Bevan’s Curse: The Genius, Stroke & Breasts

Get in close© 2009 Am Ang Zhang

“Up close and personal” those words of my first guru still ring true when he told me that to understand my patients or their parents it was what I needed to do.

It would seem to be politically incorrect in many ways but as we need to understand our politicians, my guru may well be right.

It looks as if the genius is way on its way to achieve what Bevan has closely protected with his curse for years: Our NHS or was it his NHS.

GPs will be given a sum of money and the rest will be up to them.

Hospitals may or may not fail, but it no longer matter as 49% will be ‘doing’ private patients. For all that matter, it could become wholly private or partly private. Hospital Consultants will be happy with the better income from private patients.

But why is he doing this? This is when we get “up close and personal”!

The Observer: Andrew Lansley

The answer, or at least a large part of it, can be traced back 19 years to the summer of 1992. Lansley, then head of the Conservative Research Department (where a very young David Cameron worked under him) was playing cricket in Rochester. They had both helped John Major win a fourth consecutive general election for the Tories. Lansley went to pick up the ball, stood up again and found his balance had gone. "I tried to stabilise myself on the pitch, but I had lost my balance," he recalled in an interview with the Spectator. "I walked down to the pavilion and sat down, but it got progressively worse." He collapsed and was taken to hospital, where he was told he had an ear infection.

But his then wife, a doctor, saw no symptoms of the supposed ear infection. The couple fought the system to get a second opinion and the necessary tests. "Now it was true, and continues to be true, that if you have somebody who knows their way about, you can argue your way through the system without being dismissed by the authorities," Lansley recalled in 2006. "We badgered the GP so much that he eventually sent me off to have an MRI scan."

He was referred to a private hospital where tests were conducted using the most up-to-date equipment. "[The staff] were all chatting away merrily as the results came in, then they suddenly all went a bit quiet," Lansley remembered. At the age of 36, he'd had a stroke. In the years that followed, Lansley, now fully recovered, took up the cause of other stroke victims, highlighting how delays in their treatment caused paralysis and how the NHS compared poorly with health systems in other countries.

He had been born into an NHS family and had known the medical world from a young age. His father worked in a pathology laboratory and was chair of an institute of medical laboratory scientists. His first marriage to a doctor meant he remained steeped in medicine at home as he began his professional life. But friends and colleagues believe the real seeds of his interest, and determination to change the NHS for the better, were sown in that personal experience which could have cost him his life.

Langsley divorced his doctor wife in 2001    BMJ

But, hang on, you cannot believe in Bevan’s Curse in the 21^st Century:

What about McKinsey:

The Curse of Nye Bevan usually strikes down anyone who badmouths the health service.

Poor old McKinsey, how long can it last now that it has invoked the Curse of Nye Bevan? The cult management consultancy was a prestigious global brand until this morning when it was revealed to have urged the NHS to sack one in 10 of its staff to help balance the bankers' budgets.

As a result of the Health Service Journal's scoop (I write a politics column for HSJ) the politicians have already been rushing into the TV studios to declare their undying ardour for the British way of health.

All they dare admit by way of criticism is that it must become more efficient, which indeed it must. So must we all. But what about McKinsey & Company, now that it has provoked the ghost of Nye, founder of the NHS and the swashbuckling Churchill of the left?

Nah, no way, this is the 21^st Century.

But hang on:

It took care of Daniel Hannan  & Sarah Palin.

Looks like one of their most famous sons is now in trouble:

NY Times

On Wednesday, a federal grand jury in Manhattan charged Mr. Gupta, 62, with one count of conspiracy to commit securities fraud and five counts of securities fraud. He is accused of sharing corporate secrets about Goldman and Procter & Gamble with Raj Rajaratnam, the co-founder of the Galleon Group who was sentenced to 11 years in prison earlier this month for insider trading.

…….The government has taken aggressive action against insider trading. In the last two years, the government has charged 56 people with swapping illegal tips, including Mr. Gupta; of those, 51 have pleaded guilty or have been convicted.

With Mr. Gupta, the campaign has moved beyond financial professionals. As the head of McKinsey & Company, the prominent consulting firm, Mr. Gupta advised some of the world’s most influential people, rubbing elbows with the chief executive of General Electric, Jeffrey R. Immelt, and the former President Bill Clinton.

WSJ

Now could such a curse be working through something medical: like PIP Breast Implants.

The Lancet

The events of the past month show why this policy is so misguided. When something goes wrong in the NHS the entire organisation can be mobilised to address the problem coherently, transparently, equitably, and to the very highest of standards. In the case of PIP implants, over 95% of which were done by private providers, what have we seen? Mr Lansley has had to castigate private cosmetic clinics for failing to gather and provide high-quality data on their procedures. The best he could do was ask that they “take similar action” to the NHS; he could not require such action. Bruce Keogh went further: “we can place no reliance upon [their] figures”. Yet this is the future for the NHS. A system of health care that cannot be held accountable by government, one that has no obligation to collect or supply accurate information about what it is doing, one that fiercely resists its duty of care to patients, and one that is more concerned with cost than it is with quality. The evidence is before us: it’s time to kill this Bill.

Looks as though Bevan’s Curse has hit at the most crucial of the Langsley reform: the regulation of Private Providers. Those of us who has not got his superior intelligence can understand it. Its emotive and yet it is an aspect of health care that is at its best on the fringe of medical care, until problems arose.

Regulation does not work as we are still struggling with RBS & Lloyds.

Private companies could easily go bankrupt and set up in the same place again and again. Government run NHS will always be around.

Lets see how Bevan fare against the genius.

Hottest: 

Bevan’s Run

The reason this inappropriate arrangement is being forced on to the NHS is that some companies see profit opportunities in the change, for instance the German company Helios which has contracted to run 20 UK hospitals, the private equity-dominated Circle Health[2], or the management consultancies which are lined up to support CCGs by selling the organisation of the technical side of commissioning to them. 

For their benefit we are giving up a national health service which is among the leaders in the world for health outcomes and among the most cost-effective developed world systems (Commonwealth Fund every year with 7-10 developed countries, Pritchard & Wallace 17-country comparison Journal RSM 2011).

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