Betraying the NHS: Health Abandoned

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Jessica Kingsley Publishers, Oct 26, 2006 - Medical - 320 pages
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Based on his experiences of helping to fight cuts and closures in Suffolk, Michael Mandelstam delivers a damning verdict on the mismanagement of the NHS at national, regional and local level. He charts the widespread cutbacks and closures, both rural and urban, to clinics, A&E services, beds, wards and scores of community hospitals. He outlines how humane care, particularly for older people, is compromised by the ruthless determination of NHS management to increase patient throughput and hit government-set targets. The author highlights how the chaotic change to the NHS is being driven by concealed agendas - including privatisation of the NHS, obsessive interference from central government as well as selective use, if not abandonment, of evidence-based practice. Seriously flawed and damaging decisions are the result, affecting the population at large as well as those most vulnerable - older people with chronic and complex needs, people with physical or learning disabilities and people with mental health problems. Above all, he exposes the scandalous lack of transparency and accountability behind changes that threaten to destroy the NHS.

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the Death Throes of a Health Service
2 Comprehensive Universal and Free
the Great Investment
4 Declaring the Health Harvest and Concealing Ruined Crops
5 Uprooting the Traditional Health Fields
6 Cultivation of Local Health Services
Patient Choice
8 Alienating and Spreading Fear in the Community
the Great Gobetween of Intermediate Care
Erecting the Social Care Barriers
15 The Uprooting of Real Care
Gathering Storm Over the Land
17 Rural Conflagrations and Early Hostilities
the Timetable of War
19 The Campaign in Full Flux
20 Other Fights in a Changing Landscape

9 Combing the Landscape for a Decisionmaker
10 Rushing into Decisions and Reaping the Consequences
the Shedding of NHS Responsibilities
12 The Great Hospital and Health Service Clearout
a Dimming of the Suffolk Light
22 Conclusions

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Page 26 - The aims of the National Health Service were set out in the opening sentences of the National Health Service Act of 1946: (1) It shall be the duty of the Minister of Health to promote the establishment in England and Wales of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England and Wales and the prevention, diagnosis and treatment of illness...
Page 27 - Plan (DOH 2000a) states that the NHS will shape its services around the individual needs and preferences of individual patients, their families and carers. The NHS of the 21st century must be responsive to the needs of different groups and individuals within society, and challenge discrimination on the grounds of age, gender, ethnicity, religion, disability and sexuality. The NHS will treat patients as individuals, with respect for their dignity. Patients and citizens will have a greater say in the...
Page 25 - For the limited number of cases of need not covered by social insurance, national assistance subject to a uniform means test will be available. (xi) Medical treatment covering all requirements will be provided for all citizens by a national health service...
Page 26 - So far as individual members of the public are concerned, they will be able to obtain medical advice and treatment of every kind entirely without charge except for the cost of certain appliances. They will be paying for medical care in a new way, not by private fee but partly by an insurance contribution under whatever social insurance scheme is in operation and partly by the ordinary process of central and local taxation.
Page 26 - ... private arrangements outside the service, he must be at liberty to do so. Similarly, if any medical practitioner prefers not to take part in the new service and to rely wholly on private work outside it, he also must be at liberty to do so. The scope of a "comprehensive" service The proposed service must be "comprehensive...
Page 25 - Assumption B. Comprehensive Health and Rehabilitation Services 426. The second of the three assumptions has two sides to it. It covers a national health service for prevention and for cure of disease and disability by medical treatment; it covers rehabilitation and fitting for employment by treatment which will be both medical and post-medical . . . The case for regarding Assumption B as necessary for a satisfactory system of social security needs little emphasis.

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About the author (2006)

Michael Mandelstam has provided independent legal advice and training on health and social care matters to the NHS, local authorities and voluntary organisations for over ten years. He previously worked for ten years at the Disabled Living Foundation and for several years in the Department of Health. He has written a number of widely used legal books, including Community Care Practice and the Law, now in its third edition, An A-Z of Community Care Law, Equipment for Older or Disabled People and the Law, and Manual Handling in Health and Social Care: An A-Z of Law and Practice all published by Jessica Kingsley Publishers.

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