Circle takes a step into the unknown in new hospital deal

The news that Circle, a partially listed company, has been invited to sort out the financial mess at Hinchingbrooke NHS hospital will doubtless please the remaining Thatcherites among us. The first full takeover of a hospital in such circumstances, my heart plummeted when I read the news, until I saw this leading quote from Circle boss Ali Parsal:

“We want to create a John Lewis-style model with everyone who works there in charge of the hospital, letting them own the problems and solve them. We will try everything we can to make this small hospital viable – if we can, how fantastic would that be?”

Ali is obviously a Slog reader, but the question remains, can a company with plc status and greedy shareholders deliver on the mutual promise? I have an open mind about that if the Hinchingbrooke deal is ring-fenced in a mutual division of Circle. I don’t know enough about the deal as yet to comment. But it is half a chance for the mutualised approach.

Predictably, Union leaders ‘fear that there will be job cuts’. You bet there will. I’ve spent enough time researching, interviewing and visiting the hospital sector over the last few years to know that the ancillary staffing assumptions are a complete fiction: you could strip 25-30% of the workforce out of most NHS hospitals and not notice a thing beyond the sense of extra space. Lansley’s initial solution to the problem seemed to be to starve hospitals of NHS funds, and keep giving more to GPs. When the Health Minister sees the hospital infrastructure as a haemorrhoid, you know you have a problem at the top…..and so it proved. Mr Lansley – who has always seen GPs as jolly entrepreneurial budding Alan Sugars – seems to have come up short against their naturally protectionist nature when it comes to competition: the Minister has ‘scaled back’ plans to give patients greater freedom when choosing their GP practice. And he’s agreed a new pay deal for GPs. You can always rely on doctors to get their priorities right these days.

Public sector union Unison’s head of health, Christina McAnea, said, “We just don’t accept there is no expertise within an organisation the size of the NHS, and to turn to the private sector which has a very patchy record in delivering these kind of services is an accident waiting to happen.” Constructive as ever, but the sad news is that this hospital (described by the Trust in its full-colour brochure bollocks as ‘ a forward-looking, friendly, efficient, safe and clean hospital, providing quality health care for the people of Huntingdonshire) has a £40M debt. Talented people don’t let things get to that stage.

On a broader canvas, a cross-party group of MPs has serious doubts about the effectiveness of Lansley’s Public Health Responsibility Deal, whereby fast food firms, drinks makers and supermarket chains help shape the coalition’s approach to public health, and thus avoid being subjected to further legislation, in return for what critics say are inadequate changes, such as cutting salt in food. I love this so-called ‘nudging’ policy: not only has getting manufacturers to face their social responsibilities never worked without compulsion, the campaign consists of getting unwilling turkeys to vote for Christmas…..based on health findings which may well be a load of tosh anyway. Nothing like taking the treacle road to nowhere, that’s what I say.

Earlier in the case of NHS v Lansley



  1. It was puzzling to hear Ali Parsal (A lie parcel?!) on this morning’s Today programme say financial institutions had GIVEN them the money. Annoyingly this was not interrogated by the interviewer.

  2. At last,a chance to return to common sense. When I was young there was no NHS. My father paid for private insurance,and the service he got for that was excellent. There were four levels of care. Acute care,for the very ill,and emergencies,serviced by the large hospitals,such as the Central Middlesex,and Great Ormond Street,with separate units,such as isolation,burns,as in Mount Vernon. Cottage hospitals,in nearly every town,and often in villages,to deal with day to day care. Maternity wings were usually part of a large hospital. Psychiatric care was usually in separate hospitals,in small villages,and finally the elderly were cared for in old peoples homes. There was one extra service which has long since disappeared,and that was convalescent homes for those recovering from bad illnesses,such as Tuberculosis. All of the facilities were run by matrons,whose word was god,and not even the consultants,dared to cross her. Of course everywhere was spotless,even the cleaners! need I say more. Of course if you were wealthy,there was always Harley Street.W.1.with Wimpole Street as the diagnostic centre.Oh for the halcyon days.

  3. Very interesting to see that Ali Parsal has jumped around quite a bit career wise- from physics, engineering , to banking .

    Does he get bored easily – How dedicated is he?

    Where do so called iron men like him come from?
    Nobody knows, not even Wiki!!

  4. It’ll be worth monitoring the success of this project, John. I have always liked the JL model. But I’m sure the unions will do their best to scupper it.

  5. So is the responsibility for healing in the same category as retail?
    I think not somehow-

    “We want to create a John Lewis-style model with everyone who works there in charge of the hospital, letting them own the problems and solve them. We will try everything we can to make this small hospital viable – if we can, how fantastic would that be?”

    As I said – healing and recuperation require a different type of dedication.
    Blinking money men have meddled far too much- and have skewed our wonderful NHS beyond the original altruistic scheme of things!

  6. @T_B: The JL model can be applied to many organisations, not just for-profit retail. And I believe the NHS is ripe for such a model. The multi national corp I have spent many years working in has a structure that each person “owns” the job they do and is held accountable. Rewards are high but so are the penalties for failure. It works.

  7. So a surgeon will take the rap if an op goes wrong/ bad nursing- bedsores appearing/ bad clinical health-cross infections etc- Horrendous food so bad catering. Nurses sitting around playing on their computers- reeking of alcohol etc- v nonexistent nursing care? Or mixed wards/ language difficulties/ choice of surgeon/ bad management re managers cars etc etc-

    Owning problems will become an even heavier burden- how will they sleep at night?

  8. I thought a “nudging” policy referred to “wink, wink; nudge nudge; say no more” sort of policy.

    Taking about Public Health policies reminded me of the following. Because Julia Gillard does not expect to win the next election, she is implementing her manifesto without apparent regard to her own political future. It seems that she has the support of her colleagues in taking this position. In other words, the Australian Parliamentary Labor Party members are prepared to sacrifice their futures as candidates for political office in the interests of getting on with the job of political office.

    These people can’t look forward to HoL woolsacks, EU Commissioners jobs, full time pay + expenses as part time EU Parliamentarians. Yes, they get generous pensions, but not obscenely so, and reforms have reduced the benefits for people elected more recently.

    This is an unnerving experience, politicians acting on principle rather than in the interests of increasing their wealth and/or hanging onto power. It’s a stark contrast to everywhere else, where every move seems to have the “next election” elephant hovering nearby. What’s more they are Labor politicians. We can’t call them Liebor because they didn’t lie – it was the Conservative John Howard who did the lying here. Aside : Bush referred to Howard as a “Man of Steel”, apparently no-one in the White House or the Aussie Embassy made the connection with Stalin :doh:.

    Which segues back to Public Health. The Australian Senate has just passed the world’s toughest cigarette packaging laws. Needless to say British American Tobacco & Gang have smoke coming out of their ears.

    The Camerlegg Collation should outline how, in the interests of Public Health, they will be “Nudging” the fag companies to put their products into plain brown packages with pictures of dead foetuses thereon, and then to hide them in special cupboards with opaque doors in the shops.

    The Aussie Conservatives back flipped with a double pike on this; after they said they would support it, they discovered they still take money off Big Tobacco, so they opposed half of it in an attempt to cripple it, they failed to do that – bloody cowards.

    Sometimes Aussies lead the way on issues, like the fag packets, and on matters political – might we see outbreak of principles elsewhere. Nuh, I’m probably misreading the tea leaves.

  9. Interesting post – thank you. Yes – and I always had the impression that historically (pre-Blair*) – politicians would act on principles because they had an underlying philosophy which would direct their thinking and consequent actions. I often wonder why we don’t have more politicians like that – because they would be popular!

    * Actually, the pivotal point for me was when John Major’s government hastily introduced the Dangerous Dogs Acts following tabloid reports of a couple of rottweiler maulings. At the time I thought “this is wrong – responding to newspaper articles in a knee-jerk fashion………”).

  10. I wont say it too loudly otherwise Australian heads would become insufferable but it is generally a very well managed economy with competent politicans and very competent supported by public servants that are superior to the egreciously over-inflated, unaccountable, and incompetent duffers that make up the British Civil Service. On a policy front the country tends to take the best ideas and adapt them to local circumstances. Two issues come to mind, the superannuation system and the graduate tax for financing university education. And, finally, the universities put most of ours (excluding Oxbridge, Imperial and UCL) to shame. The migration policy works too. We have copied some aspects but the civil service is incompetent to manage same.

    BTW, the national anthem sucks. Go back to Waltzing Matilda. I prefer the Oz of Bazza MacKenzie to the new PC model.

  11. He is simply following the money. He has spotted a large Government money tree bearing easy low hanging fruit and has climbed over the garden fence to give it a bit of a shake.

  12. I used to live in the area and was in Hinchingbrooke Hospital twice. It is a nice hospital but the food was dreadful and staffing levels poor. There was one properly qualified Sister who said she had less patients to deal with in India than here. As the HCA’s wear similar uniforms it is hard to tell who the nurses are, it was not until I asked some questions that they couldn’t answer that I realised that. Why not bring back the Enrolled practical nurses instead of unqualified, unregulated HCAs. Geriatric patients didn’t have their bells answered and kept us awake all night, not their fault of course but the loss of geriatric wards has been a disaster. An old woman in a nearby bed died and the staff did not notice. TV didn’t work nor did the hospital radio. I think it is high time we moved to an insurance based system as in Germany where I lived for some years. As to the Australian new laws on cigarette packets, I am sick of governments interfering in private, LEGAL businesses, either have the courage of your convictions and outlaw tobacco or leave people to make up their own minds, I feel the same about the pub ban here. Funny you never hear about ‘big pharma’ some of whose smoking cessation aids are questionable, see Champix. Wouldn’t want to give up the huge tobacco taxes though would they.

  13. TB
    I think the model not the sector is the point. Like you, I have my doubts: we must wait and see what develops.

  14. RP
    Duty on booze in Oz is incredibly high….as an attempt to stop the Cobbers drinking. It has made zero difference.
    Julia could do good by banning betting on licensed premises. But she daren’t..because the Mafia/Beerage lobby is too powerful.

  15. My dotter-in-law assures me that before the current anthem there was only ever “God Save the [Monarch]”. Waltzing Matilda is I guess the National Song, like Jerusalem is for the English –

    The words of Waltzing Matilda are as depressing as the current anthem’s music is a dirge – a bloke drowns himself in a billabong when he gets caught duffing sheep – coward, he only had one of the buggers, he would have just got a kicking, a week in the nick and he would have been sent on his way. Maybe he was a Kiwi, they have a thing about sheep.

    I don’t think I know of any inspiring Aussie songs – they’re all miserable, must be all the Irish immigrants – they’re still coming y’know.

  16. No Aussie govt would dream of banning sports betting in pubs & clubs. But I’ll bet Gillard gets the maximum stake size down to $1 on the slot machines (pokies as they’re called here).

    If the Mafia says “We’ll run negative ad campaigns, we’ll not give any money to your Party, we’ll run rabid anti labour rants in the Murdoch papers, we’ll wind up all the radio shock jocks to full volume.” Gillard will reply “Cool, its your money, now f**k off while I do this Great Big Mining SuperProfits Tax.”.

    The Aussie Pubs and Clubs lobby is small beer compared to the Aussie Mining lobby. But she’ll pass the MSP Tax to fund a Corporate Tax cut and increases to the Superannuation contribution. But the Greens want a larger Corporate Tax cut for SME’s only, they might get a compromise

    The Conservatives will find it difficult to repeal that – we are increasing the tax on SME’s and reducing everyone’s pensions so we can give all the money to BIG Mining :lol:

    Its very strange to watch a government preferring not to shore up its future electoral prospects in favour of governing and passing sensible legislation (maybe not the Carbon Tax). It’s also good to watch a government do what it wants to do rather than what some foreign Dictator wants it to do.

    I suspect the reason they have high duties on booze is the normal one, to generate revenue.

    Hang on brains trust says the woman who just put all the fags in brown packages inside cupboards, also whacked a Great Big KiddieTax on Alcopops a couple of years ago. Apparently too many 10 year old Kylies were getting pissed during their own playtimes. Now you can’t find an Alcopop for love or money. I bet the Booze Lobby said that would also bring about the end of civilization as we know it.

  17. Well said Gerry!!

    These are very scary days for the NHS. I hope that we won’t be talking about Hinghingbrooke for years to come as the beginning of the end for our beloved health service. It is totally and utterly abhorent that we are selling off our hospital services to the private sector, and I ask who is to benefit in the long term? Surely not the local people when services are streamlined, when money is siphoned off to line the pockets of big corporates. Shame on you Hinghingbrooke, shame on you. I hope the project is a catastrophic fail. Maybe then we will realise how lucky we are to have an organisation devoid of intent to use people’s health to make a profit. Heaven forbid we end up like America. DON’T MESS WITH OUR NHS, CONSERVATIVES WAKE UP!!! DO SOMETHING!! Oh wait….you don’t care about the NHS do you


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