| Has Kier gone DOGE rogue? on 13:23 - Mar 13 with 2066 views | SuperKieranMcKenna |
Pretty light on detail like all his policies - so would be interested to hear from anyone ITK.
The fact it was praised by Hunt rings alarm bells for me… |  | |  |
| Has Kier gone DOGE rogue? on 13:35 - Mar 13 with 1996 views | MattinLondon |
| Has Kier gone DOGE rogue? on 13:23 - Mar 13 by SuperKieranMcKenna |
Pretty light on detail like all his policies - so would be interested to hear from anyone ITK.
The fact it was praised by Hunt rings alarm bells for me… |
Everyone hates red tape and bureaucracy until something goes wrong and then people ask ‘where were the safeguards? |  | | |
| Has Kier gone DOGE rogue? on 14:58 - Mar 13 with 1861 views | DJR |
NHS England is part of the Lansley reforms which were embodied in the Health and Social Care Act 2012.
They were controversial at the time, with much opposition and I was one of many who campaigned against them.
One political point of them was to remove responsibility for the NHS from the Secretary of State which I always thought was designed to avoid the government being held responsible for the failings of the NHS, a rather forlorn hope. But it also caused issues during Covid when the government found it had limited powers in relation to the NHS at a time of national emergency.
The reforms turned out to be disastrous and there has already been some rowing back on them by the Tories.
https://www.bbc.co.uk/news/health-46827981
"Are Andrew Lansley's NHS reforms being binned?
Consider this, it is just over three years since the last piece of the jigsaw in Andrew Lansley's controversial NHS reforms was put into place.
In 2015, health visitors moved into local government to complete the transfer of public health from the NHS to councils.
It completed what former NHS chief executive Sir David Nicholson once described as a reform programme so big it could be seen from space.
Now - with the country mired in Brexit - it is easy to forget just how tricky it got for the government in the early coalition years.
Unions and royal colleges lined up to oppose the changes and at one point it even threatened to turn the coalition partners against each other.
Eventually changes were made and Mr Lansley got them over the line with the Health and Social Care Act passed in 2012.
The restructuring created a new body, NHS England, to run the health service, set up new regulators and replace primary care trusts with GP-led clinical commissioning groups (CCGs) to organise local services, while handing healthy lifestyle programmes to town halls.
Underpinning the changes was the idea that greater competition in the NHS would help create a service fit for the 21st Century.
But on Monday that was effectively reversed, with the NHS Long Term Plan arguing collaboration was key.
It called for integrated care systems (ICSs) to be created across the country by 2021. These are partnerships that bring together hospitals, CCGs, community services, charities and councils, so they can work together rather than against each other."
https://www.newstatesman.com/spotlight/2020/10/short-disruptive-life-most-contro
"The short, disruptive life of the most controversial reforms in NHS history
How the health service survived the first wave of coronavirus by ignoring Andrew Lansley’s Health and Social Care Act
In 2010, David Cameron promised “no more top-down reorganisations” of the NHS. Two years later, in government with the Liberal Democrats, his health secretary Andrew Lansley introduced what many describe as the most sweeping reforms in the NHS’s history.
The Health and Social Care Act, passed in 2012, ceded power away from the Department of Health in an attempt to decentralise decision-making, increase competition between local NHS bodies, and extend the so-called “internal market” in the provision of services. Purchasers and providers were to be kept strictly separate, and GPs were to be given autonomy over commissioning from either public or private entities.
But less than a decade after its implementation, the act has been abandoned, in a process precipitated by the coronavirus pandemic. Many of the key organisations it created have received fierce criticism for their purported mishandling of the crisis.
And even before Covid-19 struck, the results of the huge restructure were decidedly mixed. In 2015, The King’s Fund described the act as a major distraction for the NHS that caused huge, unnecessary upheaval. The think tank said the act had created “an unwieldy structure”, with “leadership fractured” between competing national bodies and “a bewilderingly complex regulatory system”.
A 2013 report by the Centre for Health and the Public Interest said the coalition government’s reforms had impeded the NHS’s ability to deal with a pandemic flu, in part because of the “inevitable consequence[s] of the disruption caused by such a major re-organisation”. It also highlighted “fragmentation and a lack of clarity within the newly created organisational structures”. The act’s “market-driven system” had led to a prioritisation of “efficiency savings” while “minimising spare capacity in hospitals”, the report concluded.
The Health and Social Care Act was immediately controversial. Before it was passed, opposition from trade unions, healthcare professionals and the public led to the government announcing a nationwide “listening exercise” to “pause, listen and reflect” on the proposed reforms.
Its critics derided the act as backdoor privatisation. Their concerns were accentuated when an adviser to then prime minister David Cameron told a conference of private healthcare executives in 2011 that the coalition’s reforms would speed up the transformation of the NHS into “a state insurance provider, not a state deliverer” of care. The NHS would be shown “no mercy”, he said, and the reforms offered a “big opportunity” for the private sector. A group of doctors working in the NHS formed the National Health Action Party to oppose the legislation.
The act established an alphabet soup of arms-length and semi-autonomous non-departmental bodies. These included the NHS Commissioning Board (otherwise known as NHS England); Public Health England (PHE); clinical commissioning groups (CCGs), controlled by local GPs; the NHS Trust Development Authority; Monitor, a new regulatory body; and dozens of competing, financially independent but state-funded new foundation trusts – a process that had already begun under the New Labour government.
“A key part of the act… was the idea of independent competing foundation trusts whose job really was to look after themselves,” Dr Richard Murray, chief executive of the King’s Fund, told Spotlight. “In terms of the patients that cross the threshold, it wasn’t up to the service down the road to protect them. It was all based on this idea of a market of competition between trusts.”
The legislation was tortuous and convoluted. In 2014, the British Medical Journal quoted a former No 10 adviser who described the act as “unintelligible gobbledygook”, and its passage as the biggest mistake the Conservatives under Cameron had made in government. “No one apart from Lansley had a clue what he was really embarking on,” said the Downing Street insider, “certainly not the prime minister.”
Shirley Williams, who led Liberal Democrat opposition to the bill from the House of Lords, claimed that in her long political career she had never seen a bill that was “so incomprehensible, so detailed, so long, [and] so impossible to understand”. The junior coalition partners eventually acquiesced in the act’s passage through parliament.
In August, in the midst of the biggest health crisis the UK has suffered in decades, the Health Secretary Matt Hancock announced the abolition of Public Health England (PHE), one of the bodies that the 2012 reforms established.
In his “Future of Healthcare” speech in July, he described national healthcare institutions as “too siloed… by law under the 2012 act”. For weeks, newspapers had reported on ministerial frustration at their lack of control over the running of the NHS, the disappointing performance of quasi-independent organisations like PHE, as well as on Downing Street’s plans to now restrict the service’s operational independence. Hancock, the Guardian reported, was “frustrated [by] how limited his powers [were] and [wanted] to get some of that back”.
[Post edited 13 Mar 15:16]
|  | | |
| Has Kier gone DOGE rogue? on 15:21 - Mar 13 with 1774 views | DJR |
| Has Kier gone DOGE rogue? on 13:23 - Mar 13 by SuperKieranMcKenna |
Pretty light on detail like all his policies - so would be interested to hear from anyone ITK.
The fact it was praised by Hunt rings alarm bells for me… |
Hunt was Health Secretary from 2012-2018, so obviously went along with the Lansley reforms but even he must by now have come to the conclusion that the reforms were wrong (see my post above).
As regards NHS England, its abolition is said to be a consequence of the regaining of government control of the NHS, and I believe the issue is that there is a duplication of staff with the Health Department.
As it is, virtually every policy under the Cameron government was disastrous (Failing Grayling anyone?) but Telfon Call me Dave never gets the blame. [Post edited 13 Mar 15:38]
| | | |
| Has Kier gone DOGE rogue? on 15:24 - Mar 13 with 1750 views | gsoly |
| Has Kier gone DOGE rogue? on 13:35 - Mar 13 by MattinLondon |
Everyone hates red tape and bureaucracy until something goes wrong and then people ask ‘where were the safeguards? |
Equally, everyone hates red tape and bureaucracy until Labour announce that they are... getting rid of it? |  | | |
| Has Kier gone DOGE rogue? on 15:25 - Mar 13 with 1734 views | blueasfook |
| Has Kier gone DOGE rogue? on 14:58 - Mar 13 by DJR |
NHS England is part of the Lansley reforms which were embodied in the Health and Social Care Act 2012.
They were controversial at the time, with much opposition and I was one of many who campaigned against them.
One political point of them was to remove responsibility for the NHS from the Secretary of State which I always thought was designed to avoid the government being held responsible for the failings of the NHS, a rather forlorn hope. But it also caused issues during Covid when the government found it had limited powers in relation to the NHS at a time of national emergency.
The reforms turned out to be disastrous and there has already been some rowing back on them by the Tories.
https://www.bbc.co.uk/news/health-46827981
"Are Andrew Lansley's NHS reforms being binned?
Consider this, it is just over three years since the last piece of the jigsaw in Andrew Lansley's controversial NHS reforms was put into place.
In 2015, health visitors moved into local government to complete the transfer of public health from the NHS to councils.
It completed what former NHS chief executive Sir David Nicholson once described as a reform programme so big it could be seen from space.
Now - with the country mired in Brexit - it is easy to forget just how tricky it got for the government in the early coalition years.
Unions and royal colleges lined up to oppose the changes and at one point it even threatened to turn the coalition partners against each other.
Eventually changes were made and Mr Lansley got them over the line with the Health and Social Care Act passed in 2012.
The restructuring created a new body, NHS England, to run the health service, set up new regulators and replace primary care trusts with GP-led clinical commissioning groups (CCGs) to organise local services, while handing healthy lifestyle programmes to town halls.
Underpinning the changes was the idea that greater competition in the NHS would help create a service fit for the 21st Century.
But on Monday that was effectively reversed, with the NHS Long Term Plan arguing collaboration was key.
It called for integrated care systems (ICSs) to be created across the country by 2021. These are partnerships that bring together hospitals, CCGs, community services, charities and councils, so they can work together rather than against each other."
https://www.newstatesman.com/spotlight/2020/10/short-disruptive-life-most-contro
"The short, disruptive life of the most controversial reforms in NHS history
How the health service survived the first wave of coronavirus by ignoring Andrew Lansley’s Health and Social Care Act
In 2010, David Cameron promised “no more top-down reorganisations” of the NHS. Two years later, in government with the Liberal Democrats, his health secretary Andrew Lansley introduced what many describe as the most sweeping reforms in the NHS’s history.
The Health and Social Care Act, passed in 2012, ceded power away from the Department of Health in an attempt to decentralise decision-making, increase competition between local NHS bodies, and extend the so-called “internal market” in the provision of services. Purchasers and providers were to be kept strictly separate, and GPs were to be given autonomy over commissioning from either public or private entities.
But less than a decade after its implementation, the act has been abandoned, in a process precipitated by the coronavirus pandemic. Many of the key organisations it created have received fierce criticism for their purported mishandling of the crisis.
And even before Covid-19 struck, the results of the huge restructure were decidedly mixed. In 2015, The King’s Fund described the act as a major distraction for the NHS that caused huge, unnecessary upheaval. The think tank said the act had created “an unwieldy structure”, with “leadership fractured” between competing national bodies and “a bewilderingly complex regulatory system”.
A 2013 report by the Centre for Health and the Public Interest said the coalition government’s reforms had impeded the NHS’s ability to deal with a pandemic flu, in part because of the “inevitable consequence[s] of the disruption caused by such a major re-organisation”. It also highlighted “fragmentation and a lack of clarity within the newly created organisational structures”. The act’s “market-driven system” had led to a prioritisation of “efficiency savings” while “minimising spare capacity in hospitals”, the report concluded.
The Health and Social Care Act was immediately controversial. Before it was passed, opposition from trade unions, healthcare professionals and the public led to the government announcing a nationwide “listening exercise” to “pause, listen and reflect” on the proposed reforms.
Its critics derided the act as backdoor privatisation. Their concerns were accentuated when an adviser to then prime minister David Cameron told a conference of private healthcare executives in 2011 that the coalition’s reforms would speed up the transformation of the NHS into “a state insurance provider, not a state deliverer” of care. The NHS would be shown “no mercy”, he said, and the reforms offered a “big opportunity” for the private sector. A group of doctors working in the NHS formed the National Health Action Party to oppose the legislation.
The act established an alphabet soup of arms-length and semi-autonomous non-departmental bodies. These included the NHS Commissioning Board (otherwise known as NHS England); Public Health England (PHE); clinical commissioning groups (CCGs), controlled by local GPs; the NHS Trust Development Authority; Monitor, a new regulatory body; and dozens of competing, financially independent but state-funded new foundation trusts – a process that had already begun under the New Labour government.
“A key part of the act… was the idea of independent competing foundation trusts whose job really was to look after themselves,” Dr Richard Murray, chief executive of the King’s Fund, told Spotlight. “In terms of the patients that cross the threshold, it wasn’t up to the service down the road to protect them. It was all based on this idea of a market of competition between trusts.”
The legislation was tortuous and convoluted. In 2014, the British Medical Journal quoted a former No 10 adviser who described the act as “unintelligible gobbledygook”, and its passage as the biggest mistake the Conservatives under Cameron had made in government. “No one apart from Lansley had a clue what he was really embarking on,” said the Downing Street insider, “certainly not the prime minister.”
Shirley Williams, who led Liberal Democrat opposition to the bill from the House of Lords, claimed that in her long political career she had never seen a bill that was “so incomprehensible, so detailed, so long, [and] so impossible to understand”. The junior coalition partners eventually acquiesced in the act’s passage through parliament.
In August, in the midst of the biggest health crisis the UK has suffered in decades, the Health Secretary Matt Hancock announced the abolition of Public Health England (PHE), one of the bodies that the 2012 reforms established.
In his “Future of Healthcare” speech in July, he described national healthcare institutions as “too siloed… by law under the 2012 act”. For weeks, newspapers had reported on ministerial frustration at their lack of control over the running of the NHS, the disappointing performance of quasi-independent organisations like PHE, as well as on Downing Street’s plans to now restrict the service’s operational independence. Hancock, the Guardian reported, was “frustrated [by] how limited his powers [were] and [wanted] to get some of that back”.
[Post edited 13 Mar 15:16]
|
Can we have a TL;DR for this please? I dont have a spare 2 hours to read all that. |  |
| |
| Has Kier gone DOGE rogue? on 15:34 - Mar 13 with 1670 views | DJR |
| Has Kier gone DOGE rogue? on 15:25 - Mar 13 by blueasfook |
Can we have a TL;DR for this please? I dont have a spare 2 hours to read all that. |
The Lansley reforms, including the creation of NHS England, were a disaster!
I didn't include everything from the two articles, but, as SuperKieranMcKenna said he would be interested to hear from anyone ITK, I thought it helpful to set out key passages from the articles for anyone who didn't have the time or inclination to read the articles themselves (which aren't that long anyway).
I might add that I am not an expert in this area but perhaps know more than most outside the health system about the Lansley reforms. [Post edited 13 Mar 15:37]
| | | |
| Has Kier gone DOGE rogue? on 15:55 - Mar 13 with 1593 views | DJR |
The following from one of articles I link above is worth bearing in mind when considering the Labour reforms.
"One of the major problems with the [Lansley] reforms was their implementation at a time of nationwide constraints on public budgets – the austerity drive that was at the heart of the Cameron-Osborne project. Liberating the NHS assured readers that while the country’s “massive deficit and growing debt” meant “difficult decisions” had to be made, the Health and Social Care Act would “deliver better value for money and create a healthier nation”. The Cameroonian Conservatives, unlike Boris Johnson’s, were fixated on balancing the books.
But a decade of real-terms cuts coupled with increased patient demand created severe pressures on the health and social care service. Local authorities, which had responsibility for public health passed to them, have had their central government grants relentlessly squeezed. Spending on public health services by councils was 8 per cent lower in 2017/18 than in 2013/14" | | | |
Login to get fewer ads
| Has Kier gone DOGE rogue? on 18:18 - Mar 13 with 1418 views | BlueBadger |
| Has Kier gone DOGE rogue? on 13:35 - Mar 13 by MattinLondon |
Everyone hates red tape and bureaucracy until something goes wrong and then people ask ‘where were the safeguards? |
NHSE, rather than standing up to government in the face of their incompetence in procuring PPE at the start(and indeed, during) of the pandemic, downgraded recommendations for what was considered to be suitable PPE. |  |
| |
| Has Kier gone DOGE rogue? on 18:39 - Mar 13 with 1358 views | Swansea_Blue |
| Has Kier gone DOGE rogue? on 13:35 - Mar 13 by MattinLondon |
Everyone hates red tape and bureaucracy until something goes wrong and then people ask ‘where were the safeguards? |
Governments need that red tape and they also need redundancy in the system. One of the reasons we had the worst response and outcomes from Covid is because we lacked that redundancy in the system. That’s one of the things that’s stopped us bouncing back and why NHS waiting lists shot up and are still high. Compare it to somewhere like Germany who had more slack in the system and they got back to normal levels of service very quickly.
Efficiency is the enemy of good when it comes to providing good social outcomes (within reason of course). |  |
| |
| Has Kier gone DOGE rogue? on 18:53 - Mar 13 with 1311 views | Swansea_Blue |
| Has Kier gone DOGE rogue? on 18:18 - Mar 13 by BlueBadger |
NHSE, rather than standing up to government in the face of their incompetence in procuring PPE at the start(and indeed, during) of the pandemic, downgraded recommendations for what was considered to be suitable PPE. |
I remember that, it was shocking. Not so much PPE as student fancy dress party cheap imitation of PPE.
I’m not holding my breath for there being any accountability or changes in policy and funding arising out of the Covid inquiry. I believe they’ve already decided not to talk to PPE suppliers, including that couple who profiteered in one of the largest deals (not Mone, the other ones who had a £2BN deal but 1.4BN of the stuff they provided wasn’t fit to be used and was binned/burnt). £9.9BN of equipment procured wasn’t up to standard, even the lowered standards.
People should be facing criminal charges for this; the former government ministers/officials, the VIP lane matchmakers and the dodgy suppliers. It’s pure corruption. | |
| |
| Has Kier gone DOGE rogue? on 19:59 - Mar 13 with 1223 views | bournemouthblue |
| Has Kier gone DOGE rogue? on 15:24 - Mar 13 by gsoly |
Equally, everyone hates red tape and bureaucracy until Labour announce that they are... getting rid of it? |
Didn't the Lansley Reforms actually create more red-tape and quangos etc? |  |
| |
| Has Kier gone DOGE rogue? on 21:13 - Mar 13 with 1118 views | DJR |
| Has Kier gone DOGE rogue? on 19:59 - Mar 13 by bournemouthblue |
Didn't the Lansley Reforms actually create more red-tape and quangos etc? |
That's certainly true.
One of the articles I mention above included the following about the Health and Social Care Act 2012, which gave effect to the Lansley reforms.
"It completed what former NHS chief executive Sir David Nicholson once described as a reform programme so big it could be seen from space." | | | |
| Has Kier gone DOGE rogue? on 21:37 - Mar 13 with 1055 views | DJR |
It is reported that it was Streeting who came up with the idea of scrapping NHS England several months ago.
I must admit I've always been suspicious of a man who as president of the National Union of Students supported the principle of tuition fees. [Post edited 13 Mar 21:51]
| | | |
| Has Kier gone DOGE rogue? on 08:56 - Mar 14 with 747 views | DJR |
I came across this from the BMJ on the Darsi report which as well as acknowledging Covid made things worse mentioned the following drivers for the poor state of the NHS. As regards what Darsi said about the Lansley reforms, "a calamity without international precedent", many of us predicted this at the time, and Lansley was so discredited by the time the 2012 Act was enacted, that he was removed as Health Secretary.
"The first is the austerity decade of 2010-19, when the NHS had real terms funding rises averaging about 1% over inflation, in contrast to the long run average of nearly 3.4%. This particularly includes capital spending, of which the report shows a cumulative underspend of £37bn: “the NHS has been starved of capital and the capital budget was repeatedly raided to plug holes in day-to-day spending. The result has been crumbling buildings that hit productivity—services were disrupted at 13 hospitals a day in 2022-23. The backlog maintenance bill now stands at more than £11.6bn.”
The second area of blame is the 2012 Health and Social Care Act: the NHS reforms introduced by the coalition government’s health secretary, Andrew Lansley. Darzi calls this “a calamity without international precedent. It proved disastrous. By dissolving the NHS management line, it took a ‘scorched earth’ approach to health reform, the effects of which are still felt to this day. It has taken more than 10 years to get back to a sensible structure. And management capability is still behind where it was in 2011.” He correctly relates this confusing mess of reforms to the present problems affecting English NHS management structures and systems.
Lansley has had nothing like the scrutiny expected for his disastrous NHS reforms, which aimed to turn competition, clinical commissioning, and patient choice into the new operating system of the NHS. One must have a heart of stone not to laugh at the memory of Lansley telling the 2011 Royal College of Nursing conference, “I’m sorry if what I’m setting out to do hasn’t communicated itself.”5
The Lansley NHS reforms failed absolutely: the “three Cs” (competition, commissioning, choice) have driven precisely nothing in NHS reform since 2012, and Lansley’s changes were quietly undone by Simon Stevens during his tenure as NHS England’s chief executive." [Post edited 14 Mar 9:00]
| | | |
| |
By continuing to use the site, you agree to our use of cookies and to abide by our Terms and Conditions.
