Saturday, 19 March 2011

Compare the market . . . ?



Some of the team have been freezing their rocks off in a good cause in a dull, cold, mist and cloud covered part of the world devoid of the internet but via other electronic media we have been able to warm up our little frozen bits upon the warmth of wisdom dispensed by none other than the Secretary of State for Health Andrew Lansley MP. We heard him while mobile with nothing else to do other than concentrate on the narrow tracks we were driving along through the dense mist with precipitous drops to one side and hard rocks to the other.

Come to think of it that isn’t too dissimilar to our day jobs in helping patients “navigate” their hazardous NHS “journey” - oops slipped into buzzword bingo land lets get back to the blog world.

He was interviewed on the Radio 2 Jeremy Vine program and you can listen to it here. It is fairly obvious that the knowledge of the health secretary appears to be an integer located in the range –1 to 1 as he has not a clue about general practice in particular and the NHS in general. Come to think about the same applies to his interviewer.

We cannot recount the whole of the interview but some bits did almost distract us from driving the “Ferrari” we were in. Bits of it to our crude grunt minds explained the huge “differences” between the “old” NHS and the “old” Party’s reform s and the “new” NHS and the "new" Party’s reforms and we recalled another failed "market" system from a while ago as a result.

So are we sitting comfortably? The Lansley bit starts at 18.24 so if you move your sliders to about there we will begin.

We start with Dorothy’s knee. You can see poor Dorothy sitting at home, all alone in the world, in her high backed chair, with her 1950’s NHS specs and her ill fitting false teeth from the last time she had NHS dentistry, white haired and with swollen ankles unloved by anyone other than a Radio 2 presenter and her “new” good friend Andrew. Andrew is clearly Dorothy’s advocate for almost immediately he says the most important thing for Dorothy is that she

“. . . gets really good care . . .”.

The implication is that presently Dorothy’s knee is ignored. Dorothy’s new friend, in addition to the scarecrow, the cowardly lion and the tin man, Andrew goes onto to say he wants to

“. . . hold everyone to account for the outcomes we deliver . . .”

note the royal we that will never apply to him?

Andrew continues to say that if Dorothy has a knee operation then the operation done box is ticked but no-one checks on poor old Dorothy (aah how sad dear readers Dorothy is all alone in the world again apart from her new knee that no-one cares about). So all of the patients seen post joint replacement in outpatient clinics are not being checked but Dorothy’s other new friend Jeremy says he thought that was the point of all those new targets you hated so much.

The blind leading the blind? So Andrew has

“ . . . set out for the first time a really systematic view of what those outcomes should be . . .”.

Isn’t Andrew so kind to poor Dorothy and her new knee? A return to the cradle to the grave healthcare by abolishing targets and replacing them with “outcomes”. No new bureauocrats here checking up on Dorothy (and her knee).

Dorothy’s other new friend Jeremy then goes on to say that if a private company run by the Wicked Witch from overseas (boo) sets up a “knee place” this will drive the Good Witch of the local hospital out of business. Andrew is quick to reply and says that the

NHS sets a price”.

Starting to sound familiar? All good Conservative free market stuff here but it won’t be a tariff will it?

Words like GPs and patients commissioning the care and the money follows the patient follow. Jeremy then starts to talk (dirty) free market saying if the successful overseas Wicked Witch provider does so well that the local hospital shuts down then she doubles her prices what happens then?

What follows then is a core Conservative value of the laissez faire philosophy summed up in the phrase from Dorothy’s new friend Andrew:

it is not a free market

which he says not once but twice. At this point our traveling companions were in hysterics and what followed at about 24.00 minutes forced the driver to slam on the brakes.

“ . . . and there is a regulated market with regulated prices but it is a social market not a free market . . .”

In 6 minutes of driving over hazardous terrain we had heard the architect of the liberation of the NHS describe what exactly?

What we have heard for the last 13 years but being played by a slightly different instrument? We thought the Cold War had been won but when you hear the words “ . . . and there is a regulated market with regulated prices but it is a social market not a free market . . .” you realize what a huge chasm of grey British political party’s healthcare policy is and it is all the same horrible shade.

You could if you wish listen to the bitter end at 39.07 but we think we heard the best bit. If you fancy a laugh have a listen but be quick as we do not know how long the link will be on the website and please do not listen and drive – a safety warning from the team at ND Central.

Praise be to the Party for inventing the art of reinvention in order to better us all via more bureaucracy and regulation. Isn’t it about time they did the same to other markets like supermarkets or has that been done before somewhere in the East?

We smirk as we wonder what the last great Conservative “reformer” of the health service must think of her new boy and his words. Is it time for a trip for someone to see Matron for some speech therapy?