As I was reading the detail around the proposed changes to my ex-employer the NHS, I began to cogitate on the wonderful, clean and transparent politics promised by the coalition – sad but true….
Now I’m certainly no apologist for either Strategic Health Authorities or Primary Care Trusts, the two bodies that face abolition under the recently issued White Paper. What I am more than a little concerned about was how badly I must have been paying attention to the party manifestos and electoral commitments that were made in the run up to the last election. I thought I was paying attention but I missed:-
- the biggest reform of the NHS since its inception
- the clearly thought out detail in the policy about how the new processes would work
- the intellectual rigour that could justify the rationale for change
At least we had a couple of years grace after the Labour victory of 1997 before the cynicism set in; it’s taken the coalition government just a few weeks to renege on its commitment to honesty, transparency and clarity. It’s quite shocking that there isn’t more made of this in the media – they spent enough time telling us the importance of engagement in politics, you’d have thought they might have spent a little air time discussing the pointlessness of voting for any party on the basis of what was (or wasn’t) in the respective manifestos. It’s also good to see the Liberal Democrats forsaking just about everything they purport to believe in for the dubious benefit of a referendum on a watered down alternative to first past the post.
Oh, and a final rant on the subject of the wisdom of GPs commissioning the clinical services upon which you and I depend; general practices are businesses and are run as such; it’s staggering how quickly procedures can be introduced if they affect the practice bottom line, how slowly when they don’t, irrespective of clinical benefit. It may or may not work, but a White Paper that can’t give you any detail on how the most important shake-up in the NHS since inception is going to work, and which appears to be policy on the hoof is not what the NHS deserves. Yet again, the ‘policy advisors’ who simply advocate the opposite of current structural practice (if it’s centralised, then decentralise and vice versa) are hailed as intellectual giants, when there is clearly absolutely no new thinking at all. All we need now is for the management consultants to enter the market and charge exorbitant fees to handle the “transformational and change process” and for the large facilities management companies to win outsourcing contracts that tie in the NHS for ten years and end up costing the public sector more rather than less and the brave new world of a refashioned health service will be complete. Honestly, it will!
It just that it will resemble all the other structural debacles that have been inflicted on the NHS in the last fifteen years, which have resulted in absolutely no discernible difference in delivery but cost billions to introduce. But this one is different, there will be change – for a start there will be no longer be any guarantees on how quickly you can get to see your GP, just best endeavours. A fine start, don’t you think. 🙁
Next time, I must pay more attention to those pesky manifestos!