Originally posted by Ferris.Bueller.II
reply to post by Merriman Weir
Good to see you back MW! I have a couple of questions about these Trust Hospitals.
1) Are these Trust Hospitals under the NHS or are they private insurance hospitals?
2) If they are under the NHS, does the NHS inspect these hospitals to keep them up to NHS standards?
3) If these Trust Hospitals are so bad, why are they kept open? Just so people can blame them instead of the NHS?
4) One more. If these Trust Hospitals are so horrible, do the patrons of the NHS have an option not to go to them under the NHS system if they'd
rather go to an NHS native hospital?
[edit on 3/8/10 by Ferris.Bueller.II]
The answers to these, and I say this given that you obviously started the thread with some preconceived ideas!
- won't be as clear cut as you'd
possibly like. This is not because I'm trying to confuse the issue or hide aspects of this but rather because it's all a bit messed-up in that some
of it barely makes sense. Also, as I said previously, you won't find any socialist agenda here - evil or otherwise.
Firstly, they all still come under the heading NHS: these hospitals are known as
NHS Trusts and often, rather than having a simple title such
as 'Mytown NHS Hospital', they might now be known as 'Mytown Hospital NHS Foundation Trust'. However, as I went to great pains to explain before,
do not mistake these for the NHS models of old which, if you had to, could be described a little more accurately as 'socialist'.
As for inspections, this is a serious and worrying issue as there's two types of inspections. In the earlier post I tried to explain how, once the
government have handed over a budget, the management are left pretty much to their own devices to run the place as they see fit. Now extend that to
some of the inspections and rating schemes. For some awards hospitals basically mark themselves and submit applications based on their own findings
and ratings. This practice is not that unusual though and is mirrored to an extent elsewhere such as in schools and colleges where marking can be done
internally and only a sample is then inspected externally. However, as commonplace as it might be, often it serves to give a false impression of
hospitals and the potential flaws in this are fairly obvious to anyone.
Others hospital awards are rated completely externally though. The big motivation in any of these external or internal schemes is funding as awards
usually come with 'prizes' and not just something boast about on hospital stationary on in a frame in someone's office. It's bad marks on
these
schemes that push hospitals on to the front pages of newspapers.
Now, when it comes to 'bad' hospitals, if these hospitals are closed down, where do communities then go for local healthcare? It's really only the
middle-classes that can afford to go elsewhere either to a nearby NHS hospital or just go to a private one (also, why should anyone need to go to a
private hospital, particularly after they've already paid for their treatment via taxes?).
This is also problematic in that often certain hospitals specialise in certain areas of treatment so, in a 12 mile radius there may be two hospitals
in two different administrative areas and, for example, if you live in one area your local hospital might not be the treatment centre for certain
things and you might have to go to the next nearest hospital for that treatment. That's not really that big an issue in itself for a lot of people,
even for a country where travelling 15 miles can seem like a big deal; although if you or your family don't drive, or don't even have a family those
15 miles can be alienating and difficult.
However, it does limit the idea of choice because there's not much local choice if certain treatments are being split up across hospitals (even
though there's some logic to this regarding budgets and so on). Choice within the NHS is a curious thing. It's one of those things the present
government have talked a lot about over the last decade, and have placed choice at the front of health policies. However, it's a bit of a sham as not
everyone actually wants to go elsewhere. Hospitals can be traumatic (no matter how good they are) and often people just want to be as close to home,
family and friends as possible. Often the extra travelling in itself can be problematic for patients friends and families alike - a few years ago, I
had to go to a non-local hospital that was less than 15 miles away for about a week due to it being a 'specialist centre of excellence' or some
nonsense title. Neither myself nor my partner drive and that 15 miles translated into a 3 hour travelling time (each way!) for my partner as there was
no direct bus route from her house (we don't live together) and a total of 6 separate buses for a complete return journey. If I'd have been treated
in my local hospital, the trip would have been 4 buses for her and only an hour each way as opposed to 3 hours.
Also, I've yet to speak to anyone in my part of the world that's genuinely concerned about choice. Most people just want a good local hospital. A
good local hospital actually defeats the need for choice. Unless you've got something genuinely life-threatening and somewhere offers cutting-edge
treatments, why go anywhere else if your local hospital is a good one?
On the other hand, if your local hospital is a bad one, surely it makes more sense to sort out that hospital rather than just offer somewhere else for
the patient to go? 'Choice' as a health policy, in a lot of this, is really a conjuror's distraction: you look at one hand whilst the other hand is
really doing the work and what that work is doing is Private Finance Initiative and again, PFI is anything
but socialist: it's greedy
corporatism at its worst.
So, when American healthcare doom-mongers are crying about the ills of the 'European socialised medicine' to come, ironically what we're seeing now
in England (at a time when the NHS is in the biggest mess it has ever been) is what might look more like some 'quasi-American capitalist medicine'
where things are now being placed more and more into the hands of private profit-driven firms than 'the state'.
Now, I'm sure many Americans would be unhappy with my describing what I have in the last few posts as 'American', however these people need to
understand that, similarly, what I've described in these posts is hardly 'socialist' either. Again, there's no socialism in this, only a
(non-socialist) government in bed with private firms who are out to make money wherever they can.