NHS Reform Bill – Direct Effects on Services……

23 Mar

The NHS Reform Bill passed into law yesterday.  Despite many Peers and MP’s opposition and a plethora of amendments it is now a fact and is already failing patients at the thin end of the wedge……

In My Own Experience the reforms of the services I was accessing have been withdrawn, not for the streamlining of the delivery of ‘best practice’ but due to the ‘payment by result’ the definition of which has changed……

My Case History……

I have been accessing services for addiction to Opiates and Benzodiazepines.  You may well immediately jump to the conclusion that any drug issues are self inflicted and those affected do not deserve help from the NHS and its secondary services but addiction is a recognised Neurological Disease and should be treated like any other medical condition……

In 1996 I realised I had a problem and sought help.  From that point onwards until now, the standard treatment was to replace illicit opiates with prescribed ones; namely Methadone.  This was a maintenance approach and regardless of me giving frequent samples positive for Heroin, the maintenance continued.  This approach failed as the 16 years since I engaged with the services has demonstrated.  I put this down to the failure of the Drug & Alcohol services to follow the key principals given in the 2007 NTA Guidelines which have Eight Key Principals, one of which states that ‘Substitute prescribing alone does not constitute treatment without the use of structured psycho-social interventions’; put another way, the treatment of addiction is largely psychological and not just pharmacological.  I was being prescribing by the NHS part of the service and the psychological treatment from Addaction.  Now that these services are being separated and are now receiving ‘payment by result’, the modus operandi has changed.  They previous funding was based on the number of patients in service to funding by the number of people who they can remove from service…..

I have been offered the choice of which of the services I access but am not able to access both.  Therefore, the crucial counselling service cannot be offered by either party.  Neither service provider has written to its patients to explain how the new regime will work and I have had no satisfactory answers to the questions I have asked of each Service Director, other than rhetorical spin where they talk about ‘Empowering individuals to rebuild their lives in the community and reintegrate with society’.  This is clearly at odds with the previous model of retaining patients in service to gain maximum funding……

To Cut to the Chase the effective privatisation of the NHS will lead to a situation whereby the easiest cases that can be defined as a ‘positive outcome’ will be favoured by GPs and service providers for maximum financial return.  In practice this means that patients presenting with an illness which can be completed with a one off prescription of antibiotics will tick the ‘positive outcome’ box.  In contrast, any complicated cases requiring ongoing and potentially long term treatments will be avoided……

What Can you Do?…..

Please join the ’38 Degrees’ campaign and encourage your friends to do the same.  It already has over 1 million members and is a powerful public lobbying force and its sizable membership can influence the re-election of your MP.  Also write to your MP expressing your views and real world experiences of the services you receive, highlighting its pit falls.  In the case of the disgraceful attitude of my MP, Karl McCartney, the local 38 Degrees membership is larger than the majority which elected him.  If the members vote strategically we have the ability to unseat MP’s; a fact which they would be advised to take into consideration when insulting their constituents.  See the Dripping Tap entry for4 March 2012……

Useful Links:


To find your MP and contact details: http://www.theyworkforyou.com/

I have a new Skype account and would be happy to discuss any issues raised on The Dripping Tap.

Skype address: dr.stephen.p.walker.phd – send me a request & email so we can hook up.“we are all in this together”……


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