Posts tagged with Privatisation


The Maltese Falcon

Dr No is fed up with the Health and Social Care Bill, and the interminable waffle that surrounds it. To him, it is clearly the death warrant to the National Health Service. Once enacted, it will allow any willing cowboy – and that includes the unscrupulous doctors amongst us - to ride into town, and hawk their wares. Britain’s greatest post-war achievement, healthcare on need not ability to pay, will be dynamited, and Wild West law will prevail. Many, far too many, will perish.

Faced with this threat, what do we have? Walls of argument as penetrable as fog. Touching faith in democratic and parliamentary process. But as Dr No wades through Hansard, he finds no cause for celebration. The worthy but windy briefings swirl away as an autumn mist. The Noble Lords, when not bemoaning the declining standard of Westminster biscuits, cast their breath on the looking glass of truth, and see not the angled knife at our health service’s throat, but instead their own wondrous learning, so wonderful to behold.

La La Land

Question Time last night on BBC1 assembled a panel sure to cause fireworks, and fireworks there were, on a military scale. Lansley spent much of the programme looking like a barrage balloon about to explode, Sarah Sands explained to anyone willing to listen why she should be the next editor of the Daily Mail, and Mark Littlewood previewed the bilateral cauliflower ears that all Lib-Dems will sport, once the electorate give them the boxing about the ears that they so sorely deserve at the next election. But the best and most striking bit was the visceral anger of the audience. At one point, they almost rose up as one, as if to tear Lansley limb from limb. Dr No, pacifist that he is, almost wished they had. At least we would have been spared further sight of that blasted barrage balloon.

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?

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.

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’.

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.

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:

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.

The Brave New World of the BOGOF NHS

Pity the poor patients in Yorkshire. Hot on the heels of the Haxby scandal, which saw GPs mail-shotting patients special offer in-growing toenail ops in your own lunchtime deals (£146.95 a pop), we now have Assura East Riding LLP (another bunch of suits dressed as GPs) huffing and puffing all the way to the Competition Panel about alleged predatory pricing, not by their local Asda, but by their local NHS trust. AER claim that York Teaching Hospitals NHS Foundation Trust tendered a below cost orthopaedic service, and won, and as a result the local PCT told AER and its bid to, ahem, bog off. You can read the sordid details of AER’s complaint to the CCP here (pdf, 2.3Mb).