Posts tagged with Privatisation

Would the Real GPs Please Stand Up

Monday’s Channel Four Dispatches programme featured Squeeze Esmail, a sharp professor of general practice, now turned part-time undercover Taliban operative. He lined up some stooges with a collection of red flag symptoms – so-called because they should indicate to any doctor the possibility of serious disease – and fitted them with spook-cams before sending them off to see dodgy GPs, most of whom had un-pronounceable names, and/or worked out of shady lock-up retail premises. The dodgy doctors duly obliged, failing to spot the suicide vests so visibly strapped to their patients chests. Jon Snow presented, with a mixture of knight’s move reporting and come-off-it interviews with Stilton, the chief pongo at the GMC. All in all, the programme raised some important questions, which Dr No may return to another day, but that didn’t stop the Jobbing Doctor from wailing, and hammering yet another nail into his already shattered foot on the cross.

Mary Portas: Queen of Clinic

It is a wonder they haven’t called in Mary Portas, Raptor of Retail, to fix the NHS. Nice Gerry tried a while ago, but tea and biscuits, even Nice Gerry’s 24/7 tea and biscuits, failed to hit the fan when it came to fixing the NHS. Nice Gerry’s biscuits did what biscuits do when faced with a sea of NHS tea. They got dunked - and disintegrated.

Raptor, of the other hand, would know exactly what to do. Dressed by Dallas out of Star Wars, she would stalk the wards and clinics, skewering managers. Layabout staff would be rounded up, and their nail varnish stuffed where the sun don’t shine. A wand of retail magic would be waved, dull clinics transformed in a halogen twinkle into fun interactive experiences. Freshly botoxed greeters in Thunderbird uniforms would be drafted in, and the warmth of the Mall would embrace all. Everybody would win, and all would have prizes.

Three Stabs and You’re Out

Broken Arrow is today staggering around, two daggers in his back. Earlier this week, Downing Street let it be known that there was a view that he should be ‘taken out and shot’; today, the editor of ConservativeHome has let it be known that three cabinet ministers want pretty much the same thing. That’s right: within the space of a few days, both Downing street and a bevy of cabinet ministers have let it be known: Lansley, and with him his blasted bill, must go. Other Tories, including Dodders, have been twiddling knives, but Dodders is a gentle man, and one suspects a stab in the back from him would be more Private Godfrey bear-hug than Corporal Jones bayonet.

A Tale of Two Thickies

Of all the reasons to end a long and bitter industrial dispute, imposing an unwelcome contract on a demoralised workforce to "end the uncertainty" has to be the most bizarre, given the inevitable outcome of the imposition will be not less, but more uncertainty. The demoralised workforce, our junior doctors, are already in bad shape, overstretched and in poor morale. Record numbers are considering – though we don’t yet know how many will pull the ejector seat lever – working abroad. Late last year we learnt that almost half of juniors completing their foundation training chose not to proceed directly with their training – a sure sign of ambivalence about the direction of their chosen career. Hospitals face unprecedented recruitment problems, winter pressures are now being mirrored by summer pressures, with the imminent prospect of all year round pressures. The health service is in a critical way, at risk of implosion. So what does the Health Secretary do when he doesn’t get his own way with the juniors? He hits them on the head. Hard.

The Law of Wet Paper Bags

There is a variant of Dennis Healey’s Law of Holes which says: when you are in a wet paper bag, stop pissing. Most folk who spend much time in wet paper bags appreciate the importance of this law to their survival, but it seems those folk who inhabit the wet paper bag more generally known as the British Medical Association have yet to turn off the tap. At a time when there is overwhelming and very visible professional opposition to the Health and Social Care Bill, and so a real prospect of nailing the bill, the BMA has turned on a golden shower of pension reform objections. There is even talk of industrial action.

Demographic Panic

One of the factors that is said to underpin the ‘no change is not an option’ need to reform the NHS is our ageing population, the so-called grey tsunami, or demographic time bomb. This all party political IED is sitting there, we are told, with a short and inextinguishable fuse. If we don’t do something now to counter it, then we are all, as Frazer would have put it, doomed. But are we? Captain Mainwaring and his platoon survived any number of Frazer’s doom-laden predictions.

Dr No rather suspects that this alleged time bomb is indeed more political wheeze to panic us into accepting the ‘necessity’ for ‘radical’ reform – opening up the NHS to private service providers, and inevitably in due course private funding - than reality. Let us for a moment consider some of the alleged ‘facts’.

Perhaps Not Optimal

Speaking on the Today programme, their business reporter did his best to put some heat into a cold December morning. ‘Despicable cartel like practices,’ he flamed, quite putting Humph and the rest of the gang in the shade, over OFT allegations that UK private healthcare providers have rigged the market. The lady from the OFT stayed cool, although she did concede that the performance of the market was ‘perhaps not optimal’. To Dr No, the turn of phrase made about as much sense as if NASA public relations had used the words to describe the performance of the space shuttle Challenger on its last fateful flight.

The OFT, Monitor’s big brother, have been investigating the £5 billion UK private healthcare market, and – provisionally – it does not like what it saw. Provisionally – no one’s sticking their neck out here – it found ‘a number of features that, individually or in combination, prevent, restrict or distort competition’ – or cartels and rigged markets to the rest of us. Private healthcare, it appears – provisionally, of course - to be not so much about stitching up patients with subcutaneous Dexon, as stitching them up financially, in a web of cartels, restrictions and misinformation. The OFT plans – provisionally, as they don’t jump guns at the OFT – to refer the market to the Competition Commission.

Laughing at Democracy

After a quiet few days, there have been some yelps squeaks and barks from UK medical bloggers about the British Medical Association’s SRM (Sham Representative Meeting) called earlier this week to decide the Association’s position on the government’s proposed NHS reforms. Dr Grumble meanwhile has adopted an “I’ve been telling you for years, will you believe me now” tone under a reckless headline on the ways of parliament. Or perhaps it isn’t so reckless after all – for who knows how many tens of thousands will die unnecessarily if the Tory health reforms become reality.

The trouble with all these yelps squeaks and barks (and Dr No has been at it too) is that they are faux-outrage at what is in fact inevitable. It is the inevitable result of what many of us call democracy, but which is in fact nothing of the sort, being instead something which Dr No called Sham Dem eighteen months ago; and the thing about Sham Dem is that it is anything but democracy, by any accepted definition of the term. It is, to give it a more descriptive but less snappy name, serial, or perhaps more accurately, interval, oligarchy. If that sounds a bit technical, Dr No apologises, but hopes to make all plain.

The Listening Bank

Broken Arrow - so-called because he doesn’t work, and can’t be fired – stood up red-faced in the Commons on Monday. A nervous tie-fingering moment later, he launched into a resentful defensive downcast drone about his beloved Titanic Bill. It was already more than four fifths of the way across the Atlantic, he declared – it had concluded its committee stage, and eighty-seven percent of GPs covering forty-five million patients had already signed up to join the party. Labour jeered and heckled, and Broken Arrow’s face got redder. But a spectre of icebergs had loomed, and through gritted teeth, he admitted the most unTitanic of conduct: a slow down. The government, he said, would take advantage of a ‘natural break’ in the passage of the Bill to ‘pause, to listen, and to engage’. Labour, of course weren’t having any of it. Broken Arrow hadn’t listened before, so why should he start listening now?

Not Quite Tannochbrae

The Tories, it seems, have the hots for Big Bangs. In 1986, they famously blew open the Stock Market, deregulating the financial markets, arguably paving the way to a rather different kind of bang, more crash-bang than Big Bang, twenty one years later. Today’s Tory Big Bang target is none other than our National Health Service. Agent Lansley has been charged with blowing it to smithereens. Even before the debris settles, any willing cowboy will be welcomed to ride off with rich pickings, the drear and dross discarded, as dust on the desert floor.