Attila the Humph attempted to interview Mr Lansley on the Today Programme earlier this week. Attila was in Gatling mode, achieving as usual more noise than hits. Lansley, on the other hand, was operating in lounge lizard mode, and the lizard just kept on talking. He also slithered a lot, but Atilla’s attacks bounced off him like dried peas off a plate glass window. The problem was that Atilla, despite having been tipped the big question by his previous interviewee, the King’s Fund’s John Appleby, was stuck in semi-automatic mode, and stayed stuck, like the proverbial to a blanket, while the lizard sped off, like the proverbial from a shovel.
The Impotence of Baffled Malice
One of the baffling aspects of the Tories’ plan to privatise the NHS is the persistent, mis-representation of facts that has been such a feature of their campaign. The opening case for the reforms – that UK health outcomes are amongst the poorest in Europe – rested on a bed of bent numbers, promptly shown to be misleading. More recently, we have had Mr Cameron saying the ‘the whole health profession’ – the whole health profession? – last time Dr No checked there were several – ‘is on board’, despite clear evidence that the professions, whole or otherwise, had jumped ship some time ago. In April, an overwhelming 99% of RCN Congress nurses voted no confidence in Lansley’s management of the reforms. In March, a special BMA meeting noted widespread concern about the reforms, and called for the Bill to be withdrawn. More recently, an RCGP survey of 500 GPs conducted after the ‘listening exercise’ found only a maverick 4% strongly backed the reforms. Only last week, the BMA wrote to all MPs, warning that the Government’s health reforms presented an ‘unacceptably high risk to the NHS, threatening its ability to operate effectively and equitably, now and in the future’.
The Prongs of Privatisation
In the ocean of amendments and opinions swilling round and threatening to drown sensible debate about the Tories’ Health and Social Care Bill, and its likely impact on the national health service, there is nonetheless a constant tide that ebbs and flows: the question of privatisation. Critics of the Bill – including Dr No – claim the Bill will, not so much by a big bang, as by the back door, bring about wholesale privatisation of our once national health service. Those for the Bill have been equally vehement that nothing could be further from the truth. Indeed, the Department of Health in its recent tabloid style ‘Myth Buster’ release – BIFF! SoS won’t wash his hands of the NHS! ZAP! Private patients won’t jump the NHS queue! – dismissed the privatisation claim as CRUMP! ‘ludicrous scaremongering!’. For the better understanding of any thickos who still haven’t got the point, the Department adds: ‘We have made it crystal clear, time and again, that we will never, ever, privatise the NHS’.
Bad Move
The Internet Association for Tree Hugging, Badger Loving, NHS Saving, Petition Signing and Other Worthy Causes Too Numerous To Mention, more generally known as 38 Degrees, has, at great expense, assisted a clutch of learned friends with their mortgage payments. In return, the learned friends have produced an opinion.
A few months back, Dr Death opened his coffin, exhaled a similar set of legal opinions, and retired, the silk-lined lid closing silently behind him. He has since remained as silent as a stiff on the matter.
In both cases, Dr No believes the seekers of the legal opinions have committed an error, perhaps even grave enough to put in some jeopardy the ultimate aim, that of bringing about the withdrawal of the Health and Social Care Bill. He believes 38 Degrees’ error to be especially unfortunate, occurring as it does only days before the Bill’s third reading.
How To Get Rid of Doctors
In a word: revalidation.
Amongst his medical friends, Dr No knows of two doctors who have already decided they will have no truck with revalidation. This is not because they are dodgy doctors, with dark secrets to hide – truth be told, they are very good doctors – but simply because the concept of the state deciding whether a competent, independent truly professional individual is indeed competent to practice is anathema, and a travesty of all that a true profession stands for. They would rather be out, than submit to state controlled ritual humiliation.
Hypocrisy, the Hoodie Tsunami and the NHS
Dr No is not a hoodie; nor, so far as he knows are any of his friends, or even his friends’ children. He moves in the rarefied climate of relative genteeldom that is upper middle class Britain. Most of the sharks he knows wear suits, and work in the City, or the local private hospital; and the robber barons he knows wear wellies and tweeds. Those times in the past when his medical career has taken him into the sink estates and dumping ghettoes – he recalls once being advised to ‘put his doctor’s bag first through the door’, so that the waiting Rottweiler bit it, not him – have been brief; and despite the portent of his colleague, he conducted his practice in a spirit of Croninian naivety. He came not to judge his patients, but to treat them.
Revalidate! Revalidate! Revalidate!
Press News: For Immediate Release
General Dalek Council finds ninety-six per cent of dalek organisations believe revalidation will help daleks be better daleks.
Dalek HQ, London: An independent study of over 3000 daleks in ten pathfinder sites to test revalidation has found strong support from organisations that took part. A large majority concluded that revalidation will improve the dalek experience.
‘It is encouraging that dalek organisations recognise the potential benefits of revalidation,’ said Niall Dickson, Chief Dalek at the General Dalek Council.
Services and the Split
Notwithstanding their superficially opposed raisons d’être, the armed forces, also known as ‘the Services’, and the National Health Service, are remarkably similar. Both are huge and complex organisations, charged with providing services vital to our well-being. Yet, for some reason or other, the NHS in England is run on market principles, making use of the so-called purchaser provider split. The armed services have no such split.
NHS Scotland and NHS England are both national health services that provide health care to their respective peoples. NHS England is run on market principles, making use of the so-called purchaser provider split; NHS Scotland has no such split. Indeed, prior to the Hacksaw years, NHS England had no such split.
Ned Kelly and the Art of Regulation
Dodders, late of the Worsted tendency, chugged on to the Today programme this morning. There was a hiss of steam as the old tank engine settled on its axles. The topic of the moment, aptly enough, was whistle blowing. Dodders and his Health Select Committee have been asked to look into the General Medical Council’s pernicious habit of feeding whistle blowers into the firebox, instead of listening to their concerns. Humph did his best to get up a head of steam. There were shunting noises as Humph and Dodders went back and forth over the rails. But they remained stuck in the sidings, puffing platitudes. Delivering professional obligations, puff. Professionals responsible to their regulator, puff. Much good work being done but still too many examples where standards aren’t being delivered, puff puff!
The Fracticalities of Regulation
The Care Quality Commission have reported on Winterbourne View, the rogue hospital exposed in May by Panorama – so that’s alright then, isn’t it, only, of course, it isn’t. The CQC headline, ‘CQC report on Winterbourne View confirms its owners failed to protect people from abuse’ belongs to the ‘report confirms thugs are thugs’ category, and is, as many have observed, a clear case of doors being bolted after horses have fled. No wonder the CGC has been dubbed the ‘Can’t Quite Cope’ commission. The moniker – undoubtedly British Dentistry’s greatest contribution to National Lampoonery – says it all.
The CQC, speaking on R4’s You and Yours, took the oleaginous line, and added what will surely become known as the Cameron defence – ‘we have all been in this together’.