Category: Privatisation

Over on Paul Corrigan’s blog, we learn that Dr Smith has been updated. Whether the update was achieved by a Freeview over-the-air broadcast, or plugging Dr Smith into a USB port isn’t clear, but, following the update, Dr Smith is now crystal clear on how the new NHS commissioning structures will work. This put him way ahead of Mr Corrigan, who in more normal circumstances understands more about healthcare than the entire medical profession put together. But then, it’s amazing what you can do with a bit of IT these days. We shall just have to wait until Mr Corrigan gets updated, and perhaps then he can explain it all to the rest of us.

Dr No started his medical career in a surgical specialty (O&G), and in many ways, he still thinks like a surgeon. Physicians, with their pills and potions, and frock coats and baffling cardiac murmurs, were and still are quite beyond him. So he naturally expected that he would understand the Royal College of Surgeons stance on the Health and Social Care Bill. But instead he finds today it is the RCS’s position that is baffling him. If ever surgery was called for, it is a for a wide resection of the malignant tumour that is the Health and Social Care Bill. Yet the RCS wants to not just leave the tumour in place, it wants to encourage its growth. Dr No is indeed baffled.

Not so long ago, a misguided government, aided by Collegiate lackeys, ruined medical training, in the disaster known as MMC/MTAS. The anger amongst junior doctors was as justified as it was palpable. One particular junior nailed his colours – those colours being rich and brown – to the mast, in a doctors’ only forum. Snooping eyes started, smarted and then popped, and ordered that Scot Jnr – as the doctor became known – be taken out. The ensuing scandal was dubbed Jobbygate, and has continued to rumble on. More widely, a group of juniors formed Remedy UK, but, sadly, Remedy has so far achieved little in the way of a remedy. Today, four years after MMC/MTAS was unleashed, medical training remains in tatters, morale blown, and the contempt for and loathing towards Collegiate lackeys as potent as ever.

“The hottest places in hell are reserved for those who in times of great moral crisis maintain their neutrality”

–Dante, via JFK

So – Dodders has produced his report, and, despite the best attempts by the media to whip it up, it is predictably doddery. The general gist is that the Nicholson challenge, that the NHS achieve £20 billion efficiency savings by 2015, isn’t going too well. La La’s response – that the report was unfair on NHS staff, because they are all doing a spiffing job – baffled everyone. At some point, Dodders may have suggested the Health and Social Care Bill might be something of a distraction, or words to that effect. Whatever it was the report said, it was not the rocket up the Bill’s backside that many hoped it would be.

There is a variant of Dennis Healey’s Law of Holes which says: when you are in a wet paper bag, stop pissing. Most folk who spend much time in wet paper bags appreciate the importance of this law to their survival, but it seems those folk who inhabit the wet paper bag more generally known as the British Medical Association have yet to turn off the tap. At a time when there is overwhelming and very visible professional opposition to the Health and Social Care Bill, and so a real prospect of nailing the bill, the BMA has turned on a golden shower of pension reform objections. There is even talk of industrial action.

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.

Speaking on the Today programme, their business reporter did his best to put some heat into a cold December morning. ‘Despicable cartel like practices,’ he flamed, quite putting Humph and the rest of the gang in the shade, over OFT allegations that UK private healthcare providers have rigged the market. The lady from the OFT stayed cool, although she did concede that the performance of the market was ‘perhaps not optimal’. To Dr No, the turn of phrase made about as much sense as if NASA public relations had used the words to describe the performance of the space shuttle Challenger on its last fateful flight.

The OFT, Monitor’s big brother, have been investigating the £5 billion UK private healthcare market, and – provisionally – it does not like what it saw. Provisionally – no one’s sticking their neck out here – it found ‘a number of features that, individually or in combination, prevent, restrict or distort competition’ – or cartels and rigged markets to the rest of us. Private healthcare, it appears – provisionally, of course – to be not so much about stitching up patients with subcutaneous Dexon, as stitching them up financially, in a web of cartels, restrictions and misinformation. The OFT plans – provisionally, as they don’t jump guns at the OFT – to refer the market to the Competition Commission.

This post is not, as it happens, about the misadventures of a trench soldier in the First World War, but is instead about the perils of language: for, if there is one word that fogs today’s NHS reform debate, it is surely privatisation. Unions, the media – only yesterday, Channel 4 reported on ‘proof’ that the ‘government plans to privatise the NHS’ (only to fog matters further by adding a terminal question mark) – and bloggers may all declare loudly that the Tories are privatising the health service. At the same time, the Tories and the DoH (and, of course, our very own Sam) say they are not. Clearly, both sides can’t be right. Or can they? It all depends on what we mean by privatisation, and that is where privatisation fog, like the recent weather, can bring progress to a grinding halt.

The BMA are at it again. By leveraging (Dr No has been reading too many financial reports of late) proper indignation at unspeakable parents who use their cars as smoke-houses to kipper their kids, they now propose a ban on all smoking in any car – even when the smoker is the only occupant. Perhaps they even want to ban smoking in cars when there is no one in the car. Bloggers and commenters too numerous to mention have pointed out the libertarian and practical legal objections to a total ban – but what about the science behind their proposal? Their briefing paper carries the mark of the BMA Board of Science on its front cover – so the science had better be good. But is it?