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By Michael Mandelstam

According to his reports of assisting to struggle cuts and closures in Suffolk, Michael Mandelstam provides a damning verdict at the mismanagement of the NHS at nationwide, local and native point. He charts the frequent cutbacks and closures, either rural and concrete, to clinics, A&E providers, beds, wards and rankings of neighborhood hospitals. He outlines how humane care, rather for older humans, is compromised by way of the ruthless decision of NHS administration to extend sufferer throughput and hit government-set ambitions. the writer highlights how the chaotic swap to the NHS is being pushed by means of hid agendas - together with privatisation of the NHS, obsessive interference from critical executive and good as selective use, if no longer abandonment, of evidence-based perform. heavily fallacious and destructive judgements are the end result, affecting the inhabitants at huge in addition to these so much weak - older individuals with persistent and intricate wishes, individuals with actual or studying disabilities and other people with psychological illnesses. peculiarly, he exposes the scandalous loss of transparency and responsibility in the back of adjustments that threaten to break the NHS.

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26 BETRAYING THE NHS This wartime blueprint became a 1944 White Paper. The proposed health service had to be: comprehensive in two senses – first, that it is available to all people and, second, that it covers all necessary forms of health care. It had to ‘include ancillary services of nursing, of midwifery and of other things which ought to go with medical care’. There might be temporary exceptions to such comprehensiveness. For instance, full dental and ophthalmology services might not be achieved immediately.

Certainly it was an extreme case in terms of the consequences. But the pressures put upon the NHS Trust, finance and target-wise, were government-inspired. And, at the time of writing this book, shortly after the publication of the Health Commission’s report, recruitment freezes, the shedding of NHS posts and the reduction in bed capacity of acute hospitals are all continuing apace. They are being driven by central government’s demands via its regional conduits, the strategic health authorities.

36 SOWING FINANCIAL SEEDS: THE GREAT INVESTMENT 37 2006 about what had been achieved. In summary, systems – including joint working between the NHS and local councils – had improved. However, these improvements were now in danger of being lost because of disagreements between PCTs and local councils, triggered by the financial difficulties of the former. 2 So, this reflex answer about the extra money would not do. During 2005, it became apparent why not. Bit by bit, explanations began to emerge as to why there seemed to be no direct, proportionate connection between the money and improved services.

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