Saturday, September 3, 2011

Scary or Depressing: Barrucuda or NHS Reform

                                                                                           Great Barracuda waiting / ©2009 Am Ang Zhang

Dr Grumble's reader has been in touch with him to find out why he has not been posting recently. The answer is that he has been worn down. The progressive changes that have been taking place to the NHS are approaching their zenith. Always inexorable they are now unstoppable. The faux listening exercise and the apparent response has silenced the dissent. For Grumble it is very sad. The service that he has devoted his working life to is on the verge of destruction. The NHS the public loves will be no more. Not, anyway, in its present form. 

Mrs Grumble has noticed the depths of Grumble's depression over the reforms.............................

Dr Grumble was puzzled: 

What puzzles Dr Grumble most about major governmental decisions is just how wrong they can be. You just would not think that any committee of sensible people could get things so utterly wrong. Committees do make mistakes but not on the scale the government does. There must be a reason for this. 

Could this be the reason?  ( From an earlier post)

Most people in well paid jobs (including those at the GMC) have health insurance. GPs have traditionally been gatekeepers and asked for specialist help when needed. If we are honest about private insurance it is not about Primary Care, that most of us have quick access to; it is about Specialist Care, from IVF to Caesarian Section ( and there are no Nurse Specialists doing that yet), from Appendectomy to Colonic Cancer treatment (and Bare Foot doctors in the Mao era cannot do the latter either), from keyhole knee work for Cricketers to full hip-replacements, from Stents to Heart Transplants, from Anorexia Nervosa to Schizophrenia, from Trigeminal Neuralgia to Multifocal Glioma, from prostate cancer to kidney transplant and I could go on and on. China realised in 1986 you need well trained Specialists to do those. We do not seem to learn from the mistakes of others.

When there are not enough specialists to go round in any country money is used to ration care.

So we are going to but in a peculiar manner as the NHS used to be state run and free. Reform is needed!!! Enter GP commissioning. If it is your GP doing the rationing it is no longer the State's problem.

Some very clever people indeed are working for the government. 

Is it Conspiracy or Cock-up? You decide.

But strangely they thought there is still money to be made.

That is why many GPs in the consortia have links with private providers.

It is a sure way of directing patients to secondary care.

The AQPs are already there and many specialists are working for them. It really does not need a genius to work out that Foudation Hospitals if they fail will be bought up by private firms.

So there are not enough Consultants and shortage creates demand and you can name your price. Consultants do not really want to waste time in consortia arguing about the price of hips or knees. 

Private patients will now have priority and NHS patients will fill in the slack. Very clever indeed. The notion that one should “let them eat cake” does not apply here.

More like: “Let them not see a Consultant!” And if you do, we will make money.

Reform will not save any money but it will make a few City people very rich, very rich indeed.

David Cameron, it is not too late. We will believe you if you legislate against private involvement. Yes, legislate and we would hopefully not have another Southern Cross.

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