91Èȱ¬

He will, now you've told him..!

I am told that it was Tory spin that led to stories about David Cameron being cheered by junior doctors.

A junior doctor I know who was present said this was not the case.

It is indicative of the failure of the government to provide a increase in service based on the significantly higher expenditure. The NHS has improved there is know doubt, however it is the amount of improvement or in this case more a level of beaucracy that has been the Governments Daming failure.

A bit presumptious that the Champion's League final is going to Man United / Chelsea and not AC Milan / Liverpool Nick! I thought as a political commentator you would no that the favourite doesn't always win, and that pride comes before a fall.

Do'nt hype up it up too much Mr Robinson, their were plenty of junior doctors who booed and heckled David Cameron when he made his speech in London at that doctor's rally. Also remember he has not offered an alternative to those junior doctors has he?

The NHS has not improved in Wales. Government funding will not be provided at the levels previously indicated but cut. Schemes that the local health boards have planned are having to be rethought in light of the changes.

This government has wated money on management consultants and a poorly planned and flawed IT system that is years behind schedule. The PFI scheme is a con that just takes the costs and
them to satisfy the Chancelor's arbitrary financial targets.

They have shown that they cannot manage large projects and are only to happy to bankroll private providers at the NHS' expense.

I wonder if white elephant IT systems, PFI hospitals and an over-abundance of management consultants in the NHS might not have something to do with it. After all, back in 1997 we naively thought Labour would put an end to that sort of thing. Instead, Mr Blair's friends in the City have grown fat on the extra investment paid for from increases in our National Insurance contributions.

Really Nick! That's a first. Let me remind you Nick, that when we had people dying under the Conservatives' (third world country NHS, waiting for three years for a by-pass), funny enough no doctor or nurse complained about the Tories. Emmmuuhh! Three of my friends, two doctors and one consultant work in the NHS and although they admit that not everything is A1 perfect, they thank Labour for the big, big strides forward in UK hospitals in the last 7 years, especially their salaries!

Title decider between United and Chelsea? A bit premature surely. Have you forgotten about ? But then perhaps this will tell us how closely politics and football punditry are correlated!

David Cameron might just well be right. A quick poll of the 26 members of staff (nurses, doctors, auxilliarys and pharmacist)on our 2 wards (in a geriatric hospital) and no-one would vote labour "not even if you paid me".

Louise Waugh ended her contribution, and I quote, (Not even if you paid me). One would have thought she was referring to all her colleagues in work and not herself personally. Or did the truth finally come out, or maybe it is a missprint. Not from a medic surely!

Dear David Lloyd, if it's spin you want, vote NuLab, if it's a new start then DC is the man for you:

Labour's problem stems from NHS managers not properly managing the vast increase in funding provided to them, thus cuasing the current problem of having to lay off staff to meet budgets. I'm sure if the Tories had won the last election and implemented Cameron/Letwin's budget cuts we'd have a far deeper dis-satisfaction amongst NHS staff, and the public generally (that is why they didn't get elected). I'm certainly not convinced the Tories are ready to properly fund public services.

Nick,
My daughter is caught up in the MMC/MTAS debacle - it really is disgusting and a resigning issue for Patricia Hewitt. When a New Labour Minister utters the word "modernise", it is time to run for cover. Plus of course, much of the extra funding piled in by Labour has been wasted.

My understanding of the NHS issue is it’s part of a bigger picture. Government, authority, and public show individual cases of failure and being caught up in events with a poor tone. As per the comments by Jonathan Freedland in today’s Guardian, this is not an issue that pure argument has been able to resolve. I take this as another indicator that John Reid would be the best candidate for the role of Prime Minister.

The first major cash injection into the NHS was soaked up by nurses using their collective muscle to grab what they can. This disruptive and greedy attitude seems to be continuing and infecting both Doctors and, most likely, the morale of administrative staff. Clearly, this bullish and insensitive behaviour cannot continue indefinitely. Fighting it will only lead to more trouble, but taking a firm but friendly stand may help.

One may hope that a situation is resolved to staff, government, and public’s satisfaction but people aren’t always insightful or patient enough to seize the positive consensus. I remain of the opinion this is a systemic fault in British society and the economy, and that failure here reflects badly on all stakeholders and other political parties. Better is possible, and there is scope for sound leadership to prevail, so I remain optimistic.

Yet again the NHS is a political issue,despite the large investment of national resources which should have cured all its ills.Perhaps the Health Department,like the 91Èȱ¬ Office,is "not fit for purpose".Recent British history shows that industries which become political "footballs", do not stay under British control,e.g. motor and steel industries, perhaps the NHS is heading the same way through PFI's etc and would it necessarily be any the worse for it?

I think Nick meant the FA cup final!

It's no wonder that we've had a Labour government for the last ten years, given that some people's grasp of politics is as poor as their knowledge of footballing matters: presumably Nick is talking about the Premiership fixture at Stamford Bridge on Wednesday 9 May, not a Champions League final that may or may not transpire... (when was the Champions League ever referred to as 'the title'???)

12,000 doctors marched, this reflects the deep anger and sadness felt that up to 15000 will face career termination on 1st August 2007. At the Mass Lobby of Parliament on 25th April, doctors who had voted Labour in the past were apologetic and absolutely definite they never would again. Patricia Hewitt has ruined the careers of thousands of dedicated young doctors and wasted billions training doctors for New Zealand, Australia etc. Money has been poured into the NHS but unfortunately gross miscompetence has seen it go straight down the drain. Millions wasted on inefficient penpushers,millions wasted on fatally flawed IT systems and billions wasted on training physios, nurses, doctors et al just to prepare them for the scrapheap. I was at the March and in the Commons for the opposition debate; regardless of the past most of those present cheered the Tories and Liberal Democrats and those few Labour MPs who have had the courgae to criticise their own governmnet for causing the biggest scandal in the NHS history.

Really Nick Robinson
You must have been living in that Westminster village for far too long and really need to get out more !!!!
If you remember what state the NHS was in under the Conservatives no-one in their right minds would ever trust them to run it again !!!!!!!
Some of the former suspects lurk within that Tory part despite the shiny face of Cameron

No I think the decider for premeirship.

T. Blair announce his resignation on the night of the Premiership title decider?

I really, really hope he does. That way, even if my team loses, there will be much to celebrate.

And I speak as one of the many who voted with such enthusiasm for the man in '97. More fools us.

Re: Roger Owen's post (17): I wonder if in the post PFI era any private companies would want to buy into a major NHS hospital, there can't be much profit left to take. Oh, what am I saying, get rid of the huge administrative overhead, there's the profit margin.

When this article talks about the staff in the NHS, and indeed, when anybody talks about the NHS workforce, I am amazed how everybody beyond the medical workforce is forgotton. My pay (I work in a Cafe in FPH) as a young Uni student is amazing, I have reasonable job security, I am well looked after and I get free further education should I need it. The NHS can offer massive flexibility because of its size (this summer will be the 3rd core I've worked in), and even if it's 500 million pounds in debt, this is 0.5% of its total budget. Most company's are happy with a 40% borrowing to earnings ratio. Ok, so it's a little slow, beauracratic and silly, but this is the 3rd largest organisation in the world in terms of employee's (behind the Chinese Army and Indian Railway Service) and I bet that employees in these organisations aren't as well looked after as those in the NHS. So what, some doctors won't be able to find a job? First of all, it ensures competitiveness, which is great. Second, I know my doctors will speak great English. Thirdly, I thought a surplus was good, we can export and sell them. If a doctor goes and works in Spain, for example, his N.I contributions come to Britain even though he does not use our services. This is good news surely? I fail to see this appocalyptic vision of the NHS.

One matter that is overlooked is that the NHS is both a monopoly buyer & employer of almost all typeas of health care. Health service workers have always responded to that monopsony power by forming cartels. The BMA is the most powerful of those cartels, Unison is another. All those are the normal monopoly and cartel responses that we can observe operating in the NHS.
Government - of any party - should be seeking radical change to working conditions to focus the NHS onto productivity growths. Rising productivity will release the resources needed by currently under-resources services.
Pure monopolies always resist those sorts of changes. That's what's happening today, and explains the apparently perverse behaviours of the cartels.
As employee productivity rises more quickly - and it is - their capacities will also rise. That will create excess capacity in many sections of the NHS. Resources liberated by higher productivity will enable under-served ailments to get more resources. Moreover, large reductions in specialists' waiting lists will diminish the bargaining powers of all types of specialists and their cartels. As would a nationwide patient file system.
Those changes are also accompanying a shift back to GP provided diagnoses and treatments, which also shifts employment from NHS employment in Hospitals to direct employment by GPs.
It is entirely understandable that such changes in power should be so misunderstood when their intentions have not been properly explained.

To anyone above who has criticised Nick for not knowing his football or presuming that Man Utd/Chelsea will compete for the European Cup - I believe it is actually the Premiership title he was referring to - the outcome of which will most likely be decided on one fateful match between Man Utd and Chelsea next month!

As for the NHS I think it's true that the perception of the NHS differs from the experience of most who use it (as complained about by Mr T. Blair) however what we, as members of the public cannot know, is just how hard it has been to maintain that level of service. Judging by the current level of bad feeling apparent from the noises made by junior doctors and the nurses, the strain has been unbearable. It is that which needs to be addressed by whoever is in power. So in my view banging on about waiting times is irrelevant.

I have had the misfortune to spend some time at an NHS Trust Hospital recently. All the staff I have encountered - cleaners, nurses and consultants have been fantastic - showing a level of professionalism and dedication way beyond the call of duty. The only group who did not were the junior doctors. With just one or two exceptions, they seem to strut around the wards treating patients and family as an inconvenience. They have zero initiative and only question what is before their eyes when it is pointed out to them by a consultant - of whom they all seem to live in fear of upsetting. The NHS belongs to me and everyone one in the country - yes there are problems - charging staff for car parking is a disgrace - but by and large the NHS is something that I am proud of - and I just wish the junior doctors would pull their fingers out and start behaving like the professions they purport to be.

Liam - 04:05pm - strange comments. Firstly, Government should never waste taxpayers money on the scale the present one has, even on something like the NHS - every pound spent should count. Secondly, the reason junior doctors have an employment crisis this year is purely because of Government interference in their career structure - the surplus has been engineered because of the crass implementation of MMC (Modernising Medical Careers) and MTAS. Thirdly, if a UK trained doctor goes to work long term in Spain, he will have to register to pay his tax and NICs equivalent there, not in the UK - so the UK pays to train him, but gets nothing in return!

12,000 doctors marched, this reflects the deep anger and sadness felt that up to 15000 will face career termination on 1st August 2007. At the Mass Lobby of Parliament on 25th April, doctors who had voted Labour in the past were apologetic and absolutely definite they never would again. Patricia Hewitt has ruined the careers of thousands of dedicated young doctors and wasted billions training doctors for New Zealand, Australia etc. Money has been poured into the NHS but unfortunately gross miscompetence has seen it go straight down the drain. Millions wasted on inefficient penpushers,millions wasted on fatally flawed IT systems and billions wasted on training physios, nurses, doctors et al just to prepare them for the scrapheap. I was at the March and in the Commons for the opposition debate; regardless of the past most of those present cheered the Tories and Liberal Democrats and those few Labour MPs who have had the courgae to criticise their own governmnet for causing the biggest scandal in the NHS history.

Re Liam's comments.
I too am a taxpayer and can have opinions on a wide variety of subjects no matter how ill informed they are.

Mr Hardwidge (#16), is there any announcement that you would not take as an indication that John Reid was the best man for the job of PM?

Personally, the main impression I have of Dr John is that he serves as a salutary reminder that Oswald Mosley started off in the Labour Party. His naked lust for power, his blatant authoritarianism, and his willingness to adopt any set of principles, no matter how abhorrent, frighten me. This isn't the kind of man you'd want chairing your parish council, let alone your government.

(Unfortunately, that is more or less true of almost everyone who ever gets involved in politics. It's just in Dr John's case, it's really very much more.)

But more puzzling is the kind of mindset who would look at a man for whom the thought of power induces little shiny strands of drool, a man whose consideration of alternatives is limited to how macho they will make him look or how he can use them to rail against the immigrant "problem", a man whose approach to troubleshooting would, if transferred to the Cabinet, see errant ministers "agreeing" to be publicly crucified in Hyde Park - and think "Ah yes, that truly is the man to whip this country back into shape". Does it not matter that the shape in question is a flash in a circle, so long as that shape is rigidly held in place? Or maybe it's just the idea that real whips would be involved that appeals?

Because as far as I can see, the only problem that John "Adam Susan" Reid has any real interest in fixing is the "problem" that he's not in absolute charge of everything - and as far as I'm concerned, heaven help us if that ever gets "fixed".

I said that Oswald Mosley "started off" in Labour. That's incorrect; he was elected first as a Conservative MP, but crossed the floor and became a Labour minister, before leaving to form first the New Party (remind anyone of anything?) and then the British Union of Fascists.

I know that it was definitively not true that David Cameron was booed by junior doctors.

Liam - you claim that competitiveness brought about by the new MTAS system will improve the quality of the doctor providing your treatment.
Apart from all the problems reported in the press, one which somehow hasn't seemed to find its way out into the public domain is that not only is the system a disorganised shambles...it is also set to choose doctors by a series of psycho-babble answers that can be answered by anyone, whether thay have medical training or not (and probably better the LESS training you have!). The first round of short listing didn't allow the consultants doing the short listing to see any of the candidates previous experience, exam qualifications, research etc etc.
Since doctors are oft likened to airline pilots this system has been likened to hiring an airline pilot without actually asking if they can fly a plane.

I managed to get a job through the old system (if I hadn't I'd already be in Canada to beat the rush that will occur in August) so if this hubrub was just about 10,000 doctors not getting jobs then would I care enough to travel 4 hours to London to attend a march on Parliament?

I am appalled by the way the new system has been implemented. This is because we can all see bright and brilliant candidates with breadth of experience being sidelined by the governments desire to "streamline training". So not only are doctors getting less hours per week training, and less years training in narrower and narrower specialities, but the ones who do have experience and core skills are being sidelined in a politicised system.

3 years ago the number of hospital managers grew greater than the number of beds in the NHS (300,000 against 297,000). Since then the number of non-medical staff has only increased and the number of beds has definitely decreased.

When I qualified medical and nursing staff were a lot happier than they are now. The entire profession is dispirited, morale is at an all time low and the good will that is keeping the NHS running is being undermined by a government that is taking them for granted.
The government spin has kept the public believing that it is all "greedy consultants and GP's" causing the NHS' problems. If you speak to people in the profession we will all agree that we are paid better than we were, but that that has only brought our pay into line with the work and antisocial hours that we do. Most of us also believe that the NHS is systematically being torn apart and privatised by stealth. We are all worried that in 5-10 years time the NHS will be beyond saving (it may already be so) and the quality of care in this country will be the laughing stock of the world.

Respondents like Charles E Hardwidge (reply #16) and liam (reply #25) seem to have bought the Labour Spin rumour that this is all about greedy doctors not wanting their cushy number upset by a fair and rational streamlining process. This isn't the case. The average Foundation Year One doctor (new name for a house officer, the job I'll be starting in August) gets paid less by the hour than some of the cleaners.

Modernising Medical Careers is an unpiloted scheme being rolled out nationwide, reducing the amount of experience a 'fully trained' doctor will have when they're called to treat Joe Public's heart attack, stroke, hernia or perforated ulcer. The farce regarding the application system for MMC has stirred up the resentment of the profession, and obviously the culling of thousands of dedicated juniors is the primary concern at the moment.

However, MTAS is merely a symptom of the overall problem. MMC is not designed to produce better, nor more 'modern' doctors. It's designed to cut our training, so that the Government can pay less of us less money to do our jobs in a less effective way. If you think that'll be better for the health of the populace, then I'd question your competence and suggest you should see a psychiatrist (if Patricia Hewitt wasn't planning to make them unemployed).

Don't believe everything Labour tells you.

Nick is absolutely spot on.

Labour is entirely responsible for the current NHS crisis through gross mismanagement.

There will be a summer of NHS discontent with marches through london, cancelled operations etc etc. It will finish off new labour and decide the next election. Brown is doomed before he even starts.

This is nothing to do with money - there is plenty in the NHS. It is all to do with where the money goes and how it is managed. Labour have ruined everything, and ultimately the patients will suffer. They already are.

My family and I have made extensive use of the NHS. With one exception, the service provided has been excellent and prompt. The eye-care provided in Hereford's new hospital, particularly, has been exemplary. I don't doubt there are difficulties in the NHS, but it has improved hugely since 1997 and Labour can take a huge deal of credit for that.

Tony Blair is justified in his complaints. For all the problems the NHS has, it is still an excellent service and I am grateful for it.

Nick,
You are right to say that the medical profession have lost all faith in this Labour Government. True the government have poored a lot of money in to the NHS, but with this has come their obsessive desire to micromanage the health service and dictate to its staff how, when and where they must work. This is the basis of the junior doctors greivances: for the last time, it's not about money! Junior doctors aren't asking for a pay increase, just the opportunity to pursue careers in accordance with their own aptitude and ambition and not just to fill New Labour targets.
For the misguided Charles Hardwidge I would to point out that as a junior doctor I earn less than 10 pounds an hour (and I'm not even asking for a pay rise) - does this make me "greedy"?

Delighted to hear, Nick, that you and Michael Crick are 'Reds'. So that's Red Nick and Red Mick, I suppose ? Very clever of you to make this revelation in a blog which many will have seen as pro-Tory. Cameron can hardly complain about your Red credentials now, can he ?!

I would like to share my experiences of the NHS, i have seen it improve loads in recent years.

My mum went into hospital recently, she bought a new book, a drink and a cake to help her through the wait. She was very surprised when she hadn't even finished the first page and was seen by the doctor. The service was brilliant and the people very lovely.

I have also just left university where the numbers of medics and nurses bneing trainined on campus and in the wider Birmingham area has increased loads.

I am also personally very proud that a new hospital is being built in the city - something that has not happened for twenty years.

As a young people I have also use a sexual health clinic - which is often not talked about. It was very good, very clean and i was seen with only a days wait. There has been lots more money in this area but no one talks about it because ironically it is not sexy!!!!!

I only hear bad things about the NHS but there are people who are very hard woirking in the NHS who care a lot and are making a huge difference. I also think that the govenrment are working hard in this area - you can see the new money, more nurses and no waiting lists.

Finally i would like to say thanks because I think it is not said enough!

Rich x

Correct me if I'm wrong but wasn't the only time that the NHS budget was cut under Labour when the IMF stepped in? There was never a cut under the Tories, just less given than what was demanded, which is a different thing. If not, what was the winter of discontent all about?

Things can only get worse!

According to Channel 4 news, the personal details of doctor applicants were available online in a major breach of data security.

Funny old thing, Hewitt could not be bothered to either appear on the news or dispatch a minion.

It's quite a feat, alienating the entire medical profession. One question I have - if an overworked anaesthetist was driven to suicide by 80-hour weeks, how come there are not enough jobs for doctors?

I heard something similar from a standup comedian who told me that he used always to be able to get a cheer with an "aren't the Tories crap?" line. Now it dies. But he can get a good laugh with jokes against NuLab. Straws in the wind ...

He dates the change to about last March or April, just before the disastrous local elections.

As an excuse, being too puffed out from a run in Clissold Park wouldn't work so well, I suppose!!

Watching football stopped you reporting that story?

What were you doing the other 6 working hours, then?

Re: Post 25 from Liam, the reason there's a problem is that thousands of doctors have only one interview to get training in the UK. If they fail to get a training post this August, they will have next to no chance to get training EVER AGAIN in the UK due to the new employment rules introduced by the Government. If you lose your job, you can always apply to another hospital in the same city or another city.

If doctors fail to obtain a training post this August through their one interview, the Government will not allow them to apply again.

The Government is basically incentivising doctors who don't obtain a training position this year to go abroad - most likely to the US, Canada, New Zealand or Australia - so we won't get the benefit of those NI contributions.

We have 11,500 doctors who will not be in a training position this August.

It costs 250,000 pounds of tax payers money to put a doctor through medical school.

If all 11,500 leave, that's a loss to the taxpayer of 2,875,000,000 or 2.875 BILLION pounds.

And remember another thing - those 11,500 doctors are currently working in the UK. If the Government drives them abroad (which they are currently doing), what will happen to patient care?

My advice to you all - don't get ill in August when all these new doctors' posts start!

nICK-Tony Blair might announce his departure next wednesday ..on his 10th anniversary...if he thinks its the only way to prevent a meltdown in the may 3 elections.If I were you I'd get ready for the scoop....

I would call that omission dereliction of duty - surely reporting problems with the NHS comes before watching football.

Anyway, the football would have taken only about 2 hours out of your day. What were you doing for the remainder of the day ?

So, May 9th then? Bye bye Blair. We shan't shed tears for you.

The NHS situation is representative of what the Labour government is: lots of spin, amateurism and a given talent for failure. They try to tell us about the so called multiculturalism and we end up with gigantic losses of real jobs and slavery in our own country. How much money have they wasted in a security apparatus to counter the consequences of the mess they themselves have made?

To Sean & jimc he could also have meant the European Championship Final... (sorry Liverpool)
So Nick you finally admit you're a red and I thought it was not allowed for 91Èȱ¬ reporters to admit their political alliegances...
As a matter of interest why would TB announce his retirement date during a Man U Chelsea game? Surely the point is to announce bad news when there are far more important events taking place to hide it.

The notion that the Tories can be trusted with the NHS is ridiculous to say the least and anyone cheering a Tory's speech on the health service should be ashamed of themselves. Were they around ten years ago when we had annual winter crises? When 400,000 more people were stuck on waiting lists, dying waiting for their operations? When more than half of the NHS estate was built before the Second World War? Were they protesting then?

The NHS may be going through a period of profound change, and no-one denies that that reconfiguration is going to mean pain for some. But perhaps we should cast our minds back to how the NHS was ten years ago - namely, on its knees - and recognise that that massive investment in it, yes including the hiring of nurses and doctors and paying them properly, was long overdue.

In all comments I have read comparing the NHS with a labour government to the NHS with a conservative government one thing appears to be taken for granted - the quality of the medical care provided. Waiting times, decor, 'customer service' aspects... all, essentially, pursuing the avoidance of complaints (which are counted along with many other beans)... these can improve and deteriorate depending on political imperatives (avoidance of complaints, strenuously trying to meet targets).

Government targets do not measure quality in any meaningful way. So it's going to be hard to prove that the government's Modernising Medical Careers agenda will result in a dumbed down, demoralised, less skilled, less experienced product of specialist training. Perhaps one should listen to the huge number of doctors who are protesting against the changes in training? Perhaps the fact that the opposition debate in the commons last Tuesday was so scary that the government felt the need to issue a three line whip speaks volumes?

It will take several years before the changes in training reveal their flaws... when complication and mortality rates rise... but by then it will be too late.

The junior doctors I have heard over and over in the past few days seem to be politically motivated conservative party members and just out to score points with headlines. Not once did they propose any solution to the so call ills of the NHS.
Junior Doctors and the media should read the terms and conditions of service that were in place before the present government came to power. I seem to remember a 84 plus hour week with no overtime pay. Then they should check how many training places there were then, a fraction of what there are now. They can then thank their lucky stars there will be no return to the good old days.

I am a recently retired GP and work for a PCT one and a half days a week on Primary Care education and managing the GP appraisal scheme. I think the very significant investment into General Practice will result in a great improvement in health and is the most significant thing I have seen since I became a doctor in 1969. The targets GPs have to achieve with their patients are all evidence based and linked to care of the highest order. It is the achievemnet of these targets that have prevented thousands of heart attacks, for example. I did not realise how complex General Practice was until I retired and had time to reflect. GPs earn every penny they are paid with this new contract. I am now a proper patient with an excellent GP!!!