17 March 2011

A Tsunami looms

There has apparently been a debate in the Commons about the NHS reorganisation. The miracles of modern computing enable Dr Grumble to tell you that the motion was 175 words in length which, unfortunately, is too long to hold the attention of the readers of Dr Grumble. Why they have such long rambling motions Dr Grumble has no idea. Grumble's shortened version of the motion is below:

That this House.........urges the Government to halt the implementation of the reorganisation and pause the progress of the legislation in order to re-think their plans and honour the Prime Minister’s promise to protect the NHS.
Not an unreasonable request. And, given the disquiet of the Liberals Democrats and even some Conservatives over the reorganisation, you might have expected a close vote. But you would have been wrong. Does that surprise you? Perhaps you need to be a hard-nosed hack to understand what is going on.

The arguments in favour of calling a halt to this unwanted reorganisation are so overwhelming it is difficult to grasp why our parliamentary representatives don't seen it the way everybody else does. But, disdain for the views of the public and outside organisations, seems to be a feature of our democracy parliament.

You can detect the contempt in this question from Mark Pritchard (Con):
Why has he set his face against fundamental reform, which even the public accept needs to take place?
And an unwillingness to listen to outside experts comes over in this remark from Simon Hughes (LD):
He will also remember that when his party and my party joined together to form the NHS, the doctors were not always on the side of the enlightened.
It's a fair point. Sometimes parliament has to lead where the people and professionals do not want to go. But that is no reason not to listen to them. Putting down the critics is not quite the same as addressing the criticisms. But addressing the criticisms is not quite so easy.

How about this for a bizarre question from Rehman Chishti (Con)?
Has the shadow Health Secretary seen the consultation responses to the White Paper, which show widespread support for the reforms?
How can anybody ask a question which amounts to such a perversion of the truth? And what about this question from Mr David Evennett (Con)?
Why did productivity in our hospitals decline by 15% during the 13 years of the Labour Government, while bureaucracy increased?
The answer, of course, is that the market processes took a great deal of effort to run. It is a reasonable criticism of New Labour's reforms but the ConDem proposals are clearly even worse. How can the work of 150 PCTs be carried out by over 300 GP consortia more cheaply?

The debate goes on like this with ludicrous interruptions. It becomes apparent that jobbing MPs are given one-sided briefing papers by the ruling class on the front benches. Probably there is nothing new about this but it has been an eye-opener for Dr Grumble. No wonder our governments can get things so wrong.

Of course Labour are in a weak position. Plainly their policy for the NHS was essentially heading in the same direction. Here's a question from Sajid Javid (Con) referring to the Labour manfesto:
It [the manifesto] says that Labour will support a

“role for the independent sector”,

encourage any willing provider, make all hospitals foundation trusts and give them the

“freedom to…increase their private services”.

On that basis, will he explain why he and the leader of the Labour party, who I believe to have been the author of that manifesto, are reneging on that position?
That is the nub of the problem for those of us who support the NHS. The ruling classes, whatever their political hue, have a common agenda. In the words of Simon Hughes "Labour’s record in forcing privatisation undermines its whole argument".

Let's finish on a speech by Liz Kendall (Lab):
Our health and our NHS are not the same as gas, electricity or the railway. That the Secretary of State believes that they are shows how dangerously out of touch he is. What is the likely result? GPs will be forced to put local services out to tender even if they are delivering good quality care that patients choose and like; hospitals and community services will be pitted against one another when they should work together in patients’ interests; care, which as many hon. Members have said is vital as our population ages and there is an increase in long-term conditions, will become more and not less fragmented; the financial stability of local hospitals will be put at risk, and they will have no ability to manage the consequences of choice and competition in the system; and the whole system will be tied up in the costs of red tape, as GPs and hospitals employ an army of lawyers and accountants to sign contracts and fight the threat of legal challenge, huge fines and the potential of being sued. Let us also be clear that the Bill gives Monitor the same functions as the Office of Fair Trading, so it can fine organisations up to 10% of their turnover.

The more we see of the Bill, the more the truth becomes clear. The Secretary of State says that he wants clinicians to be more involved, and “no decision about me without me” for patients, but when the Royal College of General Practitioners, the Royal College of Surgeons, the Royal College of Nursing, the Royal College of Midwives, the British Medical Association or anyone else tells him that he should stop, think again and halt his reckless NHS plans, he refuses to listen. When the Alzheimer’s Society, the Stroke Association and Rethink tell him that his proposals will not give patients a stronger voice and improve public accountability, he simply tells them that they are wrong. When health experts such as the King’s Fund warn that driving competition in every part of the NHS will make it more difficult to commission the services that best serve patients’ interests, he simply puts his fingers in his ears and walks away. What makes this Secretary of State think that he is right when professional bodies and patient groups know that he is wrong?

Doctors and nurses do not support the Government’s plan, patients do not want it, some Conservative Back Benchers and members of the Cabinet do not like it, and the Liberal Democrats hate it. They had the sense last Saturday to see what the hon. Member for St Ives (Andrew George) called the potential catastrophe as far as the future of the NHS is concerned, and to ask for amendments to the Bill. I hope they have the sense to join us in the Lobby tonight.
Sadly not many of them did so we are going to get yet another top-down reorganisation which the public just does not want. Unless Labour regroup there is unlikely to be any alternative on offer. The NHS as we know it will soon be gone. Dr Grumble has been predicting this for many years. Will you believe him now?


DaJoLi said...

You really shouldn't be surprised that this poor approximation of democracy dances to the money.
All this when technical & staffing changes - eg junior doc hours/training - all suggest we need to organise our hospitals into larger units which can provide high quality complex services 24 hours a day. So lets hive of the easy = profitable stuff to the corporate sector and destabilse the hard stuff.
Total numpties!

Anonymous said...

we have always believed you dr grumble. As usual you have explained the situation clearly
thank you
NHS 1948-2011 beloved Nye Bevan and the British public

Anonymous said...

This attitude of arrogance combined with ignorance is reflected in microcosm now in the social care commissioning area in which I work. Statements of similarly outrageous hypocrisy and idiocy drop from the mouths of senior managers on a a daily basis. Some are so far beyond belief that one simply cannot think of a sensible reply, at which silence they think they have won the argument. Please keep going Dr G you are more important than you think in reminding us all that we are not the ones going mad.

Anonymous said...

Where did your tumblr go? I enjoyed reading that...

Andy Cowper said...

Hi John

Hard-nosed? Me?

Hope you're well. The madness continues.



Dr Grumble said...

I did it for the alliteration, Andy. It did occur to me that you might take offence - though I don't think you really have. Doubtless if I was a pro like you I could have found a better set of words.

English Pensioner said...

No one uses one word these days when ten will do! Apparently, according to the media, the EU non-constitution had around a thousand words for every one in the American constitution and its amendments! This is why administration in all areas is booming, things take loner to write and even longer to read and understand. And the more words you have, the more chance of a bright lawyer finding a loophole when something goes wrong.
That is why administration in hospitals has grown at the expense of essential staff, particularly as most are busy "learning lessons" from previous mistakes and have no time to do their real job.

However, I would disagree with you when you say a majority of doctors are against the changes; I don't think anyone knows what they think. Yes, the BMA voted against, but only a tiny percentage of its members voted, much the same as when I belonged to a Trade Union.

Dr Grumble said...
This comment has been removed by the author.
Dr Grumble said...

It was the MP Liz Kendall who said that doctors do not support the plan. For what it is worth, I haven't yet met one who does but I know that here are some enthusiasts

Andy Cowper said...

No, John, I'm flattered. Hope you're well and not too gloomy. Have a good weekend.

Anonymous said...

I enjoyed your tumblr :(
I want to know what happened to it? Did you delete it? did it get shut down?

Julie said...

Here's a group that might be worth getting involved with;