Conservatism in British Society

Most toxic is the role of commercial competition, with Monitor acting as enforcer. By opening every NHS corner to \”any qualified provider\”, the whole service can be taken over by private companies, with a few token charities and mutuals. NHS hospitals, cherry-picked of lucrative work, risk bankruptcy when left with only complex cases. Stroke care surged ahead by creating pathways so ambulances take patients to designated units, open on rota, working together. Cancer and heart results improved dramatically, due to collaboration. Commercial competition prevents that – and drains away cash.

Dr Clare Gerada, of the Royal College of GPs, points to Nottingham, where 30 physiotherapy practices are now licensed to trade, breaking the close working with surgeons after operations. \”How are patients to choose? By colour of the wallpaper?\” she asks. \”And how can the Care Quality Commission possibly check the competence of every provider?\” The CQC, with a 30% cut, has just 900 inspectors to check 8,000 GP practices, 400 NHS trusts, 9,000 dental practices and 18,000 care homes. NHS instructions say: \”Commissioners cannot refuse to accept providers once they have qualified.\” So the bill opens the NHS to EU competition law. The GP Sarah Wollaston – a Tory MP – rightly calls the bill \”a hand grenade thrown into the NHS\”.

It\’s not \”the right\” being conservative here, is it?

16 thoughts on “Conservatism in British Society”

  1. That’s 36,000 units to be checked by 900 inspectors. Allowing for holidays,statutory sick leave and 2 grandmothers funerals per man per year, I make that 1 inspection per man per week if all units are checked yearly. As such inspections would sensibly be on a bi- or tri-ennial basis, I’d say the CQC might be overmanned.

  2. ““How are patients to choose? By colour of the wallpaper?” she asks. “

    So, she’d rather they had no choice? Rather like … well, now?

  3. “How are patients to choose? By colour of the wallpaper?”

    Well, they could listen to the recommendation of their surgeon.

    If they thought their surgeon was helpful, efficient and reasonable, they might want to take their advice. If they thought he was an arrogant butcher only interested in knocking off early for 19 holes, they may deliberately pick somebody he doesn’t like to work with.

  4. The left has been more conservative than the right for quite some time now, arguably since Thatcher’s reign. I recently got into a discussion with some lefties about the BBC, and they almost proudly declared that the BBC does the best “costume dramas” in the world. The fact that the only people in the world interested in such costume dramas are middle class Brits who cling to them like a comfort blanket passed them by. And only in Britain do the makers of TV programmes take pride in the fact that their titles have run for 20-30 years, and the population seems to think this is a good thing. 20 years of Casualty is not a good thing, it is a sign that people don’t like change and are quite happy to stay in whatever rut they are used to. Quite worrying at a time when people are required to adapt to survive.

  5. “How are patients to choose? By colour of the wallpaper?”

    How are we supposed to make a choice now? When I needed an MRI scan I was offered the choice of three NHS locations, but no information on which to base a decision. Most important to me was waiting time, but there was no way of finding out. Once a choice had been made you couldn’t change your mind.

  6. It’s curious that as (I assume) a GP herself, she apparently doesn’t see it as any part of her own work to get to know and help select physiotherapists for her patients, if only by noting their experiences and building a short-list. (GPs are often paid rather a lot now, by the way.) Surely she already rates (if quietly) the hospitals and consultants to whom she refers people? Perhaps the remark was taken out of context.

  7. The Apiarist’s comment suggests that instead of building a completely pointless “healthy recipe” site, NHS money might more usefully be spent making more information available, and encouraging GPs and others to inform their patients.

  8. Let’s face it, we are doing this to keep them on their toes, to get them, the health care system (and it will be largely the same people regardless of the management or ownership) to divert more resources to looking after us, and not to themselves, as happens in every large organisation. A shake-up is necessary every now and then just to remind everyone who is in charge and stymie producer capture.

  9. Also,

    “NHS hospitals, cherry-picked of lucrative work, risk bankruptcy when left with only complex cases.”

    That argument doesn’t work, does it?

  10. That argument doesn’t work, does it?

    Actually, it does – ish. Because of the hidden subsidies from straightforward work mean that the more complex cases aren’t properly costed. Which means that we can’t have a rational discussion about whether they’re worthwhile (morally, ‘greatest good of the greatest number’, medical ethically or in QUALYs).

    Now, all that would need to happen is that provision of acute services could be funded directly at a realistic rate as, oh, let’s see, what would we call it? Ah, “provision of acute services”.

    And any organisation wishing to proffer such would need to meet much higher standards than the “no, your little Annabelle doesn’t have lupus, no matter how many episodes of ‘House’ you have watched” GP surgery + minor operations type clinics. Including the damn NHS …

  11. Oh, sorry, and those hidden subsidies are expressed in the NHS nominal price for the straightforward work packages. Which means that the non-NHS provider doesn’t even have to do anything different to be able to underbid / make a profit.

    It is axiomatic here, rightly or wrongly (or do I mean ‘leftly’) that a market will develop better (outcomes or efficiency) ways of doing things but it is sensible to make them work for it …

  12. And only in Britain do the makers of TV programmes take pride in the fact that their titles have run for 20-30 years, and the population seems to think this is a good thing.

    The funny this is, I point this out to British people and mention that Australian TV is not like that, and they say “What about Neighbours or Home and Away?”, and they then don’t believe me when I say that this just reinforces my point. What is remarkable is that both of these programmes would have ceased production 20 years ago if it were not for the British sales, and in Australia, essentially, nobody watches it. Neighbours actually was cancelled in 1985, but resuscitated by a different network at least partly due to the foreign sales. Its Australian ratings have declined steadily since then, and eventually became so low that it is now on an obscure digital-only channel – the Australian equivalent of ITV3, or something like that. They still keep making it for the British, though.

  13. A brave chap

    Ali Parsa – whose Circle outfit would be sunk without the benefit of NHS staff, expertise, workforce training & infrastructure. Brave, my arrse.

    Whatever the homely rhetoric about “our industry”, he’s simply waiting to cash in on the ConDem reforms. Circle and their backers are playing a long game.

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