Privatisation

It is said British general practice is a broad church, and indeed it is. No branch of medicine collects under its wing such a panoply of talent and motivation. While most GPs sit somewhere near the centre, the tails of the bell shaped curve contain a diverse collection of crackpots, duds and no-hopers at one end; and at the other a rare collection of the exceptional – the exceptionally talented, the exceptionally compassionate – and the exceptionally greedy.

Despite the fact that general practitioners are adequately remunerated (we will leave the remuneration bun-fight for another day) for the work they do, a percentage – Dr No estimates perhaps fifteen to twenty percent – want more. Some of these individuals have an over-inflated opinion of their value to society, and consider that value should be reflected in their bank balance. And others – lets not beat about the bush here - are just plain greedy. Their primary purpose in practising medicine is to make money – lots of money.

It is a wonder they haven’t called in Mary Portas, Raptor of Retail, to fix the NHS. Nice Gerry tried a while ago, but tea and biscuits, even Nice Gerry’s 24/7 tea and biscuits, failed to hit the fan when it came to fixing the NHS. Nice Gerry’s biscuits did what biscuits do when faced with a sea of NHS tea. They got dunked - and disintegrated.

Raptor, of the other hand, would know exactly what to do. Dressed by Dallas out of Star Wars, she would stalk the wards and clinics, skewering managers. Layabout staff would be rounded up, and their nail varnish stuffed where the sun don’t shine. A wand of retail magic would be waved, dull clinics transformed in a halogen twinkle into fun interactive experiences. Freshly botoxed greeters in Thunderbird uniforms would be drafted in, and the warmth of the Mall would embrace all. Everybody would win, and all would have prizes.

Not content with just nuking the NHS – so last year, my dear - it now appears that Lang-Ho and the Con-Doms – fresh from turning a blind eye to city bonuses – are lining up to offer their private healthcare pals an eye-watering billion dollar bung to ‘ease’ their entry into the post-NHS healthcare market.

The proposals – buried deep in last week’s Health and Social Care Bill Impact Assessment – have arisen because a management consultant (KPMG) report estimates that Lang-Ho’s non-NHS provider buddies are at a financial disadvantage compared to NHS providers:

The Tories, it seems, have the hots for Big Bangs. In 1986, they famously blew open the Stock Market, deregulating the financial markets, arguably paving the way to a rather different kind of bang, more crash-bang than Big Bang, twenty one years later. Today’s Tory Big Bang target is none other than our National Health Service. Agent Lansley has been charged with blowing it to smithereens. Even before the debris settles, any willing cowboy will be welcomed to ride off with rich pickings, the drear and dross discarded, as dust on the desert floor.

So – this is the day that Cambuffoon and his Lillie Langtry are to sprinkle drops of NHS blood on the oceans of commerce; and already the corporates are circling, to devour the NHS as a shark does its prey. Rich fat and valuable flesh will be stripped from bone, and all will go, save the profitless indigestible carcass of the weak, the poor, the chronic and the incurable.

These are the headline notes of the grim fate our government has in store for our health service. Already the rabble of the right is roused; and already the cry has gone up: The NHS is a wasteful and bloated sacred cow that should be slaughtered! The steely knife of market forces will excise all waste and all inefficiency on the trading floors of the agoræ, where ‘any willing provider’ can and will step up to the mark.

Once in Royal London’s City
Stood a queer new government
Tory toffs had jump’d into bed
With Lib Dems of Con intent
David was their Premier
Niklaus Clegg their poodle dear.

They came to us from the big banks
Where shiny dollar is king
Their deep pockets soon they would line
And their mates make a killing
While the poor and sick and lowly
End up in a mess most unholy.

So – Hinchingbrooke NHS Trust has gone down the plug-hole. Privately controlled vultures have been circling over-head - Hinchingbrooke’s demise has been long fore-told – and, neatly enough, it was the circling Circle Health Ltd who have been allowed to swoop down and pluck the entrails of the Trust from the clutch of the drains. We now have, Circle say, the ‘first franchised NHS trust’. NHS East of England, the SHA ‘overseeing’ the deal, was far more upbeat. ‘History was made today’ was their clarion call, as a ‘groundbreaking’ deal secured a ‘bright future’ for the debt-laden Trust.

Now there are some who say that this is privatisation. In fact it is not - yet. The ‘balance sheet assets’ – beds, bricks and mortar etc – remain, we are told, in NHS ownership, and the staff, we are told, will be seconded on NHS terms to Circle. Instead of privatising the Trust, Circle have been given the franchise to run the hospital – and the franchise model is not a privatisation model.

A program on Radio 4 alerted Dr No to new developments in the world of MBAs. Shocked by the public backlash against MBA graduates for their part in shafting the developed economies, a group of 2009 Harvard Business School alumni have borrowed from Hippocrates to conceive the MBA Oath, an ‘inspiration and accountability tool’, to guide MBA graduates through the business jungle.

Putting aside a natural tendency to view the prospect of MBA graduates taking an ethical oath as more hypocritical than Hippocratic, the accompanying book is still thought provoking. Amongst other things it introduces the idea of the ‘MBA mind’ – that cut throat, greed-is-good brain that powers the suits in their relentless pursuit of profit – not, of course, that the authors word it that way.

It has started, not so much with a bang, as with a whisper.

Buried yesterday in Basildon’s tragically named Yellow Advertiser was an apparently run-of-the-mill story about a new hospital opening. Hidden between other shocking stories - ‘Body found in cemetery’ (‘man pronounced dead’) and ‘Bikers hit the road’ (luckily no one was hurt) - ‘Community hospital officially opens’ told a gentle tale of local gardening legend Ray Stephens unveiling a plaque to commemorate the opening of Braintree’s new state-of-the-art Community Hospital.