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mid staffsWhat a difference a year makes. Last year we celebrated the NHS as one of the great accomplishments of Britain. Danny Boyle paid tribute to the NHS during the Olympics opening ceremony because universal healthcare is one of the core values of British society.The health service was featured as one of Britain’s proudest achievements during the £27 million spectacular. Boyle said the NHS was an “amazing thing to celebrate” and dedicated a whole section of his show to the health service. Few disagreed with him. However 2013, this year has been the year of the Mid Staffordshire scandal and the Francis enquiry into it. The NHS has been lambasted and the general public’s perception has plummeted According to this week’s  BMJ there never has been such a bad year for the NHS in its entire 65 yr history.

About 500 people are estimated to have died of negligence and appalling standards of care seem to have been unearthed in Mid Staffordshire.  It is thought that there probably has never been a scandal on the scale of Mid Staffordshire NHS Trust. The Francis report was published in February and talked of the ‘Wilful neglect’ prompting the health secretary Jeremy Hunt to claim the need to put compassion back into the NHS.’ The Francis report also prescribed ‘a fundamental culture change’ for the entire NHS to put patients first. The Francis Report mentioned  that a culture of target chasing and management agendas of cost cutting took precedence over patient care in an effort to reach the financial targets required to gain NHS Trust status. Many Nursing staff lost jobs and staff to patient ratios were badly hit.  Targets distort priorities. As soon as you have a target the thing being measured becomes more important, attributes such as compassion and empathy that are hard to count start not to countCaring and consideration are hard to measure and even harder to legislate for.

BMJ cover

April 1st [April fools day] marked the day of the takeover of the NHS by the National Commissioning Board. The new changes are designed to open up the NHS in England to competition by for profit companies. PCT [Primary Care Trusts] have been abolished and their work allocated to GP led commissioning groups who will now have responsibility to ensure their patients’ health needs are met. They will decide how 80% of the NHS budget is spent. GPs have been given this responsibility as they have daily contact with patients and local services and know their patient’s needs. GPs will have to put services out to  tender [consider any willing provider’] and any organisation can bid to provide services not just NHS hospitals. Critics warn that big, often multi national companies who have been active in lobbying the government will ‘cherry pick’ the most profitable services and destabilise the rest of the NHS.

 GPs do not relish becoming the masters of the new NHS universe. Clare Gerada, their representative, said that the new changes allow for;

the wholesale dismantling of the NHS and privatisation of the supply, organisation, planning, finance, and distribution of healthcare. She goes on to say that the regulations will leave general practitioners

“bearing the brunt of the public’s wrath, while much of the health budget is handed over to the for-profit commercial sector, services are closed, and entitlements to universal healthcare are eroded.”

Is this the beginning of the end of the NHS as the BMJ cover that week suggested  [see above picture] and after the Francis report will any one care that much?