Liberating the NHS: some thoughts on the new Great Patriotic White Paper 001 of 007.

Comrade patients, the cry to battle against the oppressive Fascist scum who have been running the NHS has come from our glorious Socialist leaders of the coalition of Allies. It is time to liberate the NHS and to battle for the freedom of the supreme Soviet of patients.

Ooops!

Think we might have gone off on one there after all it was just another White Paper which you can read in all its revolutionary glory here. It has six sections and an executive summary so we thought we would “analyse” each bit and for those avid players of buzzword bingo we will put in red any buzzwords on our bingo cards. If you want to play along you can get a bingo card from here.

So eyes down for “Our strategy for he NHS an executive summary” so grab you PPSh-41 and join us in the liberation of the Motherland.

The document starts with a 3 paragraph mission statement. Always good to start a war of liberation with a strategy. It is the usual we think the NHS is a good idea and should be free, we will pump loads of money into to achieve “results that are amongst the best in the world”. Not world-class or is this now passé?

Next is “Putting patients and public first” which starts with this phrase in italics “no decision about me without me”. If this is to be a core principle what happens to the unconscious patient? Or don’t they count in the new NHS?

It goes on to say patients will have “increased control over their own care records”. Interesting to see what that might mean. An opt out clause, or perhaps having to opt in, or better the abolition of the electronic Summary Care Record?

Then the “choice” word appears no less than 5 times in 2 sentences. Particularly interesting is the “extend choice in maternity through new maternity networks”. Is this the arrival of the cyber midwife or an end to the normal way of producing babies?

Some ideas just get recycled so patients will be able “to rate hospitals and clinical departments”.

Fighting a war of liberation requires the establishment of new elite units and as this is a Great Patriotic War of Liberation, the Party “will strengthen the collective voice of patients and public through a powerful new consumer champion, HealthWatch England, located in the Care Quality Commission”.

Well that should mean a toothless tiger although when we first read it we did wonder if this would be a new BBC program hosted by Nick Ross and highlighting unsolved crimes within healthcare?

Onto “Improving healthcare outcomes” and the word world-class makes its first appearance. There appears to be a contradiction in what follows in that it starts by saying the “NHS will be held to account against clinically credible and evidence-based outcome measures” which we would hope most doctors try to do but then the antithesis of such a noble and professional ideal appears in that “Quality standards, developed by NICE, will inform the commissioning of all NHS care and payment systems”.

No let up there in State funded interference in medical care under the new Party.

Any hope that the internal market will disappear is dashed by the phrase “Money will follow the patient” and “Providers will be paid according to their performance.”

Still awake comrade for “Autonomy, accountability and democratic legitimacy" follows with stirring management buzz words like “will empower professionals and providers” a couple of good words for your bingo card in that one.

To free up more doctor and nurse time to treat patients it is planned to “devolve power and responsibility for commissioning to the healthcare professionals closet to the patients.” What joy to come!

After years of being involved in commissioning we are now about to be involved in yet more commissioning. Remember all those meeting sitting around going nowhere? Well there is more to come and until we know more we are in limbo going nowhere fast so no changes as yet there comrade commissioners.

And it gets better, another quango to brighten the dark hours as we head towards our liberation. A “NHS Commissioning Board” will be established no doubt to employ all the senior managers to be made redundant? It does however say “we will limit the power of Ministers over day-to-day NHS decisions”.

Dream on guys no Party in the history of the NHS has kept its grubby little hands off the NHS.

And then “All NHS trusts will become or be part of a foundation trust”. Will this be by driving up, or down, standards or just changing the names on the signs and letterheads? Top market tip buy shares in printers and sign painters for they will lead the economic recovery via the NHS liberation budget.

The next bit we are sure will wake you up as it is called “Cutting bureaucracy and improving efficiency”. Subtle change in wording as “savings” are now replaced by “efficiency gains” which need to be achieved on an “unprecedented” scale to release £ 20 billion” by 2014.

Reduce “NHS management costs by more than 45% over the next four years, freeing up further resources for front-line care.” Is that the front-line called the Treasury by any chance?

“We will radically delayer and simplify the number of NHS bodies . . .We will abolish quangos that do not need to exist . . .” and replace them with new ones (see above)?

And finally we reach the “Conclusion: making it happen”. “We will give the NHS a coherent, stable, enduring framework for quality and service improvement,” by once again reorganizing it.

Praise be the Party for liberating the NHS.

Will this be the kind of liberation enjoyed by Eastern Europe at the end of the Second World War? We shall see in the next 6 sections of this White Paper after all this was just the opening skirmish in the liberation of the NHS.