Latest news with #reform
The Independent
an hour ago
- Health
- The Independent
Concerns major new NHS reforms to GP appointments will make no difference
Nearly half of the public believes the government's ambitious 10-year plan to overhaul the nation's health will either make no difference or exacerbate the difficulty of securing a GP appointment, a new survey has found. The Ipsos poll, conducted for the PA news agency, also revealed that more than four in 10 respondents anticipate no improvement in A&E waiting times. Despite this widespread scepticism, the blueprint has garnered significant support for several key proposals, including the establishment of neighbourhood health centres, the expansion of the NHS app, and increased mental health provision in educational settings. Unveiled by Prime Minister Sir Keir Starmer earlier this month, the strategy aims to shift healthcare provision closer to people's homes, thereby reducing the current reliance on hospitals and emergency departments. Central to the reforms are plans for an enhanced NHS app, designed to give patients greater control over their care, alongside new neighbourhood health centres slated to operate six days a week for at least 12 hours daily. The plan also includes proposals for new legislation concerning food and alcohol, intended to proactively prevent ill health. The survey, which polled 1,023 adults across Britain, specifically questioned public perceptions on how the plan would affect access to GP services, A&E waiting times, and routine hospital treatment. Some 35 per cent said the plan will have no impact on getting a GP appointment, while 14 per cent believe it will make things harder. This compares with the 29 per cent of people who said they think it will make getting an appointment easier. More than a third (37 per cent) said it will make no difference to waiting times in emergency departments, while almost one in 10 (9 per cent), said they believe it could worsen waiting times, compared with 30 per cent who said it will improve them. Meanwhile, 31 per cent said the plan will have no impact on waiting times for hospital treatment, 11 per cent believe the plan will worsen waiting times and 34 per cent said they think the measures will help. However, a number of proposals outlined in the plan were strongly backed by the public. Some 84 per cent said they supported the creation of a single patient record, while 78 per cent backed the creation of neighbourhood health centres, 73 per cent support the expansion of the NHS app and 72 per cent are in favour of more mental health support in schools and colleges. However, more than a quarter (27 per cent) of people do not support making hospitals fully AI enabled, compared with 44 per cent who would back the move. Almost one in five (18 per cent) said they would not support so-called 'patient power payments', which would allow patients to hold back some of the payment for their care if they are not satisfied, while 42 per cent would support the measure. Some proposals aimed at helping people to lead healthier lives were also strongly supported. A ban on the sale of high-caffeine energy drinks was backed by 78 per cent of people, while 69 per cent back plans to restrict junk food advertising. However, almost one in five (18 per cent) tended to disagree with measures that could see alcoholic drinks labelled with nutritional information, although 57 per cent backed the move. One in four people think the measures included in the plan will make no difference to patients, the poll found. Almost one in 10 (9 per cent) said they think the changes will make things worse, while 35 per cent believe it will improve the health service. A similar proportion, 23 per cent, said the 10-year health plan will make no difference to NHS staff, while 13 per cent said it could make things worse and 33 per cent believe it will have a positive effect. A Department of Health and Social Care spokesperson said: 'We're getting on with the job of delivering for patients, with NHS waiting lists falling by 260,000 since July 2024, delivering more than 4.6 million additional appointments since the general election and recruiting over 1,900 extra GPs to fix the front door of the NHS. 'Backed by an additional £29 billion, our 10-year health plan will seize the opportunities provided by new technology, medicines and innovation to deliver better care for all patients, no matter where they live or how much they earn, and better value for taxpayers. 'It is no surprise the plan is popular with patients, it was the result of the biggest conversation with staff, patients and the public since the formation of the NHS, with more than a quarter of a million contributions.'
The Guardian
4 hours ago
- Business
- The Guardian
Water review in England and Wales: seven key takeways
The biggest review into the water industry in England and Wales since firms were privatised in 1989 has said that the sector is 'broken' and requires fundamental reform. Sir John Cunliffe, the former Bank of England deputy governor who led the Independent Water Commission (IWC) review, has published a 465-page report to attempt to address an industry beset by underinvestment, rising pollution incidents, soaring customers bills and meaty shareholder payouts. The report makes 88 recommendations to government with significant ramifications for the industry and consumers. Here are some of the key takeaways. The report has said that a fundamental 'reset' of the water sector is needed with the proposed scrapping of existing regulators and replacing them with one body for England and one body for Wales. In England, this would lead to Ofwat and the Drinking Water Inspectorate being scrapped, and the removal of the environmental regulation functions for the Environment Agency and Natural England. Under the proposal a new combined, integrated regulator that would be 'less desk-based' would be set up. In Wales, Ofwat's economic responsibilities would be integrated into Natural Resources Wales. The government said on Monday it would adopt the plan. The IWC recommends that meters should be made compulsory for a 'wide range of circumstances', in a drive to force consumers to reduce household water consumption. That includes installing them for households in areas where there is not 'water stress'. It suggests that the water industry could look to the energy sector, where suppliers must install a smart meter if they are replacing a meter or installing a meter for the first time – unless there is a good reason not to. Proponents of smart meters argue they encourage households to use less water. However, larger households with high water usage would be at risk of paying more than a standard flat rate tariff. Water companies could be let off fines if the government accepts a recommendation to allow them 'regulatory forbearance'. The report argues that a regulatory regime should be established to improve the performance of struggling water companies, including tightening oversight of ownership and governance. However, as well as this 'enhanced power of direction' the regime should allow 'regulatory forbearance', which would see companies dodge some financial penalties potentially further enraging campaigners already furious about the rise in pollution incidents. In March, the Guardian revealed that troubled Thames Water – which could collapse into a temporary nationalisation – was asking to be spared billions of pounds of costs and fines over the next five years, claiming that potential investors would be scared off otherwise. The government will also adopt a recommendation to upgrade the existing Consumer Council for Water (CCW) to a fully fledged ombudsman for customers. It currently runs a voluntary ombudsman scheme. The report suggests a nationwide social tariff to help consumers who cannot afford their bills, which the CCW has campaigned for. The change would give customers a clearer route to resolving complaints, such as issues including sewage floods in their gardens and taps running dry because of burst pipes. The report says that the new water regulator would need to be able to offer 'suitable' remuneration, which would mean it would not have to follow 'public sector pay controls'. The argument runs that to be effective the regulator will need to be able to hire and develop 'high-calibre' engineers and staff with financial expertise to provide proper oversight of the infrastructure and funding operations of water companies. 'Attracting skilled staff will require the regulator to offer suitable remuneration, outside public sector pay controls,' the report says. The high pay of water company executives has long been a source of anger among critics of the industry, most recently reignited by Southern Water's chief executive receiving a doubled pay package. However, Cunliffe, said: 'We are not proposing the regulator should set pay scales for the industry. They do need to recruit, and you have to attract the best people. What really makes the public angry is when the pay is there but the performance is not.' The report said that the current metrics Ofwat uses to measure infrastructure resilience, such as sewer collapses, mains repairs and leaky pipes, is short-termist and 'backward-looking'. The report calls for new national resilience standards for infrastructure to help guarantee the maintenance of underground pipes and other water and water waste assets. It also says that the requirements for companies to map their assets should be strengthened. The commission suggests the new regulator should have the power to set minimum capital levels for water companies. That system could mirror the regime in the banking industry, where financial cushions meant to shock-proof the banking system from another 2008-style crash were introduced.
Yahoo
7 hours ago
- Business
- Yahoo
Will the water industry proposals make any difference?
A review of the water industry has proposed the biggest reform of the sector in England and Wales since privatisation more than 30 years ago. The review's author, Sir Jon Cunliffe, has made 88 recommendations, which range from scrapping the current regulator Ofwat to stronger introducing stronger environmental regulation. The reforms are deep and wide, and come at a time when there has been widespread criticism of the industry over leaking pipes and sewage spills. If these proposals are adopted in full it would be hard to see how things could not get better than where the sector is now - underinvested and widely derided. Scrap Ofwat, says major report, as author warns water bills will rise by 30% in five years New water ombudsman will tackle leaks and overcharging Excessive debt and inappropriate dividends that threaten some water companies' resilience – such as Thames Water – would be addressed by minimum capital levels and powers to block ownership changes if not in the company's long-term interests. We already know that water companies will invest more than £100bn in upgrading systems over the next five years - and that bills will rise sharply to pay for it. Sir Jon says there are some "inescapable facts", including climate change, higher environmental standards, a growing population, and replacing ageing infrastructure. The problems plaguing the industry come from not investing for a long period, meaning there needs to be a "massive" investment, in order to catch up, he says. The amount companies can invest is a function of what they are allowed to charge and for the last 20 years, bills have risen by less than inflation - so have been getting cheaper in real terms. It is widely accepted that Ofwat prioritised keeping bills low over new investment. If consumers want a better water system, someone has to pay for it. But what the Environment Secretary Steve Reed wants - and Cunliffe suggests - is a way of making sure bills do not have to spike so dramatically in future to catch up for years of underinvestment - as we are seeing now. Ofwat is paying the price for that by being abolished. Throughout the report there are continual references to the telecoms regulator Ofcom - which is seen to have done a better job by maintaining a focus on continual investment in better infrastructure over time. But while you can change the regulator, the reality is that higher future bills are the price for fixing the underinvestment of the past. There's a lot to digest in this - including compulsory metering and public health officials on water planning bodies. It will take time to take effect. But at least the government will be able to point to the Cunliffe review and insist it has set the wheels of change in motion. Solve the daily Crossword
BBC News
8 hours ago
- Business
- BBC News
Water industry review: Will these proposals make any difference?
A review of the water industry has proposed the biggest reform of the sector in England and Wales since privatisation more than 30 years review's author, Sir Jon Cunliffe, has made 88 recommendations, which range from scrapping the current regulator Ofwat to stronger introducing stronger environmental reforms are deep and wide, and come at a time when there has been widespread criticism of the industry over leaking pipes and sewage these proposals are adopted in full it would be hard to see how things could not get better than where the sector is now - underinvested and widely derided. Excessive debt and inappropriate dividends that threaten some water companies' resilience – such as Thames Water – would be addressed by minimum capital levels and powers to block ownership changes if not in the company's long-term already know that water companies will invest more than £100bn in upgrading systems over the next five years - and that bills will rise sharply to pay for Jon says there are some "inescapable facts", including climate change, higher environmental standards, a growing population, and replacing ageing problems plaguing the industry come from not investing for a long period, meaning there needs to be a "massive" investment, in order to catch up, he amount companies can invest is a function of what they are allowed to charge and for the last 20 years, bills have risen by less than inflation - so have been getting cheaper in real is widely accepted that Ofwat prioritised keeping bills low over new investment. If consumers want a better water system, someone has to pay for what the Environment Secretary Steve Reed wants - and Cunliffe suggests - is a way of making sure bills do not have to spike so dramatically in future to catch up for years of underinvestment - as we are seeing is paying the price for that by being the report there are continual references to the telecoms regulator Ofcom - which is seen to have done a better job by maintaining a focus on continual investment in better infrastructure over while you can change the regulator, the reality is that higher future bills are the price for fixing the underinvestment of the a lot to digest in this - including compulsory metering and public health officials on water planning bodies. It will take time to take effect. But at least the government will be able to point to the Cunliffe review and insist it has set the wheels of change in motion.
Telegraph
8 hours ago
- Health
- Telegraph
Britain must stop subsidising pensioners to save the NHS
The Government recently produced a paper on the NHS entitled 'Fit for the Future – The 10 Year Health Plan for England'. It included many radical ideas and didn't pull its punches in regard to the need for reform. It said: 'The choice is stark: reform or die'. And, if nothing is done, it said, the NHS could become 'a poor service for poor people'. Despite its radical tone and many good ideas, this report did not go far enough. In particular, it accepted the continuation of the current system of funding whereby just about the whole cost of the Service is borne by the taxpayer. In a report published last week by Policy Exchange entitled 'The NHS – a Suitable Case for Treatment?', I and two co-authors went much further and called for an end to the system of predominantly taxpayer funding which has been the model since the NHS was founded in 1948. In the mid-1950s the government spent about 3pc of its GDP on healthcare. Today the figure is 9pc (excluding the private sector), amounting to almost a fifth of all government spending. If nothing is done, by 2070 we could end up spending more than a fifth of our GDP on the NHS. This is unacceptable. If we allowed this to happen, other sorts of public spending would have to be squeezed and/or taxes would have to be raised to eye-watering levels. This would have a devastating effect on incentives and therefore a materially depressing effect on the economy. The funding system is the first of the NHS's major problems. The second is inadequate quality. Many British people think that the NHS delivers a first-class service. Yet, it is clear that the NHS offers neither the best nor the worst healthcare in the world. Admittedly, at its best, it is superb, but the standard is hit and miss, and at its worst, it is pretty bad. Among a group of countries of comparable economic development (Australia, France, Germany, the Netherlands, Singapore, Switzerland and the US), on both life expectancy and healthy life expectancy the UK comes in second to last. Only the US scores worse. On preventable and treatable mortality, the UK again comes in second to last, ahead of only the US. On the proportion of patients waiting over a year to see a specialist, the UK is the highest in the group. We also perform badly on the ease of securing an appointment with a GP and access to GPs out of hours. What is to be done? Whenever someone criticises the NHS and suggests that we need to move to a different model, a chorus of voices loudly proclaims that we must not become like America. Indeed not. The US health system pulls off a remarkable double whammy. Although some of the best healthcare in the world is to be found in the United States, average health outcomes for the population as a whole are simply dire. Meanwhile, the system is about the most expensive in the world. However bad the NHS may seem, it is infinitely preferable to the American system. Under no circumstances should we consider copying the US. But we don't have to. There are many countries in the world which operate a different system for funding healthcare and enjoy better average health outcomes than the UK. The essence of their approach is to combine charging and co-payments with a system of social insurance. That is to say, compulsory purchasing of medical insurance, covering everyone in the population, with concessionary rates or even full reimbursement available for poor people. The state remains involved as both a partial funder, co-ordinator and regulator of the system. But governments spend much less on healthcare in these countries than we do, and thereby place a much smaller burden on their taxpayers. Countries that run such a system include Australia, Canada, France, Germany, the Netherlands, Singapore and Switzerland. The most outstandingly successful of these is Singapore. It spends only about 5pc of its GDP on healthcare and of that, not much more than a half comes from government. Meanwhile, Singapore achieves just about the best health outcomes in our comparator group. Yet Singapore is a very special case, with a particular political and social model. For an example that would serve the UK well, we should probably look closer to home. The obvious place to look is the Netherlands, not least because it underwent a radical reform of its health system in 2006. It delivers high standards of healthcare yet the government spends only 1pc of GDP on health. Some people will argue that we already have a system of insurance to pay for healthcare, namely National Insurance. Despite its name, however, this is not really a system of insurance. It is rather another form of tax. The amount of money the state pays for healthcare is not restricted by the amount of National Insurance contributions coming into the Treasury. Moreover, unlike pensions, where eligibility is connected with National Insurance contributions, a person's ability to access the NHS is not circumscribed by their NI contribution record. Moving from a system of funding through taxation to one based largely on social insurance is going to be a tough ask. It cannot be completed overnight. The place to start a programme to reform the financing of the NHS is with the introduction of a small charge for GP appointments and an end to the automatic entitlement to free prescriptions for pensioners, regardless of their financial circumstances. Doubtless many people will say that these proposals destroy the essence of the NHS as it was established in 1948. But the provision of healthcare in this country cannot be treated as a sort of museum exhibit. We can adhere to the spirit of the NHS in creating a system that delivers excellent healthcare for all within a funding framework that is right for the 21 st century.
