A few days ago the good Dr Grumble reproduced an article which pretty much sums up what many feel is slowly happening to the NHS. The Ferret Fancier, welcome back you have been missed by we heathens up North, also commented on the piece. Now there is a phrase called the Third way (possibly more in this process?) and we wonder if this is already happening within the NHS.
Imagine a scenario where a PCT devolves responsibility for a service to a sub section of its staff and puts them in a separate unit let us call it Bletchley Park and runs it for a while. If the PCT decides as a result of “budget constraints” or a “service redesign” it can no long afford to run it what does it do then?
Perhaps it could set it up as a private concern using a variety of guises for example a limited company or a corporation or a federation. This "private" entity could then run the same service while being paid by the PCT and later even have it bid against a “competitor” by submitting a tendor which the PCT would consider.
If this “independent” business entity wins then they hold the contract. All good and ethical business’ practice.
Now consider the state of PCTs which will be disappearing soon. Their staff will be fearful of their jobs. What better way of preserving some of them than by farming out certain services to this “private" sector?
Consider next what will happen when GPs start commissioning. If there are good local services up and running cheaply GP consortia will properly use them rather than go through a long and complex commissioning process.
There is another aspect in that it might be conceivable that the true private sector might want certain services in a particular area and might offer to buy out the “private” former PCT provider.
Look carefully at your own area for this process may already be occurring albeit slowly and by stealth, or as the Witch Doctor blogger puts it by “creep”.
Could it be a case of PCT self preservation by creep and in doing also the selling of the family silver?
Praise be to the Party for giving us the Third Way but where that Way will lead nobody knows. Or do they?
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2 comments:
aha! Yes, this is exactly what seems to be happening with psychological therapy services in my local area. They are currently "out to tender" and it seems that they are likely to set up a pseudo private service, using much the same staff.
It's happening in Borsetshire too, supposedly a Staff Buyout of some services based on the John Lewis model. Only it doesn't look much like John Lewis to me, those in charge are ruthless in their attitudes to staff. I expect that the management buyout would sell on the facilities in time, and pocket a handsome profit.
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