Like a dim-witted tourist returning with a sulled donkey and aback.
pack of hideous souvenirs, Health Secretary Alan Milburn has again borrowed more "modernising" ideas for his latest planned reforms in the NHS - this time from the disastrously unfair and expensive US health care system.
You may well not have noticed the few low-key paragraphs in the Guardian (October 18) announcing the new 'payment by results' policy - which amounts to a more extreme version of the "internal market system introduced by Thatcher's government in the 1990s, at colossal expense and with miserable consequences.
New Labour boasted in 1997 that it was to "scrap" this internal market: now it is coming back, big time.
Beginning next April, a steadily growing share of hospital caseload will no longer
Please make cheques payable to RESISTANCE
I enclose £10 • £15 • £20 D
Name ..
Address ..
Post Code
be funded on the basis of "block" contracts with local Primary Care Trusts, but commissioned on a case by case basis. Hospitals would be financially penalised for every case they failed to deliver - while those that managed to attract and deliver additional work could increase and retain the extra cash. All this will cost money, time and effort. But the decisive point which is set to destabilise the NHS as this system comes in is that no negotiation will be allowed over the price to be charged for each operation or treatment: these will be fixed nationally by a single "tariff", calculated by the Department of Health, leaving only small regional variations. Squeeze on staff his potentially means that dozens of major hospitals whose costs per treatment are SUBSCRIBE to resis We are offering a special introductory subscription rate 1 year for £10 (UK), £15 (Europe) or £20 (other overseas. For more details simply fill in this coupon, ticking the appropriate box and send to us c/o PO Box 1109 London N4 2UU
• Please send me a year's subscription to the new paper.
I enclose a donation of £.... .... Phone. emal currently above the "average" will have to squeeze down their costs, or face losing money on every operation they carry out. And since upwards of 70% of NHS spending is on staff, this means that nursing and professional staff are likely to come under the hammer.
The situation will be the sharpest in the new wave of PFI hospitals, where all support services such as deaning, portering and catering are already subject to a separate, legally binding contract. The only staff whose pay and conditions can be controlled by these Trusts are those dinical staff delivering patient care.
This relentless drive for a new, more savage internal market comes with the promise that patients can "choose" which hospital they want for their operations - a move expected to benefit the more prestigious teaching hospitals at the expense
KE Fine words in opposition: but now New Labour's market-style "reforms" go further than Thatcher ever dared - while PFi siphons millions from NHS budgets
of district general hospitals. But Milburn also plans to float off a new