Mini Budget aka Fiscal Statement

[malvolio]

Hunt The NHS Destroyer can't lose can he? If he fails to steady the ship it's because Truss did them up like a chicken, if he does steady the ship it's because of his own brilliance. I bet he thought his front bench career was done, he;'s been handed a gilt edged reprieve.

You can't blame Hunt for the state of the NHS. I know several senior NHS people who think he did the best of an impossible job (those same people also know the answer - bin targets, centralise purchasing and sack all the non-clinical managers).

But apart from that, I agree that if he can get things back on course, which is not beyond him, it will do him no harm at all.

Meanwhile assorted papers are suggesting that the Tories are looking to Boris, May, Wallace, Braverman and Sunak to replace Truss, which rather demonstrates just how unfit to govern they really are. If only there was a half decent alternative...

[Lost It]

Really?

If you look at Hunt's history you will soon discover that when you looked past his press releases, you found a very different story – one of missed targets, lengthening waits, crumbling hospitals, missed opportunities, false solutions, funding boosts that vanished under scrutiny, and blaming everyone but himself.
Hunt’s hospital legacy?


Hunt took over responsibility for the NHS in 2012. By the time he left the post six years later, patient experience and staff morale had both taken a dramatic turn for the worse across many key indicators. The Winter crises deepened, with official figures showing 2017, 2018 and 2019 were successively “worst on record” up to that point. The British Medical Association (BMA) reported that by 2018, “the “winter crisis” has truly been replaced by a year-round crisis”. He took an axe to the NHS. Promised funding that was a rehash of what had been promised the year before, funding that never appeared.

The man systematically took apart everything that Labour had done to cripple the NHS. That's his "legacy".

NHS rules say 95% of patients visiting A&E should be seen within a maximum of four hours. When Hunt took over, the performance was just below target – 94.9%. Performance worsened steadily during his tenure and was 84% by the time he left, with the target having been missed every winter since 2013/4, and every single month since July 2015. That meant three times more patients waiting over four hours to be seen in A&E when Hunt left office than when he started. He damaged the NHS so much that even without Covid the figures were still climbing.

Hunt’s answer aside from making it harder to access the figures was to float the idea that patients could perhaps be banned from just walking up to A&E – an idea that he was forced to disavow, but that has resurfaced recently.

A&E is a bellwether for the NHS. The number of hospital beds (already low compared with those in most developed countries), also dropped significantly – from 135,559 beds in the quarter that Hunt took over, to 127,305 when he left, a loss of over 8,000 beds. Bed occupancy rates over 85% are considered overcrowding, and increase infection risks, cancelled operations and pressure on nurses. They peaked at record levels of over 90% in Hunt’s last winter – and this was an average, with some hospitals repeatedly hitting 100%.

Other targets – notably cancer referral times and waiting times for planned operations – also went from being comfortably exceeded to being missed every month under Hunt’s watch.

I was particularly concerned about the Cancer figures... Vested interest here.

Nationally and locally, a range of treatments were restricted. Hernia, hip and knee operation patients weren’t treated until they were in severe pain. Cataract operations and hearing aids were restricted to one eye or ear (who needs two anyway?). Vasectomies, erectile dysfunction treatment and diabetes monitoring were scrapped or severely restricted in growing numbers of areas. In response, NHS hospitals increasingly turned to offering ‘self-pay’ options to private patients.

Hunt oversaw years of historically low funding increases (around 1%, compared with an average of 6% in the years between 1997 and 2010, and compared with the 4.3% recommended by the Office of Budget Responsibility and the likes of the Kings Fund, Health Foundation and Nuffield Trust, as the minimum to keep up with health inflation and increasing demand). Perhaps most damagingly, he oversaw a significant cut to the amount that hospitals were paid per procedure (payments which make up three quarters of their income).

Hospitals now receive on average 10% less for treating a patient than the treatment actually costs the hospital (by the admission of the head of the then regulator, Ian Dalton). And when cash-strapped hospitals missed financial and performance targets that the Public Accounts Committee said were ‘unrealistic’, they were fined, something that – unsurprisingly – has been shown to do nothing to improve performance.

I stand by what I said. Hunt is the destroyer of the NHS.

[Lost It]

That's only a small bit of what he did. Virgin got a huge chunk of money out of his policies, he introduced "care in the community" completely ignoring that it costs more to look after people outside the care system, he privatised left right and centre.

Do you rememberthe "Circle" fiasco? That was his work too.

The man is a complete see you next tuesday.

[sadkingbilly]

not a fan of his then??

[malvolio]

And the root cause of all those failings in the NHS?

Allowing GPs to give up 40% of their work in exchange for a major pay rise. People can't get appointments so they go to A&E. An acute service is therefore having to perform a chronic care function.

95% waiting in an arbitrary period? A pointless measure by any standard, especially when every hospital now needs to devote a whole team to measuring wait times and reporting them, as well as not recognising that A&E is a triaged service and if you aren't at death's door you can bloody well wait until they have the people to see you. Or go home and try to get to your GP or even your local chemist, who is more than capable of helping with minor ailments.

The deterioration started well before Hunt's tenure, and while he didn't make it better - hard to see how anybody could given the constraints - it certainly didn't make it worse.

Long term care also suffers, mainly from bed blocking meaning operations and consultations are routinely delayed at short notice. That care in the community is not such a stupid idea, but it does need resourcing properly.

There are a dozen other major problems, but here's the thing - they all share the same root cause.

All that apart, I totally agree that from our side of the fence the NHS is in a shocking state and is failing us badly. But perhaps go talk to the professionals and hear what they think...

[sadkingbilly]

typical rabid tory - 'it wasn't us! - big boys did it, and ran away!'

[malvolio]

typical rabid tory - 'it wasn't us! - big boys did it, and ran away!'

Typical non-student of history: stick to slogans, much safer than confronting reality.

And I didn't mention any parties. I also didn't mention that the new GP contracts date from 2007, after 2-3 years of negotiation. Nor did I mention who was in No 10 at that time.

[SueEllen]

And the root cause of all those failings in the NHS?

Allowing GPs to give up 40% of their work in exchange for a major pay rise. People can't get appointments so they go to A&E. An acute service is therefore having to perform a chronic care function.

There was a shortage of GPs then but a much bigger shortage now.

Which party in government had 12 years to sort out work force planning and doctors pensions?

95% waiting in an arbitrary period? A pointless measure by any standard, especially when every hospital now needs to devote a whole team to measuring wait times and reporting them, as well as not recognising that A&E is a triaged service and if you aren't at death's door you can bloody well wait until they have the people to see you. Or go home and try to get to your GP or even your local chemist, who is more than capable of helping with minor ailments.

Which party in power had 12 years to sort that out?

The deterioration started well before Hunt's tenure, and while he didn't make it better - hard to see how anybody could given the constraints - it certainly didn't make it worse.

He, his predecessor Lansley and those who came after them all from the same party in government have had 12 years to change it.

[malvolio]

There was a shortage of GPs then but a much bigger shortage now.

Which party in government had 12 years to sort out work force planning and doctors pensions?



Which party in power had 12 years to sort that out?


He, his predecessor Lansley and those who came after them all from the same party in government have had 12 years to change it.

Am I denying that? I don't believe I defended any of it.

How easy do you think it would be to do it, given any attempt to discard any bit of the NHS, even the most pointlessly expensive, will result in mindless cries of privatisation and penny pinching.

£157bn a year goes in to the NHS. It's not well spent... The problem transcends knee jerk politics.

[SueEllen]

Am I denying that? I don't believe I defended any of it.

How easy do you think it would be to do it, given any attempt to discard any bit of the NHS, even the most pointlessly expensive, will result in mindless cries of privatisation and penny pinching.

£157bn a year goes in to the NHS. It's not well spent... The problem transcends knee jerk politics.

So it is knee jerk politics to do workforce planning which the doctors unions and other health unions asked the government that has been in power for 12 years to do?

It is knee jerk politics to sort out a mechanism to stop doctors paying into their pensions so they don't retire early which the government in power had 12 years to sort out?

Etc
If the party in power could force through the Lansley reforms and junior doctors pay deal, I'm sure if they had the willing they could have sorted out the 2 issues I've mentioned above plus other things that have already been mentioned.