17 April 2011

The Plot Against the NHS

If you detected an element of despair in Dr Grumble's last post you would be right. Dr Grumble has just read The Plot Against the NHS. To be frank the picture on the cover says it all.

For years now poor old Grumble has been banging on about what he has seen being planned for the NHS. For years he has been incredulous at the disparity between the official position on the health service and what is clearly the intended direction of a multitude of policy documents that have emerged from our political masters. For years he has been wrestling to understand the real meanings of deliberately vague words such as contestability and plurality.

Grumble likes evidence. When data are massaged and the whole truth is kept secret, you do begin to wonder if perhaps you have misunderstood or are a victim of a pathological obsession. Can it really be that successive governments have deliberately kept their intentions for the health service a tight secret? Can it really be that the staff in the Department of Health no longer have the ethos of traditional British civil servants and do not ensure that the public know what is going on? Can it really be that we have a government that promises no top-down reorganisation of the NHS but is actually hell-bent on privatisation of our NHS?

If you want the answer to these questions and much more you need to buy this book. If you work for the NHS you need to buy this book. If you are an English NHS patient you must buy this book.

In case anybody's wondering, Dr Grumble bought this book with his own money. He has received no inducements. You can order it here. Grumble's copy arrived the very next day. Order it now. It's a good read.


Yoav said...

"Can it really be that successive governments have deliberately kept their intentions for the health service a tight secret?"

No, it was always obvious if you looked in the right place and assumed from the beginning (in 1979) that the politicians are a bunch of lying, scheming bastards who are only in it for themselves and their corporate paymasters.

the a&e charge nurse said...

Better than NHS PLC?

Dr Grumble said...

I don't know because, despite my high regard for Allyson Pollock, I never got round to buying NHS Plc.

Demetrius said...

"Private Eye" out this week has its lead on the subject of how PFI has already and will worsen its dire effects on NHS budgets. On my patch we are looking at a disaster.

Stuart Jeffery said...

It is certainly on a par with NHS Plc and both are highly recomended.

the a&e charge nurse said...

Thanks, Stuart - sold!!

the a&e charge nurse said...

Incidentally, there is a summary of the main themes in the book here (written by Colin Leys)

Leys says, "If Mr Lansley had taken office last year facing an NHS as it still was in 2000 his project would be unthinkable. In 2000 there were no foundation trusts; no payment by results for hospital treatments; no private health companies already providing NHS acute care and GP services; no independent regulator of a healthcare market (Monitor). Without all these changes, and many others, what Lansley’s Bill now proposes would be unthinkable.

Thank you Alan Milburn, et al - your NuLAB acolytes must be nodding their heads approvingly now that your party's covert project is almost completely?

Dr Grumble said...

Yes. This is the continuation of a New Labour policy. That's the reason why they are reticent to criticise it head on. They don't want to reveal that they were essentially heading in the same direction.

My colleague, Professor Parrot, was always of the view that it was easier for Labour to push through the changes that have led to this than it would have been for the Tories. He was right. The public (wrongly) trusted Labour with the NHS and the increased funding was a smokescreen for what they were really up to.

Now we have Tories (essentially) in charge and the funding problem is back so the shit is hitting the fan.

At last the public are getting wind of what all this really means and the politicians are either going to have to row back or pay the price.

Anonymous said...

This book is very useful to confront critics who say that doctors and nurses who oppose competition and privatisation are bound to say that because of 'vested interests' because it reveals that the reforms are built on vested interests. I will confess to writing the comment on the back cover, but for free and I do not receive royalties!

Rebs said...

Dear Dr Grumble,

Are you aware of the situation that prospective graduate medical students are facing currently? We aren't eligible for student loans to cover the new £9000 a year fees and they might be scrapping the partial NHS Funding for graduate degrees and the 5th year of the 5-year undergraduate degree.

We are in effect being priced out of studying. I started a thread on doc to doc and many graduates have responded outlining how it is effecting them. What are your thoughts on this matter? Thanks Rebecca

Blog http://doc2doc.bmj.com/forums/bmj_careers_attention-graduates-being-priced-out-of-studying-medicine-viewhelp-needed

Dr Grumble said...

This is not something I was particularly aware of, Rebecca, though I can't say I'm surprised. The graduate entry is a relatively new thing. The government used to like it because the course was shorter so it cost them less to train a doctor. Some of the graduates I have taught have been more motivated than the run-of-the-mill student some of which, I'm afraid, have been steered into medicine by pushy parents.

I can't really see the current government doing anything out of the kindness of their hearts. I don't think they have much kindness in their hearts but I would have thought that they might just see giving loans to the graduate entry as cost-effective.

I am against the whole concept of loans. The money comes from the government for the loan. They then recover it from the repayments. If I ran the country I would give the money to the students as a grant and have them pay it back through income tax later.



Of course it is not surprising that so many universities are going for the highest fees because higher fees means more money. Since the universities have been turned into businesses money is their number one interest as it is now for hospitals. Patients and students come second. The focus on money means that the high fees were predictable. Why people like Willetts failed to realise this I have no idea. Perhaps they were telling porkies.

Rebs said...

Doctor Grumble,

Thank you for your response and I will read the links you have highlighted. Would you consider writing a post on my thread on the BMJ highlighting your views on this matter? I know many people would be interested.

Anthony Udi said...

Anthony Udi

Cut is necessary, but it should never be at the expense of long term progress. Make cuts in departments that need cut. I, as a person, would greatly suffer, and probably give up on serving the country that I love, in the capacity that I aspire to. For up to two years now, I have been volunteering my service for care homes and the NHS, and doing everything possible to make me a good doctor in the future (only if given the chance to study medicine).

If the NHS withdraws tuition fee support (grant or loan), for graduate applicants, my years of toil would be in vain. I might as well give up hope for life. I am from a family background where no one ever had the opportunity to attend a University – so, I was the first to attend, and graduate from a university. It was not easy – I had to work most of the time to be able to meet the cost of my education. However, I do not think it is possible to work as I did before, if studying medicine; it requires a year round attention to studies. The possible thought of not being able to study medicine, despite my hard work and determination to serve, makes me feel like I am inferior to more privileged applicants. I would not be surprised if policy makers do not heed my plea – after all, if you have never been poor, it might be harder to understand what the poor have to put up with.

If support is not provided to cover my fees, I am going to be devastated, but I would do whatever is necessary to realise my dream of becoming a doctor. I might even live the country, and never come back; or take a blind gamble at it working and studying at the same time again, and accept whatever the outcome.

The government should consider the experience and determination that graduates like me have to offer, and what the country stands to lose if we give up hope and trust. Yesterday, the 29th of April, 2011, I witnessed a global marriage ceremony, between Prince William and Kate Middleton (now the duke and duchess of Cambridge respectively), something struck a chord with me: That, this country is a great country, and we must not compromise our future by saving penny to lose a pound, because the world look up to us; and also, a commoner, given the chance to marry a prince, is only heard of in fairy tales – if this can happen, why am I being priced out of studying medicine?

onegprotest said...

You should leave a review on Amazon, I did.