The fallout from the sorry tale of the PIP implants that went pop in the night is starting to settle. We have calls for the MHRA, the agency who green-lighted the PIP implants, to pull its finger out of its prostheses, and get some dentures with edge. What else, it is now asked, has the agency, which green-lighted breast implants filled with a Vulcan’s brew of fuel-additive enriched industrial grade rubber, also endorsed? Mobile phones recycled as pace-makers? Mild steel hips that will rust before time? Could it be that, far from entering the bionic age, we are instead in an ironic age, where that which pretends to improve turns out to do quite the opposite? Will we, indeed, ever know? We shall have to wait and see.
All that is as may be, but the bigger fallout, it seems to Dr No, is the revelation of the Secretary of State’s powerlessness, in the face of denial of responsibility by two of the biggest private providers, to insist that those who made the mess clear up the mess. The Minister for Implants is, at one and the same time, wont to wave his arms in the air, but impotent to act.
The moral of this tale is clear. At present, when things go wrong in the NHS, the Secretary of State has a legal responsibility – placed on him by his ‘duty to provide’ – to remedy, through the NHS, mistakes that have been made. But when the Secretary of State has no legal responsibility for healthcare, either because, as is the case with private providers, he never had it in the first place, or because, as will be the case if the Health and Social Care Bill becomes law, he has wantonly thrown that responsibility out of the window, he is powerless to act when things do go wrong.
Deplorable as the PIP implant fiasco has been, it has nonetheless affected only relatively small numbers of patients. If the Secretary of State gets his way, and combines an abdication of his direct responsibility for a national health service with an explosion in private healthcare provision, then sooner or later we can expect more impotent arm-waving from the Secretary of State. Who then will carry the can when it turns out that a private concern, keen to maximise profits, has been fitting hip replacements made from recycled tin cans?