Latest post of the previous page:
Fair enough. And what I am trying to do, is to show that some of the points you raise have different interpretations and reasoning than what you may suppose. I am not, however, Secretary of State for Health! I do not know if I would have done the same if I were. It is not my role in life to determine the best NHS model, nor to defend a particular government policy out of any loyalty. So if I don't know something, or can't find something, it proves nothing. I will see if I can find some evidence, but it is as much your responsibuility to look for evidence as it is mine. I know I repeat myself, but I am saddened that your tenacity to research and evidence, which I so admire in your efforts to expose medical nonsense, seem to be left resting in bed when it comes to economic matters.Alan H wrote:For the avoidance of doubt, what I am trying to establish is what Lansley thinks needs changed, why, and what evidence does he have that the HSCB will achieve those changes.
Lansley thinks things need changing to improve the cost efficiency of the NHS. His estimate is £4.5 billion a year. He also thinks that health services can be improved my making the decision-making closer to the patient. Put crudely, patients and their doctors should determine what services are required, rather than bureaucrats in London. I think they are also trying to make the health service more flexible.
I don't have all the evidence at my fingertips, but I've seen some, and I'll try to find more. But at the same time, in engineering terms, just because you have a mousetrap that works, doesn't mean there is not a better way of catching mice. You seem reluctant to explore that possibility.
Well, yes, actually! Firstly because I would hope you would not say something without reason to do so. Secondly, because the alternative, (that no research has been conducted before making major changes,) seems ridiculous. Do you really believe that?Alan H wrote:What am I to do? Believe you when you tell me there has been research?
As a public figure, I would expect virtually all his pronouncements to be about changes and benefits. I think it is unreasonable to accuse him of going without research, just because he does not spend his time discussing research papers with the public. Does the Energy Secretary shower us with research papers on nuclear safety? No. Has any research on nuclear safety been done? I hope so!!!Believe Lansley (although I'm not aware he's ever said there was research)?
Or should I - as a good skeptic - ask for that evidence?
Of course, it is perfectly OK for you to ask for evidence if you want to know more. Try asking the department for suggested reading. I am not a source of such evidence. However, I can point out a few economic factors which have profound effects, and are IMO, crucial in understanding some of the changes.
And where is your evidence that the old system is the best? Why not go back to the old system which pre-dated Blair's reforms?Where is that evidence, Nick?
Take any break you need, Alan Do you honestly think there isn't such evidence, that no work has been done, that Lansley just thought it up while playing with his duck in the bath? I said I expect there is evidence because (like a good skeptic) that is a suitable word to use. I have seen some evidence, but it has not been my life's work to analyse it. How can you justify you apparent position that there has been no research? Is that really the most likely?The biggest top-down reorganisation in the history of the NHS and you expect there's evidence? Give us a break, Nick.It's not me saying it, but I expect it's out there...Where's the evidence that these 'reforms' will achieve what you say they will?
What we have here are two competing hypotheses. So it is just as reasonable for me to ask for your evidence. Let's see what we can find....As I always would say to a quack, the onus is on you/Lansley to provide the evidence that the 'reforms' will do what is asserted for them. Where's the evidence, Nick?Where's your evidence (not opinion!) that it won't?
But Alan, the reforms have hardly begun. It can't have failed before it starts can it?But there are now far more bodies now than there ever were - if it was a main aim of the 'reforms' then it's failed already.Except that eliminating a whole layer of bureacracy is the main aim and result of the reforms.And all that with greatly increased bureaucracy.
What happened in a different situation about different changes at a different time and with different people is irrelevant. We're discussing these changes now and their effect on the NHS.I'm not saying that we should ignore doctors completely, but they have a history of objecting to every changeAnd the vast majority of GPs don't want this extra responsibility and bureaucracy.
The point I am makingh is that people don't often like change. Of course ther poeple are diffferent, but that characteristic remains. It also demonstrates that sometimes change must happen in the face of dissent. That is as valid today as it was then. Hence my allusion.For pete's sake, Nick. The 'they' you're referring to might just about be the grandfathers of the ones objecting to it now.They objected to the NHS in the first place.
OK Alan. It is your assertion that patients will suffer. Evidence?Of course not. And just because Lansley says it's good for us doesn't mean it's good for us.Hmmm... the vast majority of those who don't want it have said they don't want it, which isn't quite the same. And just because someone doesn't want something, doesn't mean it should not happen because of that opinion.And the vast majority of other healthcare professionals don't want it and say the NHS and patients will suffer.
I came across this the other day. Can't recall precisely where, but I will endeavour to find it again if I can.Who? Evidence, please - not that that makes any difference to whether the 'reforms' are actually going to do what we're told they will - but your answer might be interesting.Some organisations are attempting to sabotage the changes for political reasons,and sod the patients.
Probably. It won't be overnight, certainly.Will we? I suspect it'll take several years before we really know.We will see soon enough how effective the changes are
Well, yes there is. Compare the virually non-existent praise for the raising of personal allowances, with the ridiculous outcry over the so-called "pasty-tax". I think that demonstrates my point very well.That's what we've been told, certainly, but yet again, there has been no evidence that that is what is likely to happen.but it's a racing certainty that any set-backs will be yelled about from the roof-tops, while increases in efficiency and health provision will just be accepted and go unpraised. The whole idea is to improve the NHS, for the benefit of patients.
Have you asked them for their evidence?The Government no doubt believe lots of things - is it too much to ask for the evidence they based their beliefs on? And if they won't supply that evidence - or don't even have it - does that not make the whole exercise one of pure ideology?The Government believe their reforms will do so. We shall see.
His point was that the health service should not be run by Whitehall. That is what he meant by "top-down". The opposition are calling anything "top-down", just to make their objection seem valid, whereas in fact, all they are objecting to is any change at all.Wasn't it Cameron who used the phrase?"Top down" is used as a perjoritive statement.Lansley says it'll be good for us. That's OK then. All we are left with is to trust him. That is, trust a Government who promised that there would be no top down reorganisation of the NHS and who seem to be up to their necks in conflicts of interest. Sounds a lot more like dogma and ideology.
Well, I was beginning to wonder....No, why should I say such a stupid thing?Are you saying that any reform should be banned?
No, but see my responses above. The government wasnt to see improvements in health provision, and a reduction in costs, so that billions of pounds of extra services can be provided. (As I said before)But I would like to see what they think needed reformed, why and how they think their 'reforms' are expected to achieve those changes. Is that too much to ask?
Come, come. That is what oppositions do, isn't it? Does one really need "special insight" to discern the bleedin' obvious? This is reinforced by the fact that there has been a total silence from Labour when asked how they would find an extra £4.5 billion. Their ideas cupboard is bare.I'm not sure what special insight you have into the Labour Party's reasons - or do you mean that's what you'd like to think their reasons are.And as for dogma and ideology, the Labour Party are just criticising it for party political reasons, and just stirring the pot generally. And the public sector unions are thinking not about patients, but there own union power.
No, but they are objecting to change. So their reasons for objecting to change are just as relevant. It is not a divertion, merely a response to an accusation.Whitabootery again, trying to divert from the actual issues. The Labour Party isn't making these changes, are they?As for conflicts of interest, I don't see how the Labour Party, utterly dependent as it is on public sector unions, can claim to be free of claims of conflicts of interest either.
I'll see if I can dig out that web-site I found a while back. May take a while, though...