Lansley….blinded by the light
THE COALITION MAKES ITS FIRST BIG MISTAKE
The Editor argues that Andrew Lansley’s NHS ideas represent the triumph of dogma over reality
For the first time since its inception two months ago, I find myself this morning bitterly disappointed that once more, dated and ill-informed polemics are ruling a UK government’s policy.
In yet another ‘sweeping reform’ of the Health Service (this marks, at my count, seventeen since 1972) Andrew Lansley – a chap whose performance during the Stafford Hospital revolt didn’t impress The Slog – plumps for the ageing Thatcherite mirage of ‘choice’. In doing so, he is exacerbating the problems that already exist.
GPs, it seems, are to be given much more responsibility for spending the budget, while an independent board could be formed to oversee the health service. Oh dear: more money for doctors, more quango jobs for the boys.
According to the BBC’s website this morning, Mr Lansley sees giving more power and money to primary care doctors as the key to making the service more responsive to patients. The new Health supremo ‘believes GPs know what works best….[he] wants to tap into their entrepreneurial spirit to drive improvement from the front-line’.
Regular Sloggers will know why I think this utter tosh, but for those who are newer to this site, herewith the summary:
- Doctors do not have any entrepreneurial spirit; if they did, they wouldn’t be doctors.
- Even if they did, it is not what’s required and it most decidedly doesn’t reflect what patients want.
- It is once more committing the page one error of giving GPs a ‘moral hazard’, if I may be permitted to use the current commercial euphemism of choice out there. The more they control their own budgets, the more there will be fewer genuine consultations, and the more they will turn into negotiations. (“You don’t want this shiny new effective and horribly expensive drug….here, take this 1958 stuff and enjoy life on Planet Zog”)
- These pillocks and order-takers have 80% of the NHS budget already: they should be getting less, not more.
I’ve been on the record for years as saying we should never give doctors any responsibility beyond the purely surgical, physiological or psychological areas of life. Even there they change their minds about what ‘works’ three times a decade, but at least by applying this draconian restriction we can limit the damage they might do. But to give them an even higher proportion of the budget beggars belief.
Ask yourself this: do you think most life-threatening and other serious illnesses are treated at primary care level? Do you think nursing standards have fallen and they need to be paid more to attract better and more dedicated people? Tell me somebody – are there waiting lists to see GPs or to get urgent surgical help? Are their patient pressure-groups grumbling about very poor service and diagnosis, or ‘choice’?
This is what it says on Lansley’s website:
‘Andrew was educated at Brentwood School, Essex and the University of Exeter, where he was President of the Guild for Students. He began his own career as a civil servant, working at the Department of Trade & Industry….Andrew frequently visits hospitals and GPs across the country, listening to clinicians and NHS professionals and is well respected across the medical profession for his knowledge fo (sic) the NHS.’
It says it all, really: politico-civil servant, never had a proper job, didn’t talk to any patients.
If only the Tory Party could finally accept that State health provision is not a market, and doctors are not somehow born holier than the rest of the population, we might get somewhere. But this – so early in its life and on so big an issue – is an open goal missed. Where, one wonders, was this legendary LibDem ‘influence’ in all this?
‘Sceptics have questioned whether it is wise to give what are effectively independent businesses – GPs are not employees of the NHS in the same way other doctors are – such vast amounts of money,’ concedes the BBC this morning. Had Auntie written ‘sane’ rather than wise, that observation would be spot-on as a start – but not much more.
The Slog 