(And you read it here first)
It’s been nearly two years now since Andrew ‘Smoothy’ Lansley took over as Health Secretary. I doubt if he’s going to leave much of it on his cv.
This morning, the BMA said 4 out of 5 member-respondents had rejected the new pension proposals, which include higher contributions and working for longer. This is also partly DSS (or whatever it’s called this week) turf of course, but strictly speaking the buck stops at Lansley, as he is responsible for all NHS budgets and liabilities. In fact, everything – progress, action, clarity and so forth – stops when Lansley gets involved.
His brainchild-cum-brainstorm of giving GPs even more of the available NHS money – and control over how the whole shebang is run – has caused civil war between the local health authorities and the group set up by power-mad self-starting entrepreneurial GPs to achieve Lansley’s ends – the Clinical Commissioning Coalition. Local health managers have been bullying the CCC, allegedly.
Examples cited included groups being told to merge with others because they are considered to be too small….and being given so little involvement with spending money that all they had power over was “paper clips”. The coalition said that the groups were being threatened with having their applications to “go live” in two years time blocked, which would mean the managers retained control of the budget. A third former later said he would get one of the managers at playtime.
Next please…
The unions representing nurses and midwives have joined others in stating their “outright opposition” to the government’s NHS plans in England. The Royal College of Nursing and the Royal College of Midwives had expressed concerns in the past, but then suggested they cooperate for the sake of patient care. Their only condition – a minor one, really – is that they want the entire bill covering the changes to be dropped. The government said it was disappointed as the bill would “empower” front-line staff to take charge of improving care. Quite where empowerment and disappointment leave us is anyone’s guess, as the Bill is currently going through the Lords.
So continues the 42nd year of f**king about with State healthcare. The Lansley Bill would abolish the strategic health authorities (put in by Tory Ted Heath) and primary care trusts (put in by New Labour Blair) with a National Board (put in to balance the diagram’s boxes) sitting atop 250 CCCs. In theory, the removal of two completely useless tiers of Big hair and Quangoites – with devolution of organisational power to local level – is a good idea. In practice, a remarkable percentage of the BH&Qs seem to have found gainful employment in the new structure; and there is little evidence as yet that the National Board will be any more skilled or tough in negotiating discounts with the unbelievably greedy pharmcos who have been taking the piss pharmaceutical suppliers for whom the NHS is the biggest single client in the world.
But the two basic flaws in the Government ‘plans’ remain unaddressed. First, an NHS controlled ultimately by the State will always be an unaffordably top-heavy and bureaucrat-strangled hydra; and second, how those same GPs (whom most of us find incredibly inefficient) will handle running the whole show does beg the question, “Who’s minding the hospitals, and how will they afford the monies they need?”
The Left predictably sees it as creeping privatisation – and for once, I agree with them. The chequered history of private health systems throughout the Western world teaches anyone prepared to study the stats for five minutes that the ‘calling’ of the Hippocratic oath is soon replaced by the call of munneeee. Unfortunately, the Left also sees the NHS as the last repository for those of its members who like walking about, doing meetings, watching procedures and putting up notices: a State-controlled NHS is no more the answer than a privately owned one run by doctors who have not, thus far, covered themselves in glory when it comes to taking more of the taxpayer’s money for doing less work. (See Lady Bountiful Patricia Hewitt et al, 2005-2008).
The best answer by far would be a localised community hospital system, liaising closely with area GPs, and run by the efficient Head Office of a large mutual company….in which the staff had shares. This would then compete head-to-head with a private system designed for Arabs and others with more money than sense.
If you think this pie-in-the-sky, then think Waitrose v Sainsbury. It is exactly the same principle: we need hard-headed commercial managers on the case, not make-believe entrepreneurs who do meetings….but we need to keep the social weal of healthcare provision intact, not hand it over lock stock and barrel to a bunch of carpet-baggers – and then find our streets littered in ten years time with heart-attack victims who can’t afford the ambulance.
This latter is what we’re going to get, because Lansley is a creep and a clown. I said he was a clown last May, I’ve said it half a dozen times since, and I will keep on saying it until the silly bugger goes. The full history is below, for those who can bear it.
Related: Why the Lansley recipe is a dog’s dinner
Andrew Lansley and the myth of the GP-entrepreneur
Is Mr Lansley on his way back to 1945?
The optically challenged vision of Andrew Lansley
Lansley’s dementia about NHS care for the aged.
The Mutual society is better for everyone than the Big Society
The Slog 