The NHS from a (wealth) builder’s point of view.

So, what’s happened to the NHS whilst I was working, constructing (with others) the wealth of millions (house owners) covering the country with buildings for our population to live, work, rest, be cared for, study and play. Hoping the NHS will be there when needed with a Doctor, Nurse, Consultant or Surgeon. What do I find its full of bureaucratic greedy head workers. All hot air and wind from the administrators (Not Doctors or Clinicians) mostly social academics some on £250,000 per annum, with local councillors telling me whether I can have my treatment or not.

The following is some of the many changes and observations made over 50yrs.

“Our basic purposes are to unite the National Health Service and to integrate its separate services locally.” Baroness Serota, Minister of State, Department of Health and Social Security, 11 Feb 1970.

“Our proposals for the new NHS offer a great, and indeed a new, opportunity for a partnership with local authorities.” Sir Keith Joseph, Secretary of State for Social Services, 1 Jul 1971.

DHA (district health authority) was an administrative territorial entity of the National Health Service in England and Wales introduced by the National Health Service Reorganisation Act 1973.

The crude differences in mortality rates between the various social classes are worrying. “Secretary of State for Social Services, David Ennals, 1977.

“If Florence Nightingale were carrying her lamp through the corridors of the NHS today, she would almost certainly be searching for the people in charge.” Griffiths Report, 1983.

GP Fundholding was created in 1991[1] as part of the quasi-market created in the National Health Service by the Thatcher Government’s National Health Service and Community Care Act 1990

In 1997 the incoming Labour Government abolished GP Fundholding. In April 1999 they established 481 primary care groups.

Primary Care Trusts (PCTs) were launched in April 2000 and fully established across the country in April 2002. The original 303 PCTs across England were initially established with three objectives: • to purchase care for local communities from hospitals and other local providers • to directly provide services such as community care • to work with local agencies to tackle health inequalities and improve public health.

We are clear that Government cannot – and should not – pretend it can ‘make’ the population healthy. But it can – and should – support people in making better choices for their health.”

Prime Minister Tony Blair, in Department of Health (2004) 

Clinical commissioning groups (CCGs) were established as part of the Health and Social Care Act in 2012 and replaced Primary Care Trusts on 1 April 2013. CCGs are groups of general practices (GPs) which come together in each area to commission the best services for their patients and population.

“I worry what happens next. I fear that in order for hospitals to virtually eradicate their deficits as NHS Improvement and NHS England want the next steps could be brutal service reductions and bed closures – which will shock an unprepared public.”

Nigel Edwards, Chief Executive, Nuffield Trust July 2016

Next move (knight takes bishop)

Currently, our region’s NHS is organised into nine Clinical Commissioning Groups (CCGs).

Under the new proposal, the more than 2.5m residents of the nine boroughs which make up Cheshire and Merseyside will have their health services commissioned by just one authority.

The new singular CCG for Cheshire and Merseyside could be in place by April 2022.

The total number of available beds in 1974 was 400,000 today there are 118,500.

Spending has gone from 4.5% of GDP to 7.2%. More money fewer beds.