Posts tagged with Privatisation

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.

End Game

Dr No is getting increasingly bored by the futility of the gesture politics flaming round the NHS reforms. Being bored, he found himself, by quirk of a daydream, thinking of another kind of bored, a chess board, and for a moment he saw the end game of this blasted bill as a game of chess, played not on a square, but on a triangle. Three opposing GP sides – for as Dr No has said many times, it is in the hands of GPs that the fate of the bill now rests - face each other across this lone and level triangle, one side dark, another light, and the third grey.

Who, then, do we find on the opposing sides in this end game? On the dark side, we find, as we did last Sunday, the likes of Hot Burning Coales, pro-government, pro-competition, pro-private sector and so pro-reform. Their strength is that they are aligned with government, and government with them, but their evidence is blown, and their arguments in tatters. Neither stridency nor volume could save HBC’s case for the reforms, as they wilted and folded, a styrofoam cup of competition coffee microwaved in the radiant beam of Evan Harris’s glare.

Mary’s Bottom Line

The Retail Raptor is developing a social conscience. Hot on the heels of her project to put the High back into High Street, she has moved on to save Britain’s dying textile industry. Following the trend set by Hacksaw’s there is ‘no such thing as society’, which taken to its logical conclusion means there is no such thing as Britain, and the rise of globalisation, Britain’s textile industry has, like many others, gone west by going east. Here at home, the looms lie still, the sewing machines silent, the thread of manufacture first snagged, then cut short. The grim jaws of benefit dependency have bitten across generations; the darkness of despondency and despair lies thickly in the air. This is the kind of blight up with which the Raptor will not put.

The Two Tier Health Service in Action

Dr No’s colleague, the Formidable Missile, who cares so much it must hurt, has been campaigning tirelessly on behalf of her PIP ladies. Whether lumping these women together as ladies is a push up too far that affords them a degree of nicety not always entirely fitting is a moot point, but on the matter of doing something to help these women, as Dr No prefers to call them, Dr No is right behind the Formidable Missile’s point. No matter what collusion of vanity and distress prompted these women to put a rocket in their tits, the fact is they presented to their surgeons in good faith, expecting a competent procedure, done using the proper materials. That the booster in their rockets turned out to be sinister industrial grade silicon, and prone to rupture to boot, is a calamity that simply cannot be laid at their door. And for this reason, Dr No agrees with Dr Coales: there is no moral justification for leaving these women to fend for themselves.

Speed 3: Health and Social Care Bill

The government has now tabled yet more ‘amendments to the amendments’ to the HSCB – this time 137 of them, complete with ‘briefing notes’. The pace of developments is making Dr No quite giddy, so he settled down with his opium pipe, and before long it dawned on him: the government isn’t making laws, it’s making movies

After the success of the 1994 movie Speed, starring Sandra Bullock and Keanu Reeves, and the dismal sequel Speed 2: Cruise Control, there was for a while a suggestion of a triquel, Speed 3: Ignition, but it turned out to be a hoax. No doubt the catastrophic bombing of Speed 2 blew up any chance of Hollywood making Speed 3, but never mind – for we have our very own Speed 3, already up to speed and running fast at an NHS trust near you. It is, of course, Speed 3: Health and Social Care Bill, produced by David “Wide-screen” Cameron, and directed by Andrew “One-track” Lansley.

Hypocrisy, the Hoodie Tsunami and the NHS

Dr No is not a hoodie; nor, so far as he knows are any of his friends, or even his friends’ children. He moves in the rarefied climate of relative genteeldom that is upper middle class Britain. Most of the sharks he knows wear suits, and work in the City, or the local private hospital; and the robber barons he knows wear wellies and tweeds. Those times in the past when his medical career has taken him into the sink estates and dumping ghettoes – he recalls once being advised to ‘put his doctor’s bag first through the door’, so that the waiting Rottweiler bit it, not him – have been brief; and despite the portent of his colleague, he conducted his practice in a spirit of Croninian naivety. He came not to judge his patients, but to treat them.

How To Compete on Price Without Competing on Price

Twenty five or so years ago, in the Hacksaw years, there was a move afoot (there had also been a Michael Foot, but that is another story) to relax the then decidedly restrictive and yet unworkable Sunday Trading Laws. Hacksaw and her buddies attempted to introduce a Shops Bill in 1986 to relax the rules, but the move was seen off by an unlikely coalition between the God Squad, acting in best Ian Paisley style, and by the Unions, marking the only time – a precedent we might want to note - that a Hacksaw Bill was ever defeated. Thus the restrictions, including the quaint absurdity of allowing the sale of a pornographic magazine but not a Bible or a birthday card on a Sunday, continued for another eight years, until the liberalising 1994 Sunday Trading Act came into force.

The early Hacksaw years were nonetheless a time of unbridled market adoration – yuppies had just been born, and the Stock Exchange Big Bang was around the corner – and so the spivs and suits, who had no intention of letting tiresome laws fetter their marketing zeal, set about devising ways of getting round the restrictions. Dr No’s favourite, for its audacity, was the carrot wheeze: carrots, but not beds, could be sold, so the spivs sold carrots, at a hundred quid a pop, and threw in a bed for free.

Looking Inside the Surgeons’ Mind

Dr No started his medical career in a surgical specialty (O&G), and in many ways, he still thinks like a surgeon. Physicians, with their pills and potions, and frock coats and baffling cardiac murmurs, were and still are quite beyond him. So he naturally expected that he would understand the Royal College of Surgeons stance on the Health and Social Care Bill. But instead he finds today it is the RCS’s position that is baffling him. If ever surgery was called for, it is a for a wide resection of the malignant tumour that is the Health and Social Care Bill. Yet the RCS wants to not just leave the tumour in place, it wants to encourage its growth. Dr No is indeed baffled.

Lest We Forget: A Poppy for the NHS

Dr No observes Remembrance. Last Friday, the day before yesterday, at the eleventh hour on the eleventh day of the eleventh month, and this time as it happens of the eleventh year of the century, he fell silent and still for two minutes, and remembered those who have given their lives for the freedom we enjoy today. It is a moment of solemn awe for the sacrifice made, and of great humility in the face of such selflessness.

Remembrance was made that bit more poignant this year by the breaking news that Circle Health had signed the long foretold contract to run Hinchingbrooke Hospital. This contract is a clear challenge to the authority, competence and perhaps most of all to the values of the NHS; a challenge which, if not seen off, will in short order threaten the very life of the NHS.

BBC: Balanced, Biased or Just Plain Conkers?

“Is there any other point to which you would wish to draw my attention?”

“To the curious incident of the dog in the night-time.”

“The dog did nothing in the night-time.”

“That was the curious incident,” remarked Sherlock Holmes.

–Sir Arthur Conan Doyle, Silver Blaze, 1892

Like Dr Watson, Dr No is in awe of Sherlock Holmes, and forever baffled by his cryptic utterings. Unlike Dr Watson, who had the delight and privilege of watching Holmes in action at first hand, the rest of us must enjoy Holmes at our leisure, and many will already know that the reason the dog did not bark was because the visitor was someone whom the dog knew well. Dr No finds himself wondering whether a similar reason might explain the BBC’s ongoing curious incidents on the Health and Social Care Bill. The BBC should be barking like a Baskerville about it, but instead much of the time it remains silent. When it does make a noise, it is more whimper than bark. Could it be that the BBC knows who its master is?