At the end of the day if we are not prepared to help ourselves then why should we expect the NHS to do our job ? There is also the fact that about 65% of our demand on the service is when we are over 65 but we then pay nothing as a direct contribution. On the other side of the coin we have to FORCE the government to take steps to ensure funds are not being wasted on the services which exist. For example some years ago I think it was Phillips who had to reimburse some Yorkshire hospitals for overcharging on call out repairs to some of their machines. Look at Scarborough hospital catering as seen on TV; there are countless more examples like them including a body scanner being installed at considerable cost only to stand idle for years, by which time it was out of date. Then there is the scandalous IT program. Plus we are told that 20% of taxes is spent on the NHS. At the same time we can see that large companies and their directors pay little if no tax, which means that us commoners are financing the NHS through high taxation; meaning those with the least are paying proportionately the most. So we need:- A stop to abusing staff – learn from your 4 year research. **** within a month, each and every department in the service. Draw up a Critical Path Analysis fully costed and fully programmed for the entire service from top to bottom. Such that it can self adapt to the ever increasing developments in the service, without having to resort to major restructuring every few years. Then draw up a similar program of integration of the existing services. Establish a head of each individual department at national and in the 5 regions [can be dual role] to ensure all local departments are fit for purpose; managed efficiently; are up to date ; cost competitive; see quick use of best practice and oversee speculative developments. Abandon Post Cod Services and reestablish a NHS. Ensure ALL individuals and companies pay taxes according to their earnings. What would you have thought if you discovered that they had started to build the London Shard or the A380 or some similar project without planning it in every minute detail. I suspect you would have split your sides laughing or been in total shock. Bu that is EXACTLY what they are doing with the Health Service!! voice for logic

12:15pm Fri 28 Dec 12

voice for logic says...

The messenger brings the same old news, with the same old unplanned, without any detail, there “VISIONARY” proposals.

Let us stop and recap:-

There is not and never has been a detailed set of plans for the NHS.

In 1992 the TREASURY announced ALL government departments were only about 66% efficient and proposed cuts in budgets across the board of 30%. I have not come across any detailed report of assessment of all departments prior to that statement.

The government appointed a CEO – a surgeon with limited planning skills to take charge of the “VISION” of the NHS.

He is on record that he did not produce a plan because he could not instruct the staff how to achieve the changes. That is direct from the horses mouth.

Instead he and his colleagues embarked on the biggest ever change on the back of numerous documents misleadingly entitled NHS PLAN – issued at least one every year.

These documents were no more than verbal diarrhea of some fanciful set of “VISIONS” - in other words DREAMS that had not been thought through structurally, financially or in practicality. And at no time had been set out in detail in any critical path format.

One of his counterparts said in one of these “VISIONARY” documents, that after FOUR YEARS research they discovered that if you involve your staff and value them, sickness and absenteeism falls and productivity improves.

Well, the first thing one has to ask is what the hell is this guy doing running the NHS ? Clearly he had never had any experience of direct man management.

They then impaled themselves on this stupid idea of “NO top down management”

Then they did away with Region Offices, so now there is one office for thousands of individual units.

Then they announce they are turning the service on its head and giving it to the GPs.

Then they were FORCED into realising they needed to reinstate staff they had made redundant.

They spent a fortune on increasing the number of beds, nurses and doctors only to now make them redundant. What a waste.


The result a total shambles, WHY? - because NOBODY sat down and drew up a set of detailed plans fully costed and programmed to see if their “VISIONS” would work.

There is only ONE good thing to come out of this diabolical farce and that is – the service is in such a mess from top to bottom that nobody can reassemble the broken pieces so somebody needs to sit down with a clean sheet and draft detailed plans for a totally new service.

At the same time EVERY department from the porters to the general managers should have to draft a report on their department – identifying :-

ALL codes of practice, laws etc that they are charged with fulfilling and identifying any shortfall.

The reason for the shortfall and any cost implications.

The cost of their services and cost of comparable locally available services.

Only then can one see which existing services can be incorporated directly into the new plan and which can be improved / modified to incorporate and which need to be totally overhauled and which services would be best farmed out to other units or private providers.

The NHS is charged with providing a health service as specified by the government, be that best served by in house or private provider.

You cannot put a financial cap on the service without specifying which services will and will not be provided.

At the same time we the public have to accept that there is no such thing as something for nothing. So we MUST take responsibility for our own health and if government funds do not increase in line with the changing service costs then we are going to have to look at how the gap can best be filled.

There are many options but none popular – never is when you are told to pay more.

Why do patients and GPs wait until a patient is grossly obese before taking positive steps to correct it. And more to the point in most cases obesity is self inflicted – so why should the NHS pay and not private servers as a direct charge to the patient. Why should the NHS pick up the tab for self-inflicted health problems.

Any private insurance would charge extra for self inflicted problems so why is it not considered for the NHS? At the end of the day if we are not prepared to help ourselves then why should we expect the NHS to do our job ?

There is also the fact that about 65% of our demand on the service is when we are over 65 but we then pay nothing as a direct contribution.

On the other side of the coin we have to FORCE the government to take steps to ensure funds are not being wasted on the services which exist. For example some years ago I think it was Phillips who had to reimburse some Yorkshire hospitals for overcharging on call out repairs to some of their machines. Look at Scarborough hospital catering as seen on TV; there are countless more examples like them including a body scanner being installed at considerable cost only to stand idle for years, by which time it was out of date. Then there is the scandalous IT program.

Plus we are told that 20% of taxes is spent on the NHS. At the same time we can see that large companies and their directors pay little if no tax, which means that us commoners are financing the NHS through high taxation; meaning those with the least are paying proportionately the most.

So we need:-

A stop to abusing staff – learn from your 4 year research.

**** within a month, each and every department in the service.

Draw up a Critical Path Analysis fully costed and fully programmed for the entire service from top to bottom. Such that it can self adapt to the ever increasing developments in the service, without having to resort to major restructuring every few years.

Then draw up a similar program of integration of the existing services.

Establish a head of each individual department at national and in the 5 regions to ensure all local departments are fit for purpose; managed efficiently; are up to date ; cost competitive; see quick use of best practice and oversee speculative developments.

Abandon Post Cod Services and reestablish a NHS.

Ensure ALL individuals and companies pay taxes according to their earnings.

What would you have thought if you discovered that they had started to build the London Shard or the A380 or some similar project without planning it in every minute detail. I suspect you would have split your sides laughing or been in total shock. Bu that is EXACTLY what they are doing with the Health Service!!
The messenger brings the same old news, with the same old unplanned, without any detail, there “VISIONARY” proposals. Let us stop and recap:- There is not and never has been a detailed set of plans for the NHS. In 1992 the TREASURY announced ALL government departments were only about 66% efficient and proposed cuts in budgets across the board of 30%. I have not come across any detailed report of assessment of all departments prior to that statement. The government appointed a CEO – a surgeon with limited planning skills to take charge of the “VISION” of the NHS. He is on record [in print] that he did not produce a plan because he could not instruct the staff how to achieve the changes. That is direct from the horses mouth. Instead he and his colleagues embarked on the biggest ever change on the back of numerous documents misleadingly entitled NHS PLAN – issued at least one every year. These documents were no more than verbal diarrhea of some fanciful set of “VISIONS” - in other words DREAMS that had not been thought through structurally, financially or in practicality. And at no time had been set out in detail in any critical path format. One of his counterparts said in one of these “VISIONARY” documents, that after FOUR YEARS research they discovered that if you involve your staff and value them, sickness and absenteeism falls and productivity improves. Well, the first thing one has to ask is what the hell is this guy doing running the NHS ? Clearly he had never had any experience of direct man management. They then impaled themselves on this stupid idea of “NO top down management” Then they did away with Region Offices, so now there is one office for thousands of individual units. Then they announce they are turning the service on its head and giving it to the GPs. Then they were FORCED into realising they needed to reinstate staff they had made redundant. They spent a fortune on increasing the number of beds, nurses and doctors only to now make them redundant. What a waste. The result a total shambles, WHY? - because NOBODY sat down and drew up a set of detailed plans fully costed and programmed to see if their “VISIONS” would work. There is only ONE good thing to come out of this diabolical farce and that is – the service is in such a mess from top to bottom that nobody can reassemble the broken pieces so somebody needs to sit down with a clean sheet and draft detailed plans for a totally new service. At the same time EVERY department from the porters to the general managers should have to [in one or two months only] draft a report on their department – identifying :- ALL codes of practice, laws etc that they are charged with fulfilling and identifying any shortfall. The reason for the shortfall and any cost implications. The cost of their services and cost of comparable locally available services. Only then can one see which existing services can be incorporated directly into the new plan and which can be improved / modified to incorporate and which need to be totally overhauled and which services would be best farmed out to other units or private providers. The NHS is charged with providing a health service as specified by the government, be that best served by in house or private provider. You cannot put a financial cap on the service without specifying which services will and will not be provided. At the same time we the public have to accept that there is no such thing as something for nothing. So we MUST take responsibility for our own health and if government funds do not increase in line with the changing service costs then we are going to have to look at how the gap can best be filled. There are many options but none popular – never is when you are told to pay more. Why do patients and GPs wait until a patient is grossly obese before taking positive steps to correct it. And more to the point in most cases obesity is self inflicted – so why should the NHS pay and not private servers as a direct charge to the patient. Why should the NHS pick up the tab for self-inflicted health problems. Any private insurance would charge extra for self inflicted problems so why is it not considered for the NHS? At the end of the day if we are not prepared to help ourselves then why should we expect the NHS to do our job ? There is also the fact that about 65% of our demand on the service is when we are over 65 but we then pay nothing as a direct contribution. On the other side of the coin we have to FORCE the government to take steps to ensure funds are not being wasted on the services which exist. For example some years ago I think it was Phillips who had to reimburse some Yorkshire hospitals for overcharging on call out repairs to some of their machines. Look at Scarborough hospital catering as seen on TV; there are countless more examples like them including a body scanner being installed at considerable cost only to stand idle for years, by which time it was out of date. Then there is the scandalous IT program. Plus we are told that 20% of taxes is spent on the NHS. At the same time we can see that large companies and their directors pay little if no tax, which means that us commoners are financing the NHS through high taxation; meaning those with the least are paying proportionately the most. So we need:- A stop to abusing staff – learn from your 4 year research. **** within a month, each and every department in the service. Draw up a Critical Path Analysis fully costed and fully programmed for the entire service from top to bottom. Such that it can self adapt to the ever increasing developments in the service, without having to resort to major restructuring every few years. Then draw up a similar program of integration of the existing services. Establish a head of each individual department at national and in the 5 regions [can be dual role] to ensure all local departments are fit for purpose; managed efficiently; are up to date ; cost competitive; see quick use of best practice and oversee speculative developments. Abandon Post Cod Services and reestablish a NHS. Ensure ALL individuals and companies pay taxes according to their earnings. What would you have thought if you discovered that they had started to build the London Shard or the A380 or some similar project without planning it in every minute detail. I suspect you would have split your sides laughing or been in total shock. Bu that is EXACTLY what they are doing with the Health Service!! voice for logic

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