30 April 2009

The NHS market

Dr Grumble would argue that the market has failed. It seems he is in good company. The top man agrees.


Cockroach Catcher said...

Our old system was “BUFFET” style health care. For one fee, you can eat drink and be merry.
Then they separate out DENTAL. Then midwifery by stealth, then create Targets which eats into total budget. Then they have performance related pay for some and because of market forces, CEOs get pays that matched top lawyers, bankers and so on. Except the highly paid bankers bankrupt the whole country and the lawyers say we must still pay them. The CEOs in the different Trusts if they fail, they change the name of the TRUSTS, move themselves to another one. We all knew years ago BUFFET was best value. GP for 24 hours a day!!!

The Cockroach Catcher

Dr Grumble said...

We all knew years ago BUFFET was best value.
Yes, we certainly did. Just as Dr Grumble knew his money was safe in the building society. For some reason private was seen as good, mutuals and anything run by the government were seen as bad. Civil servants and mutuals responsible for their own money won't take risks and you need to take risks if you are in business. That anyway was the nonsense we we told. The thought police were out if you claimed otherwise. Of course, it was all engineered by Big Business whose one and only aim was to make as much money for themselves as possible.

Why did nobody believe that we had the most cost effective healthcare system in the world and all it needed was a bit of lubrication and empowerment of the clinicians who always want to compete with each other to provide a better service regardless of money?

Even Lord Darzi agrees with that bit about clinicians wanting to compete and do better. He said so in a talk last night.

Cockroach Catcher said...


It is a well known fact that a lot of "middle people" were left out in a BUFFET style restaurant and that is why it is better value. No need to have a waiter for each table like at the Fat Duck. It is easier to plan the menu too.

Once you remove the market situation and do away with PCTs and Trusts as bidders for business ending in stupid situations of using cheap and poorly trained staff to do the doctors work or only seeing cases knowing there will be a charge or to rack up a spurious referral again and again after cancellations.

Most of us do take pride in our work and in the old system we take pride in asking the right specialist for help. That is what good doctors do. Let us doctors work in the old GP/Specialist manner with direct doctor to doctor relationship without nonsense like referral screening. The human race is part of the ECO system and as such something good will come out.

We need a new and different more accountable regulatory body purely elected by doctors to oversee doctors for the good of patients.

Pay and bonus should not be used as the driving force. Pride and professional excellence should be. There should be rewards for those and not for towing the party line. If we are not careful the good doctors would have left and then what.

All doctors and nurses and other front line medical staff must unite.
The Cockroach Catcher