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The National Health Service in the UK faces many challenges. Some are just an ageing population, a diversity of patients in the 21st Century, the availability of more treatments and modern day expectations. Then there is money. Yes that old chestnut.

The UK Coalition government has proposed reform of the NHS which will see funding reverting back to General Practitioners. This was the way of the NHS sometime ago. It will be a costly exercise to implement such changes. It always is. This means that money which could be better spent on patient care will end up being used for administration and planning. New posts will be created to implement the changes and they will not come cheaply.

Whether the changes will benefit patients or make real savings we will find out in the future. If they don't then it could be another costly exercise to change things once more. And so on it goes.

Already most hospital trusts are having to cut their work forces. Wards have been closed, staff numbers reduced and some services shifted into the private sector. This means that in an emergency situation many cannot cope. They are already working under pressure so an outbreak of the winter vomiting bug, which is ongoing now, can tip services over the edge.

Today there is news once more that the NHS is failing the elderly.

There have been many stories regarding poor health care of the elderly in the UK and the latest is with regard to cancer treatements.  The report follows a poll by British cancer charity Macmillan Cancer Support. SkyNews reports that:

 45% of 155 GPs, oncologists and specialist cancer nurses surveyed said they have dealt with a cancer patient who has been refused treatment on the grounds that they were too old.

Macmillan said the UK has some of the worst cancer survival rates in Europe for older people.

Ciaran Devane, chief executive at Macmillan Cancer Support, said: "Health professionals' concerns about the prevalence of age discrimination in cancer care mustn't be ignored.

"Unless staff are given the time and training to carry out a proper assessment of a patient's overall physical and mental wellbeing, some patients will be unfairly written-off as 'too old' for treatment.

"The number of older people (aged 65 and over) living with cancer in the UK is set to rocket in the next 20 years from 1.3 million to 4.1 million.

"Unless the barriers to timely treatment are tackled now, many older people could die unnecessarily from cancer and services will become unaffordable."

Government Health Secretary Jeremy Hunt claims that the government is working with the Macmillan charity in order to address these issues. He accepts that there is still a great deal of work to be done to ensure that tose aged over 70 receive appropriate care. Look online though and you will see stories relating to this have been around for at least a year. That means that whilst Ministers procrastinate lives are lost.

Opinion
13 years of working in the NHS has shown this blogger that if you work there long enough you will see all reforms come around again. The if it is not broke why fix it scenario never applies. Then when it is broken change is a long time coming.

Elederly patients with cancer tend to end up on Medical Elderly Wards rather than on the modern oncology wards. This is sometimes true of other specialities such as heart failure patients. When there is a bed shortage being moved is acceptable when it is due to an emergency situation. When it is normal practice something must be done.

There may be nothing wrong with a ward you are admitted to but if it does not have the level of care or facilities you need your prognosis will be poor.

Time to cut the management tier at the top of the NHS and reopen wards which are needed with the right staff.

The current government in wanting to move services away from the NHS into the private sector must take responsibility.
 
 
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The UK Liberal Democrat Party held its brief Spring conference last weekend. As the Lib Dems currently share government with the Conservatives unsurprisingly there was some discord. Much of the Lib Dems unease surrounds the NHS reform bill.

Veteran Liberal Democrat Shirley Williams was brought out to try and persuade the rank and file to support the government Bill. According to Dame Shirley the Bill has undergone many changes since it was first announced. The Bill is now said to be beyond recognition. As such Dame Shirley was adamant that it was now a good thig and should be given Lib Dem support. The rank and file begged to differ.

In the end a compromise of sorts was reached."Delegates endorsed a motion backing the policy. But, defying Mr Clegg, they refused to order Lib Dem peers to vote for the changes in Parliament". Whether the Lib Dems are more concerned about the effects of the Health and Social Care Bill or what it could do to their political support is not clear. What is abundantly clear is that they are not happy with the Bill. In parliament and the Commons the Bill has been amended time and time again by the Lib Dems.

Once again Nick Clegg is in a tricky position. He had hoped that the Lib Dem delegates would now support the amended Bill and put and end to months of wrangling.

Nick's conference woes continued with his tax plans. A so called "tycoon tax" had seemed a viable alternative to the proposed Mansion Tax. When Nick unveiled his tycoon tax proposals to conference though he rattled Business Secretary Vince Cable. Mr Cable had been kept in the dark about this tax and it directly challenges his planned property taxes.

Next week the UK will hear the Chancellor's Spring Budget. It is not expected to include the Mansion Tax. With a front bench of parliament that is full of Millionaires it could look to the general public as if they are simply looking after each other. That is of course unless Chancellor Osborne has a fair well though out budget to announce.

The problem for Nick Clegg and the LIberal Democrats is that any Government negatives reflect badly on them. Right now it is hard to imagine that the Lib Dems could ever gain office again.

 
 
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In the UK we tend to take our National Health Service for granted. At times we all complain about it. When we receive exceptionally good treatment few of us bother to praise the NHS. After all the best should be the norm, right? Well yes but would it hurt to occasionally take a step back, take a long hard look and consider the alternative.

That said people in the UK tend to be protective of the NHS. It is a very British care system, one that may need to be tweaked from time too time, but one that few would want to wave good bye to.

David Cameron made much in his election manifesto about how the NHS was safe in his hands but he has since proved that is far from the truth. The NHS has been under attack on all fronts. Reform looks set to put funding back in GP hands. If you work for the NHS, as this blogger does, you will find that work there long enough and you will see a circle of changes. Almost 13 years down the road the latest changes are reminiscent of a few years ago.

Much is made that over paid administrator posts will be rightly cut but in reality it is front line jobs that are going. Those at the top handle the job cuts and predictably protect themselves.

The NHS is facing too many changes at one time. In order to meet demands and targets it is disappearing in a type of twilight zone. Government fines are levied against some sections, constantly making budget targets impossible to achieve.

February 8, 2012, the NHS reform was discussed in UK Parliament. The House of Lords has again rejected the bill without more amendments. The Tories though look set to continue like a dog with a bone. Labour leader, Ed Miliband, got the upper hand against Cameron the Commons, in spite of the derision and smarm eeking out of the Coalition front bench.

David Cameron's only defence seemed to be a personal attack. He attacked Mr Milband saying that Ed's position in the Labour party was fragile. We all know that attack is the poorest form of defence which this proved. Mr Cameron had little to say that was positive about the NHS reforms, so launch a personal attack on the Labour leader instead. I ask you?

Even an oped in the Financial Times agrees that the reform plans are a mess. As it says, the plans lack the necessary skill. If Cameron chooses to belligerently stay on the same NHS path it could prove to be his political downfall. Could we be so lucky?