"Promessas vazias" Os grupos financeiros portugueses / PPP prestarão melhores serviços que os Ingleses na exploração do "Negocio da Saúde"? Leiam o relatório independente "Promessas Vazias"

"On independent report, commissioned by UNISON, by Jane Lethbridge, Public Services International Research Unit, University of Greenwich"

Nota Prévia : Trata-se  de um estudo  independente e  idóneo de uma Universidade Inglesa  especialista na avaliação de Serviços Públicos. 

Relativamente ao futuro Hospital de Todos os Santos esta a   ser construído por um PPP, estamos já  certos de um facto:  Os  seus congéneres Ingleses são   mais civilizados e nunca incluiriam  nos seus planos a  destruição de  um Hospital Pediátrico de forma a maximizar os seus lucros.....ou seja em Portugal  e ao contrario da Inglaterra e do mundo civilizado, nem as crianças são poupadas....Aos Gestores e Grupos financeiros portugueses  lançamos  assim o repto:  apontem um único Hospital Pediátrico Publico  desactivado sem esteja a ser construido outro novo que o substitua   quer no Reino Unido quer  em qualquer Pais do mundo....

On independent report, commissioned by UNISON, by Jane Lethbridge, Public Services International Research Unit, University of Greenwich

As PPP na Saúde ... Experiência do Ingleses....

An independent report, commissioned by UNISON, by Jane Lethbridge, Public Services International Research Unit, University of Greenwich

6 Conclusion

This project has identified a range of studies that have examined some aspects of outsourcing in the NHS and the effect on patient care. It is noticeable that much of the evidence demonstrates either the negative aspects of introducing competition into the provision of health care services or inconclusive results (Appendix A). A lack of data makes it difficult to assess the impact of contracted out services on accessibility of services and health outcomes. Overall, there is a lack of evidence to show that outsourcing leads to improved quality of patient care. The experience of outsourcing cleaning services shows that there was a negative impact on patient care. Outsourcing of clinical services, for example ISTCs and GPs ‘out of hours’ services, shows negative effects on patient care, poor value for money as well as evidence of inadequate monitoring and evaluation

of the services. Although there is some evidence of the benefits of shared services, the experience of the NHS IT project was a clear failure of outsourcing.

What is emerging from research into the impact of privatisation and contracting out is that the initial impact can often be strongest on how people are organised in internal hospital systems, which in turn impacts on the ways in which health workers and health professionals work together. This is a complex relationship but appears to be a significant one if the impact of contracting out is to be assessed in terms of patient care.

The tendering process has an impact on how services are organised, the flexibility for responding to change and the pressure to reduce staff costs. A lack of comparable data has been identified as a problem for both ISTCs and GP ‘out of hours’ care. With increased competition, information is less widely shared and often considered commercially sensitive for private sector providers

The introduction of outsourcing to the NHS has identified the need for data collected to measure the quality of patient care after the contracting process. At the moment, a combination of academic research, research from regulatory agencies and trade union research provide the most effective way of gathering evidence of the impact of outsourcing into the quality of patient care. Many of these studies do not show any demonstrable benefits from outsourcing. Other academic studies have assessed the impact of competition on the NHS in a limited way, either using one service, or one health outcome. The conclusions are then applied to the whole of the NHS, as a way of justifying more competition. This research needs to be challenged because it is being used to justify continued competition and marketisation policies in the NHS.

In the light of the 2011 Health and Social Care Bill, currently going through Parliament, the findings of this review are significant. Outsourcing often has a negative effect on the quality of patient care. It affects how NHS workers work together to deliver care. Effective commissioning, regular reviews of contract specifications and monitoring of

contracts require skills and experience. The experience of how ‘out of hours’ services were contracted out and the effect on patient care illustrates the problems when commissioners and providers are unaware of how to fulfil their responsibilities. In a re-organised NHS, where much commissioning experience, developed in primary care trusts, will be lost, the likelihood of the new contracting systems affecting the quality of patient care will be even more likely.

LER O RELATÓRIO NA INTEGRA NO SITE:

http://www.psiru.org/publications?sector=77&country=All&subject=All&author=All