Posts tagged with Privatisation


Apples and Oranges

Following some excellent posts by the medical blogosphere’s resident Pest Control Officer, Dr No has been learning two new words. Both get flagged as misspelt by his spelling checker, and only one has so far made it into the OED. The one that has made it into the OED is ‘commodification’, and the dictionary defines it thus:

“The action of turning something into, or treating something as, a (mere) commodity; commercialization of an activity, etc., that is not by nature commercial [emphasis added].”

At a stroke, Dr No has stumbled on the word that perfectly describes the core malevolence at the heart of Tory’s proposed healthcare reforms. And on this they have form.

A Good Day to Bury a Bad Bill

Conveniently, the Health and Social Care Bill completed its final parliamentary stage on the eve of the budget, ensuring it was in hours knocked off the top of the news pile by Porgie’s Biddy Tax. But, mean as the Biddy Tax is, it is not the erosion and loss of the Pensioner’s Allowance that will hit Granny hard in the years to come, it is the erosion and loss of the NHS brought about by the Tories’ now soon to be unleashed health service reforms that will hit Granny – and indeed the rest of us when we need healthcare - hard. So the question arises: what are we going to do about it?

If It Walks Like a Duck...

Dr No has no doubt that the most devastating blow to be wrought by the Tories on the National Health Service in their Health and Social Care Bill is the abolition of the Secretary of State’s duty to provide a comprehensive health service. At a stroke, it removes ministerial responsibility and accountability, and so renders the NHS as an army without a chief, a supertanker with no one on the bridge, a body without a head. And when mayhem arrives, as it surely must, when the troops run wild, or the tanker strays off course, there will be no one in charge, no one on whose door we can knock, and demand redress. So long as the Secretary of State has ‘acted with a view’, an invidious wording blessed with the legal slipperiness of a bar of soap, he can profess to have done his duty, and declare, even as the tanker hits the rocks: ‘not my problem’.

The Minister for Impotence

The fallout from the sorry tale of the PIP implants that went pop in the night is starting to settle. We have calls for the MHRA, the agency who green-lighted the PIP implants, to pull its finger out of its prostheses, and get some dentures with edge. What else, it is now asked, has the agency, which green-lighted breast implants filled with a Vulcan’s brew of fuel-additive enriched industrial grade rubber, also endorsed? Mobile phones recycled as pace-makers? Mild steel hips that will rust before time? Could it be that, far from entering the bionic age, we are instead in an ironic age, where that which pretends to improve turns out to do quite the opposite? Will we, indeed, ever know? We shall have to wait and see.

A Nod’s as Good as a Wink…

Not content with just nuking the NHS – so last year, my dear - it now appears that Lang-Ho and the Con-Doms – fresh from turning a blind eye to city bonuses – are lining up to offer their private healthcare pals an eye-watering billion dollar bung to ‘ease’ their entry into the post-NHS healthcare market.

The proposals – buried deep in last week’s Health and Social Care Bill Impact Assessment – have arisen because a management consultant (KPMG) report estimates that Lang-Ho’s non-NHS provider buddies are at a financial disadvantage compared to NHS providers:

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.

Services and the Split

Notwithstanding their superficially opposed raisons d'être, the armed forces, also known as ‘the Services’, and the National Health Service, are remarkably similar. Both are huge and complex organisations, charged with providing services vital to our well-being. Yet, for some reason or other, the NHS in England is run on market principles, making use of the so-called purchaser provider split. The armed services have no such split.

NHS Scotland and NHS England are both national health services that provide health care to their respective peoples. NHS England is run on market principles, making use of the so-called purchaser provider split; NHS Scotland has no such split. Indeed, prior to the Hacksaw years, NHS England had no such split.

The MBA Mind and the NHS

A program on Radio 4 alerted Dr No to new developments in the world of MBAs. Shocked by the public backlash against MBA graduates for their part in shafting the developed economies, a group of 2009 Harvard Business School alumni have borrowed from Hippocrates to conceive the MBA Oath, an ‘inspiration and accountability tool’, to guide MBA graduates through the business jungle.

Putting aside a natural tendency to view the prospect of MBA graduates taking an ethical oath as more hypocritical than Hippocratic, the accompanying book is still thought provoking. Amongst other things it introduces the idea of the ‘MBA mind’ – that cut throat, greed-is-good brain that powers the suits in their relentless pursuit of profit – not, of course, that the authors word it that way.

When a Dentist Sneezes, the NHS Catches a Cold

Dr No’s NHS dentist is a likeable old cove. Asked how he proposed to fix Dr No’s new crown in place, he announced ‘Bostik Number Five’ – a Dr No response if ever there was one. So – just to be clear – this post is not about knocking dentists as a profession. What it is about is looking at what happens when you run a substantial private mostly insurance based system alongside a publicly funded NHS one; and what has happened in dentistry does not bode well for the rest of the NHS.

On Monday, Channel Four’s Dispatches programme invited dentists to open wide. A number obliged, and an unedifying collection of drill sharks, cement mixers and card snitchers sprung into view. The general wheeze was to get you, an NHS patient, in the chair, and then offer a Hobson’s choice of private treatment, at which point wallets, inevitably, opened wider than mouths.

Mission Impossible

The Blameless Broadcasting Corporation, which doth protest too much, because it did take sides, by providing skimpy superficial coverage of the Health and Social Care Bill, have at last done something useful. An independent survey ordered by the corporation of over 800 doctors, which we have no reason to assume is not unrepresentative, unlike the GP monkey surveys, has found that only 12 percent of doctors believe GP led commissioning will lead to ‘patients seeing a noticeable improvement in their care’. More than half (55%) disagreed; the remaining third must have sore perineums, for they are still sitting on the fence, saying they don’t know one way or the other.