We wonder if anyone else in GP land has noticed subtle changes to their practice based staff and not realized that what seem to be small and incredibliy awkward changes were in fact part of a possibly more sinister plan?
Many many moons ago we used to have district nurses and health visitors attached to ND Central and they had their own part of the ND bunker as offices. This arrangement worked very well for it meant that we had regular communication and if things were not done it was easy to chase up who was responsible.
Now the Party does not like professions to fratanize for if this occurs then counter revolutionary ideas might be born and a cohesive resistance to its benolvance might develop so a few years ago it removed our attached district nurses and health visitors away to new Party controlled central barracks.
Communication went from being face to face on a daily basis to such advanced methods as message books which were read “whenever” someone happened to be passing or leaving phone messages on an answer machine or via a Party controlled call centre with the inevitable dilutation and censorship of information.
Needless to say the local Soviet will have held a public holiday and drank lots of vodka to celebrate its success in improving local services. Those on the gound saw once good services destroyed and a two way exchange of information destroyed too. The health visitors were particularly missed as it gave local paedophiles a free reign but this was Party approved for we were repeatly told that this new model for health visiting was the highly successful Doncaster/Haringay model. So no chance of a baby Peter or a Victoria C here in Northernshire.
This at first seemed to be local Soviet incompetance but scratch a little deeper and this was not immediately apparent but it was in fact part of a process called TCS (Transforming Community Services).
Did you, or more importantly, do you know what this is? Try googling it and see how easy it is to work out what it actually is. You could try the FAQs here for starters. We did not until a recent lecture presented by a midget ex nurse, one of the snide evil idle kind who have spent all of their (very) limited time with patients doing bugger all hands on nursing before moving into nurse management and then onto NHS management.
At each level such snide evil idle kinds do less and less work but generate more and more for those few nurses that do what they used to be trained for namely to look after and care for patients rather than print off loads and loads of care plans to show patients were looked after as they died of dehydration.
This midget both of body and mind told their audience about how successful the TCS programme had been. Unfortunately Party stooges do not take kindly when their audience of frontline healthcare workers start standing up and asking midget mind why things are so bad and worse than before despite the midget’s Party spin.
Midget mind had to get the Stasi in to quell the disgruntled audience. No doubt when they went back to report to their commissars about their propaganda trip they would have told them that the sun was shining, wheat production was at its highest ever level and all was good in the world of NHS management cream teas and cakes.
What we learnt from midget mind was that the withdrawal of district nurses from the frontline and health visitors was all part of the TCS programme – whatever that is try googling this. Now consider the wider picture.
With the advent of commissioning one of the first things local GPs here in Northernshire wanted was the return of district nurses and health visiters to practices. Midget mind had told us that the first TCS contracts were up for renewal and with this information local GPs were keen to restore the status quo for the better.
Unfortunately this is not an option for a far more insidious parallel plan has been running. The parts of the local Soviet PCTs that were once “responsible” for the district nurses and health visitors were farmed off into little separate “corporate” entities initially part of the PCTs and then completely “separate”.
These little entities are now “independent” of the local PCT Soviets, have there own crap computer system (System One) that cannot (or will not be allowed to talk to any others despite SHA sponsorship) and have all been Party sponsored.
This division of a once more joined up service between GPs, health visitors and district nurses has been politically destroyed with the active involvement of the relevant professions at a senior (more lardy) level.
Locally resistence has been huge but of course ignored for when the sh*te hits the fan it will be those that knew better that go down the pan even if they dared to complain and resisted the policy not those who implimented it.
No doubt the TCS programme creates little entities that come whichever version of alleged “GP led” commissioning crawls out of the political slime will be sellable commodities and GP commissioners will have to purchase their services from former PCT bodies.
As simple grunts on the ground the “improvements” produced by TCS namely no district nursing or health visitor communications, less accountable care, delays in communication all have had a positive impact on patient care which is that of the negative for all are worse off especially locally regarding child protection.
Praise be to the Party for ensuring that when it comes to the provision of healthcare this will always be compromised by political expediecny at the expense of excellent healthcare.
This has all been done by stealth and unless there is a massive mind shift in UK healthcare policy whereby
Conservative healthcare policy = Labour health care policy = Lib Dem healthcare policy
ceases then there will be more to come. All of it of course for the better, comrade.
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Northern Doc was once a blog originally written by a group of GPs in Northernshire and expressed their experiences and frustrations of working in today's NHS. The pieces were compiled at social meetings after work and published anonymously in a once free society. Following the Government's Medical Council clamp down on freedom of thought, speech and expression by doctors and our belief that the views of a few doctors DO NOT represent the views of the profession as a whole their views will now be written by and published by a journalist who has previously contributed to the blog by virtue of social ties. Any inference that the word Doc means a doctor is now purely coincidental. This is as of the 22 April 2013.