Dr Mark Porter, who I don’t know but who usually comes across as a conscientious hospital doctor, is reported in the Guardian today as worrying about cherry-picking, inequalities, hospitals closing and patients being turned away. He puts these down to the proposed NHS Reforms.
My biggest gripe with the media coverage of the Reforms at the moment is that we are not getting any sense of balance. We have inequalities already, we have patients already being turned away with covert rationing, we have some ‘cherry-picking’ because the private sector hasn’t been allowed to diversify as much as some would like and we know we have too many hospitals. Why aren’t we having more sensible scrutiny that doesn’t imply everything is ok as it is now?
The important questions about sorting out lines of authority and accountability, 
scrutinising proposed changes to NICE that will undermine our international standing, driving down demand and patient safety (as previously blogged here and here) are being given very little airing. Yet some hospital consultants whose domains are being challenged by other providers (including other NHS hospitals) are simply feeling threatened instead of looking for opportunities to up their game and improve patient outcomes. If you are delivering high quality, safe, specialised care then you are in a strong position! If you’ve been more concerned with your golf handicap than your surgical techniques and safety (Questions for surgeons: how many patient experience outcomes – scarring, pain, healing rates, mobility etc are you aware of after discharge?) then this could be why you are possibly feeling less secure.
And if you are really interested in the future, come along and meet us at the Health Innovation Expo where we will be talking about transforming delivery of healthcare through telehealth – remote monitoring that improves quality of care and reduces costs! A win-win for hospital and community health professionals alike.
Healthcare without walls – transforming the cost and quality of care through telehealth
with presentations and time for questions with Julia Manning, John Cruickshank and Gail Beer
Locations:
9th March, Room SG33 10.15-11.00 (ref S169)
10th March, Room SG24 11.15-12.00 (ref S170)
We very much hope to see you there.
2020health's Blog 
The “ability to provide a comprehensive and universal service” won’t be lost because of the Health Secretary’s plans to increase competition with “private, charitable and co-operative providers” as Mark Porter argues. You can’t lose what do you don’t already have. As you point out, there is a considerable degree of variation in existing practice that goes without professional acknowledgement or public debate.
There is much talk of competition, fragmentation, types of providers and GPs’ ability to commission. All important points, but the key to making any reform work will be in the underlying accountabilty and performance incentive structures. Rather than, as yesterday’s Guardian editorial suggests, “Every Conservative, and…every Liberal Democrat MP [considering] whether his promise of a more consumer-friendly service is a prize that justifies denationalising the NHS,” each MP should consider whether the reforms will deliver better, more transparent outcomes for all patients in England. Only then can there be a real, national conversation on the state of our beloved health system and how to improve it.
Memphis Personal Trainer I do agree with Charlotte that ability can make you different in skills . You can do anything what you want .