Posts tagged with Privatisation


Patient Abuse - A Bad Case of Management Blowback?

Is there more patient abuse in the NHS today than there was, say, thirty years ago, or are we just better at exposing it? Dr No does not know for certain. He chose a thirty year comparator because it was about that time ago that he was a medical student, and then a junior doctor, and so frequently exposed to different wards and hospitals. His recollections from that time are more of starched white sheets, and of course the starched but very beguiling nurses who smoothed them out, than of beds doubling up as commodes. He does recall once seeing a cockroach on the polished wooden floor of a ward, but it was a one-off sighting of a very lonely cockroach. Today, it seems, the cockroaches have grown in both size and number, many now standing on two legs as they mishandle and maltreat the patients on their ward. Has it come to pass that the once occasional failing has now become normal practice?

The Night of the Liam Dead

Last night’s News at Ten on BBC1 was fronted by a back room cove with hair pulled straight from a Brylcreem ad. The lead item presented Liam Fox, the Defence Secretary, as a cross between a schoolboy caught with his shorts down, and a Klan buddy with his ex-best man. The editorial line was let’s pop Liam on a spit and roast him, because he might produce some good crackling. But then again he might not. We shall have to wait and see.

The second item featured a collection of brightly coloured blood stained table clothes spraying lead in the air somewhere in North Africa. A man wearing the neutered remnants of a community support worker’s uniform made from recycled egg cartons winced in the bottom left hand corner of the screen every time a gun went off. In between winces, he assured viewers that, whatever else was going on, there was a lot of gunfire going on. Gaddafi might have been somewhere in the background. But then again he might not. We shall have to wait and see.

A Serpentine Spaghetti of Words

One of the more tiresome ways of our legislators is their habit of changing law through the use of amendment clauses. You know the sort of thing: instead of rewriting the clause from scratch, and presenting it in its entirety, we have ‘In section 650 of the National Health Service Act 2006 (Chapter 5A of Part 2: interpretation) (the existing text of which becomes subsection (1)) at the end, insert—’, the end result of which is a serpentine spaghetti of words so convoluted that the eyes glaze over and the temples throb. Never mind that the apparent zero after 65 is in fact the letter ‘O’, or that the said Act 2006 appears in fact to be said Act 2009; the fog generated while trying to cobble together the parts to make an intelligible whole is a masterpiece of Sir Humphreian obfuscation.

TTIP – Blofeld’s Charter or Scaremongers’ Chatter?

As acronyms go, it’s the tits-up PITTs, but for many concerned about the NHS, it is a pile of shit. Presented as a partnership, TTIP - the Transatlantic Trade and Investment Partnership – is, depending on your point of view, either a sensible deregulation of transatlantic trade and investment that will free up a few extra bob for the folks back home, or Ernst Stavro Blofeld writ large, hell-bent on a grim SPECTRE TM – much more of this, and Dr No will need treatment for acronymitis - of corporate world domination at the expense of the nation-state. At the crux for health care is a TTIP proposal to allow private capital to sue sovereign states in ‘ad hoc’ tribunals for loss of profit. Claims of this sort have already happened under other trade agreements: in Europe, the private Dutch health insurance company ACHMEA recently sued Slovakia after a new government introduced a more socialised health service that threatened ACHMEA’s profits. The outcome appears for now at least to be in Slovakia’s favour: the tribunal said it had no jurisdiction - ‘the design and implementation of its public healthcare policy is for the State alone to assess’ – meaning, in effect, ACHMEA had lost.

Franchising the NHS

It has started, not so much with a bang, as with a whisper.

Buried yesterday in Basildon’s tragically named Yellow Advertiser was an apparently run-of-the-mill story about a new hospital opening. Hidden between other shocking stories - ‘Body found in cemetery’ (‘man pronounced dead’) and ‘Bikers hit the road’ (luckily no one was hurt) - ‘Community hospital officially opens’ told a gentle tale of local gardening legend Ray Stephens unveiling a plaque to commemorate the opening of Braintree’s new state-of-the-art Community Hospital.

Crossing the Circle

The twilight shadows of Southern Cross have today grown longer, as news emerges that the troubled care home chain is to shut down. The chill of closure will be felt most keenly by the 31,000 vulnerable residents and their families, but the shadow is a long one. Southern Cross’s opco-propco business model, which separates out the operating interest, Southern Cross, from the property owning interests, the care home landlords, has become increasingly popular over the last decade A number of health and care businesses have adopted a similar approach, including the private hospital and ISTC operator Circle, tipped to take over operation of the bust NHS Hinchingbrooke Hospital later this year. Could the cross of Southern’s shadow extend as far as, even cross, Circle’s circle? Almost certainly, the answer is yes.

It’s the Market, Stupid!

Attila the Humph attempted to interview Mr Lansley on the Today Programme earlier this week. Attila was in Gatling mode, achieving as usual more noise than hits. Lansley, on the other hand, was operating in lounge lizard mode, and the lizard just kept on talking. He also slithered a lot, but Atilla’s attacks bounced off him like dried peas off a plate glass window. The problem was that Atilla, despite having been tipped the big question by his previous interviewee, the King’s Fund’s John Appleby, was stuck in semi-automatic mode, and stayed stuck, like the proverbial to a blanket, while the lizard sped off, like the proverbial from a shovel.

Drive-By Surgery

David ‘Ozymandias’ Cameron’s five NHS pledges – worthy of only the briefest flash in the news-pan yesterday – are already showing all the substance of five brown ballerinas. Even as he made his speech, the smart finger was on the money. PCTs have been running rings round the fixed national tariff for months, allowing private providers to compete on price.

The Bureau of Investigative Journalism has spotted a loophole, a loophole, we might add, that is as wide, open and inviting as a barn door, that allows – forgive the jargon – community services provided under the any willing provider procurement process to escape the national tariff. Since this is the kind of terminology that gives the rest of us a migraine, we may translate this to mean stuff done outside hospital, excluding normal general practice, that is not subject to fixed prices.

The Silence of the Lambs

The hottest places in hell are reserved for those who in times of great moral crisis maintain their neutrality

–Dante, via JFK

So – Dodders has produced his report, and, despite the best attempts by the media to whip it up, it is predictably doddery. The general gist is that the Nicholson challenge, that the NHS achieve £20 billion efficiency savings by 2015, isn’t going too well. La La’s response – that the report was unfair on NHS staff, because they are all doing a spiffing job – baffled everyone. At some point, Dodders may have suggested the Health and Social Care Bill might be something of a distraction, or words to that effect. Whatever it was the report said, it was not the rocket up the Bill’s backside that many hoped it would be.

It’s the Right Care, the Right Place, It’s McKesson

One of the more toxic forms of health care delivery is a system known a “managed care” – an American import which takes a car fleet maintenance approach to looking after the punters.