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NHS Care Failing Older People


The BBC News site led today with a story about the NHS failing ' treat the elderly with care and respect.' What makes this story particularly disturbing is its origin. It doesn't come from a charity representing older people, or from a political group opposed to the cuts. It comes from the Health Ombudsman, the government regulator, the highest authority you can appeal to through the NHS complaints system. As such, it describes real failings. The government's response is that changes resulting from the Health and Social Care Bill will makes the NHS 'more responsive'. Leaving aside the obvious question about the relationship between 'responsiveness' and massive cuts to the NHS budget, the Bill's proposals for public involvement also look like being more like rebranding than real reform.


Part of the Health Secretary's flagship proposals involve setting up a new watchdog. In fact the new body,  HealthWatch, will be a continuation of the previous government's LINks (Local Involvement Networks), with no statutory powers. GP consortia will have a duty to 'involve' patients, but (like the old system) without handing over any real power. The outgoing NHS commissining bodies - PCTs - are at least required to have a Board of Trustees, which must by law have a majority of non-Executive Directors. These people are supposed to represent lay people's views, and can be held responsible if they do not. Although in practice the system has never produced real accountability, Board meetings are minuted published online, and other papers are subject to the Feedom of Information Act. This has given local people information and a point of contact when they want to influence the actual decision making process. On the other hand, most GP practces are private profit-making enterprises (the Royal College of GPs sells courses on how to run practices for profit) and they are not required to have any public representation on their governing bodies. A duty to consult is meaningless where the governing body is still able to make decisions that are not open to challenge or even real scrutiny.


There is nothing in the Bill to stop GPs from handing over their new commissioning powers to private companies, and there are plently who are planning to do just that. Some are looking at giving bonuses to commissioners who underspend their budget and make a 'profit' - giving them an incentive to spend less public money on public services, and line their own pockets instead.  Far from making services more accountable to ordinary people, the changes in the Bill will hand the NHS over to people who will be allowed to run it for profit. Instead of  making the NHS more responsive to the needs of older people and other vulnerable patients, this Bill will make savage cuts even worse by allowing greedy private sector bosses to divert public money into their own pockets.


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