05 July 2008

What have a cottage hospital and John Lewis in common?

Dr Grumble has worked for the NHS every day for the last 12 days. It's a quiet time of year for his specialty so it hasn't been too bad but the latest Darzi report has had to go on the back burner. He's heard the hype on the news but the nitty-gritty will have to wait. Dr Grumble is not yet sure whether the report is a bombshell or a damp squib.

Another thing that has been on the news is the John Lewis list. Readers of Dr Grumble are overwhelmingly from the UK. Most of you will know about the John Lewis list. But it may just be that some of you in the rest of the world, intrigued by the stories of our robotic lord , are still reading this so, especially for you, here is a link to the John Lewis list. Sometimes Dr Grumble wonders what our friends from across the pond think of a country that pays its Members of Parliament in goodies from a department store and gets a robotic lord to decide on the future of its greatest national asset. But that is today's UK. Even our prime minister, it seems, has realised that one of these eccentricities needs fixing. It's a shame he doesn't seem to know which one.

Anyway the news of the John Lewis list set Dr and Mrs Grumble talking about John Lewis. The John Lewis organisation is different - very different. Now Dr and Mrs Grumble know nothing about business and nothing about finance. Few doctors do. But one thing the Grumbles are aware of is that John Lewis is a partnership. There are no shareholders there creaming off as much as they reasonably can. They are partners. If you work there you are part of it. That's how it works. And it seems to be successful. So if it's so successful why are there not more of these sorts of enterprises? Knowing as little as he does about business that's not for Dr G to comment upon. But he does have some ideas.

Dr Grumble has always liked the idea of a partnership. When the water suppliers were sold off he wondered why ownership couldn't pass from the public to the water customers. If the pipes went to your house, you would be a partner. Of course, this would never have happened because the object of the exercise was to raise much needed cash for the government. It's always matters related to the flow of money that governs these things. Is that why there are not more partnerships? Potentilla would have known.

If you have got this far, you will be wondering why Dr Grumble is heading off into the realm of things that he just does not understand. The answer stems from this video of Mr Brown visiting a cottage community hospital.

Dr Grumble was a little worried that this was a venture involving Virgin, an organisation whose raison d'ĂȘtre is to make money. If you set out to just make money in healthcare you focus on the young worried well who don't need you but take whatever resources you are prepared to throw at them. These are the people prepared to spend billions on useless remedies for conditions they do not have. These are the people prepared to pay for water that comes equally or more wholesomely out of taps. The companies manipulating these gullible punters create anxieties and then deliver solutions for a problem that was never there in the first place. These are the avaricious healthcare organisations that advertise on the bottom of swimming pools to make sure they don't have to spend money treating the genuinely sick.

So you can see why Dr Grumble was worried about Gordon Brown's latest venture. After all, there was surely a reason why Mr Brown went to this particular cottage hospital. You can be certain of that.

But this can't have been a Branson venture or he would surely have parachuted in dressed in some ridiculous eye-catching garb designed to fill a front page. The truth worries Dr Grumble much less. It's clearly an experiment. But it's not one that Dr Grumble minds too much. Because it seems that the cottage hospital being visited by our esteemed leader is part of a partnership.

With thanks to the Witch Doctor who drew Dr Grumble's attention to this latest NHS venture. And with some reservations as quite a lot of these non-profit organisations turn out to be fronts for big business hiding in the wings. We shall see.

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