With friends like the British Medical Association, who needs enemies? On the day the Care Quality Commission revealed that three out of twelve hospitals it reported on were hanging elderly patients out to die, the BMA chose to blow its anti-Health and Social Care bill trumpet. But the Association’s call was inevitably drowned in the howls of anguish that arose in the face of hospitals turning biddies into Ryvitas on an industrial scale. Even Humph rose to the occasion, and adopted his best dishcloth wringing tone. No need to get bogged down in the statistics, said he, as he wrung the dishcloth of despair to its dying drop. As beads of disbelief coalesced on the brow of concern, he told the nation what it so desperately needed to hear: it was, he said in a whisper, about humanity. The BMA story, naturally, sunk like a stone in a pond.
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.
Opening Titles: Camera swoops across London teaching hospital rooftops – St Thomas’, Guy’s Tower, the cruciform Royal Free. The second half of Mars from Holst’s The Planets throbs loudly. Cut to UCL’s Accident & Emergency entrance at night. A large NHS blue Roller, Registration Mark NHS 1, arrives, with what appears to be a Belisha Beacon in the back seat. The door opens, and Lord Sugar steps out, looking very grim. He points at an Ambulance Paramedic.
Sugar: You’re Fired.
Paramedic: Thank you, Lord Sugar. (walks off, trailing a defibrillator trolley on wheels, towards a waiting taxi. The Belisha Beacon gets noticeably oranger).
Voiceover: The NHS. A decayed, inefficient state monopoly that consumes money as a waterfall does water. Waste is everywhere, and indifference is rife. Even nice Gerry Robinson couldn’t fix the NHS. Lord Sugar has had enough.
Sugar (to camera): It’s a shambles, a bloody disgrace.
Twenty five or so years ago, in the Hacksaw years, there was a move afoot (there had also been a Michael Foot, but that is another story) to relax the then decidedly restrictive and yet unworkable Sunday Trading Laws. Hacksaw and her buddies attempted to introduce a Shops Bill in 1986 to relax the rules, but the move was seen off by an unlikely coalition between the God Squad, acting in best Ian Paisley style, and by the Unions, marking the only time – a precedent we might want to note – that a Hacksaw Bill was ever defeated. Thus the restrictions, including the quaint absurdity of allowing the sale of a pornographic magazine but not a Bible or a birthday card on a Sunday, continued for another eight years, until the liberalising 1994 Sunday Trading Act came into force.
The early Hacksaw years were nonetheless a time of unbridled market adoration – yuppies had just been born, and the Stock Exchange Big Bang was around the corner – and so the spivs and suits, who had no intention of letting tiresome laws fetter their marketing zeal, set about devising ways of getting round the restrictions. Dr No’s favourite, for its audacity, was the carrot wheeze: carrots, but not beds, could be sold, so the spivs sold carrots, at a hundred quid a pop, and threw in a bed for free.
An extraordinary letter has appeared in The Telegraph this morning, online version here, a letter so bizarre that it elevates those chirpy Eurovision Song Contest result package links to communiqués of Kissingerian consequence. Signed by a clutch of GP chavs, it appears to be the brainchild of a scuba-diving Masonic medical wax chandler (motto: Non Angelus sed Anglus – No Angel but at least I’m English) who, tellingly, lists Conservative poiltics as one of his ‘interests’, which is putting it mildly: here he is blogging in 2009 about what the Tories are going to do to the Labour legacy once the Tories had achieved the ‘moral authority of victory’ in the 2010 election. Taken together with today’s Telegraph letter, it appears that Pimlico GP Dr Jonathon Munday’s zeal for nuking Labour legislation is matched only by an equal and opposite zeal for propping up Broken Arrow’s dud legislation.
“So, first of all, let me assert my firm belief that the only thing we have to fear is fear itself…”
—Franklin D. Roosevelt: First Inaugural Address: Saturday, March 4, 1933
Now that the elections and referendum are over, and the results have knocked the egg out of Clegg, the talk has turned, as it will, to what the Lib-Dems must do to lay themselves sunny-side up again. The general thrust is that they need to get tough, rattle a few sabres, perhaps even fire a few arrows, and so assert their identity in the face of their coallusion partners, the Tories. A top candidate for the sabre rattling treatment is of course the NHS reforms.
The Today programme’s resident grumpy old bull, John Humphrys, took a charge at Prime Minister David Cameron this morning, and ended up with his horns stuck in wood, and his tail between his legs. Cameron, in excellent patroniser-in-chief form, ordered Humph back to school. Humph, unable to extract his horns from the wood, acceded. “I will go back to school,” he said, adding petulantly as only Humph could, “and I will choose my teacher”.
Dr No has for some time been bemused by the media coverage of the Alternative Vote (AV) referendum, and, less bemusingly, by the public’s apparent lack of grasp of what is, all said and done, not a difficult a concept to grasp. Certainly, the jargon does nothing to help: ‘First Past the Post’ is nothing of the sort – there is no post, just a brutish my-pile-of-votes-is-bigger-than-yours battle, while the ‘Alternative Vote’ is a first past the post race – the post being 50% of cast votes; but the procedure, serial elimination of the candidate with the least votes, and allocation of those voters’ successive choices until one candidate passes the 50% post, is comprehensible. Or at least should be comprehensible – unless, that is, one is, as Cameron described Humph this morning, the BBC’s ‘lead broadcaster’, a remark which on paper gains the added thrill of plumbic insult.