Saturday, August 28, 2010

Dial 111 to Replace NHS Direct

Mr Civil Libertarian just left this comment on my Facebook page...

"You know, the 111 number was a part of Labour's manifesto. See HERE.

This isn't a new idea from the coalition. It's Labour's idea. So why are they campaigning against it? Ah, of course, because it's not them actually doing

I hate party politics so damn much."

It's a fair point. The way some people (i.e. John Prescott) have been carrying in, you'd think the coalition intended to axe NHS Direct and replace it with sweet F A. That's not the case at all. But nothing like a good old anti Tory scare story on the NHS for Labour to pursue, is there?

I'll be putting these points to Shadow Health Secretary Andy Burnham on LBC tomorrow at 10am.


The Filthy Engineer said...

Personally I'd axe the entire NHS as it stands and go for a part insurance based scheme.

Why are we using a system founded in the last century for the last century's needs and population?

David Boothroyd said...

The point isn't the number you dial to get it. The Coalition isn't proposing just to change the number.

The point is that the healthcare professionals with proper qualifications who are answering NHS Direct calls now will be replaced with people who have no medical qualifications, and only 60 hours training.

Unknown said...

But why change it all. If they are keeping some form of non emergency health advice system why not keep NHS direct and modify it where necessary. After all it seems from reports that the same people are being used.

Sunder Katwala said...

That conflates two points.

(i) Very few people will oppose giving NHS Direct the 111 number, or supplementing/replacing the NHS Direct brand with eg "NHS 111" so the number was in it.

This is what your link is about.

(ii) The second point is that the plan appears to be to significantly reduce the number of nurses and medical professionals involved, to save money, but it would be odd not to admit that is on a "less is less" basis.

If the Coalition wants to u-turn on the second point, and say this was only about making NHS Direct more accessible, the opposition will happily melt away. I suspect that, by the time David Cameron returns from paternity leave, that is where we will be. My reading is that would be due to the campaigning response, and not because this has misunderstood what the policy is.

Unknown said...

"The service will not replace 999 for emergencies, but in the long term it is set to become the gateway to the NHS Direct nurse led phone service."

Labour planned to change NHS Direct's phone number; the coalition intend to scrap NHS Direct. So it's not a a fair point at all.

richard.blogger said...

No Iain, the 111 service was in addition to, and not a replacement for, NHS Direct. Get your facts right.

Also your figures on Any Questions were wrong. ONS figures say that "productivity" fell by 0.4% annually, not 4% as you said. ONS point out that it is not easy to calculate productivity and the figure they gave includes capital expenditure in the inputs. Since Major did bugger all capital expenditure on the NHS the expenditure on the NHS in the last decade was simply making up for what Major did not do (the phrase fixing the roof while the sun shines" comes to mind).

A better measure of productivity is how many people there are are and what they do. NHS Information Service say that over the period 1997 to 2007 the number of employees increased by 28%, but ONS figures say that the "outputs" (ie the work done by those people) increased by 52.5%.

I think you'll agree that getting 52% more of something for only a 28% increase in staff is rather good.

Iain Dale said...

Richard, I did not say anything of the sort. The 4% figure was quoted by Adrian Fawcett, not me. If you are ging to accuse me of getting my facts wrong, at least get your own right!

Unsworth said...

Is there any statistical information which shows the effectiveness or otherwise of NHS Direct?

Why is it necessary for doctors and nurses trained for many years and at vast public expense to work in call centres?

Anonymous said...

Labour politicians are being dishonest opportunists, but I think Conservatives would do the same if they were in opposition. It's a shame Andy Burnham may have some knowledge of the questions he'll be asked on LBC tomorrow.

Mirtha Tidville said...

I`m frankly amazed by the news that any Medical Professionals work in NHS direct at the present..When I`ve used them they all sounded like call centre cant see any great difference with 111...Totally agree with Unsworth though..

As for Prescott, well, still as thick as ever obviously..

Libertarian said...

@richard blogger

An increase of 28% of staff and output up by 52% in 13 years. Hmmm you think that is good? Take my advice don't EVER try and start/run a business.

Dick Puddlecote said...

"I`m frankly amazed by the news that any Medical Professionals work in NHS direct at the present"

From personal experience, Mirtha Tidville nailed it right there.

Nich Starling said...

The problem though Iain is yet again, this government has shown itself to be no better than Labour in that policy is leaked out in wither s slip up (like Lansley did) or by press release and not through the proper channels.

If this government want respect, they should not leak information in the way that they do.

Tapestry said...

The problem with the NHS is that it is not a comprehensive health service. That would not be a problem if the NHS admitted as much.

But it does not.

If the doctor knows he cannot afford to check you out further (after a five minute cursory chat) you are invariably told that you are depressed.

What he should say is,'I have decided not to dedicate any more resources to your case, as you are not fitting into a targetable category. The quango that runs the NHS has instructed me to bundle you out of my surgery as quickly as I can. You will have to find alternatives to the NHS if you need further help.'

There is a desperate need for an alternative health service, provided outside the NHS non-comprehensive service, where people can pay to be assessed in more detail and over a longer time frame.

I know of such a hospital, where I go and have paid about £40,000 over three years. It has saved the quality of my life, and maybe my life total.

Prior to that, once I had spent years being told that I was depressed by uninterested GPs, I used to travel to Brussels where there are many private doctors operating for very reasonable prices. I believe that one of these doctors probably saved my life by administering intravenous magnesium, at a time when my heart was malfunctioning.

He told me he was amazed that British hospitals don't administer magnesium to critical heart patients, but still give electric shock treatment, which knocks out a lot of the circuitry your heart might need to survive.

Another doctor told me that we have spare circuits which the brain eventually activates once it has decided to abandon the original circuit. Zapping the heart with strong electric currents can damage these spare circuits, but that is the NHS' chosen method of dealing with heart rhythm malfunctions, unless you're called Tony Blair, whose case was treated with a more expensive process (freezing the tissue around the main nerve to stop it malfunctioning. He had ventricular fibrillation which is not life threatening, unlike atrial which can be).

No wonder we lose 100s of 1000s more people to heart problems a year than Germany does, given the cattle class treatment that most of us get.

Saying that, the Belgian doctor told me that vets give farm animals magnesium shots as a matter of course, but humans in Britain are clearly seen as more expendable. If we produced milk or wool, our lives would be worth more to the State.

The private hospital that keeps me going in London also administers vaccines. They were delivering the MMR as three separate jabs to give sensitive kids less of a smack of mercury. The licensing authority removed their license to administer the vaccines.

Many of the hospital's patients have Lymes Disease, caused by tick bites where deer roam.

The NHS are not permitted to diagnose or test for Lymes Disease. They have to call it something else, which gets the patients out of the surgery...depression and the like.

If this little private hospital did not exist, these patients would have nowhere to go, like in my case, I was lucky to find it.

It is sad to think that such excellent small private hospitals have to fight against the health bureaucracy to exist.....and very very wrong.

We have a non-comprehensive dishonest big brother health regime, which needs dismantling to the point that other forms of provision can come into existence.

Or just die, as we are doing now.

Anonymous said...

Notice where the pilot service was taking place, Scotland and the North of England. Another attempt at creating non jobs to fiddle the unemployment figures.

Anonymous said...

By definition NHS Direct was for none emergency none dangerous issues. As such it was costing too much money. The NHS is not facing cuts but it does face huge strains on its budget - a budget that would be better spent on people who really need it.

So why are lefties complaining - where do you want the cuts to fall? labour SAY they should not fall on front line services - here is a classic case of it not doing and they still complain.

All the while conveniently forgetting that we have a labour inheritance of 155 billion deficit.

Lossie Beachcomber said...

Ah, Andy Burnham. Guardian of the NHS, enforcer of standards, protector of patients everywhere. I'd ask him how well he did when he oversaw the Mid Staffs PCT.

Unknown said...

Aftermy experience with NHS direct I would suggest that the people that work there may be medical but they certainly are not proffesional.

Lord Palmerston said...

On reading this blog post I picked up my copy of the Labour Party manifesto to check out the commitment. Whilst doing so, I noticed that chapter five of Labour's manifesto is entitled 'crime and immigration'.

I wonder what some Labour politicians would have said if the Tories had lumped immigrants in with criminals in such a way?

mtrcricket said...

As a young doctor I was taught NEVER to give advice over the phone and without seeing the patient.
This remains cogent and what is required for safe practise is the total closure of all telephone medical advice services.

Man in a Shed said...

Axing NHS redirect without replacing it would be fine - if you reintroduced the level of service you used to get from your GP before Labour wrecked that service.

Matt said...

Anyone who defends HNS Direct without question is a Labour Party stooge.

I rang them up at 1am for advice for my wife who was ill. and gave a non-medically qualified call centre worker the details of why I was calling. And was told there was an 8 hour wait for a call back. Did I still want it? I replied that I did. Obviously trying to put people off and then probably claiming that as a successful result. We would, she told me, have to wait as there were not many people on duty. "You'll need to wait 'til they change shifts. More people will come on at 8am."

Eight hours later someone called back, listened to the reason for the call (which was NOT that complicated) and said: "I suggest you call your doctor when the surgery opens."

So, exactly how useful is NHS Direct? And is it cost-effective?