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.

How to Fix the NHS

The Institute of Economic Affairs, reckoned by Diamond Marr to be a mustard cutting outfit if ever there was one, has come up with a plan to nuke not just the NHS, but anybody even remotely concerned with providing healthcare. Dr No has studied this plan, and can reveal that it is in fact a typical skipload of NeoCon tosh; it may even be a NeoTosh con. Dr No has a much better, simpler and eminently more practical plan, and he proudly takes this opportunity to present it to his readers:

• Perhaps most importantly, shoot Lansley, and abolish the DoH. To be fair, some brighter Tories have suggested the former, but in typical political fashion, have failed to execute any plan, let alone Lansley.

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.

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.

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.

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.

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.

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.

Shakin’ Stevens

Yesterday’s news was bob-a-job docs, £55 for each and every dementia diagnosis, with old hands who should know better – they have been handbagging item of service fees in various shapes and forms since the beginning of time – decrying the idea as bribery, likely to cloud professional judgement, possibly even unethical. Dr No will believe their wails when they start handing back the contents of their handbags. For his part, Dr No thinks the idea, though crude, is not without merit, even if the sum is paltry for what is rather more long-term work than a snap diagnosis, because it sends a signal in terms the ex-apothecaries have always understood – payment for an item of service. Dementia is under-diagnosed, and patients and carers who want to know and plan miss out on help that is or at least should be available. Indeed, upping the recorded prevalence might even push up dementia funding. So all in all, though a bit grubby, the idea gets Dr No’s approval.