Big Brother’s members continues to get bigger.

We here at ND Central apologize for using smutty innuendo in our title but a piece from the GP magazine caught out eye and a lot of it we found quite offensive for it is showing how clearly the bottom up liberation of the NHS is more of a monster top down command and control exercise. We took offense to the classification of cataract surgery and knee replacement surgery as low clinical value treatment that must only be restricted on the basis of strict evidence based criteria.

Well if these are procedures of low clinical value then we are sure that some alkaline substance sprayed into the eyes of the dumbkopf that thought this was a low clinical value treatment followed by a knee capping might make them realize the high clinical value that both of these procedures have to patients. Not being able to see or to walk comfortably are not fun and correction of these has a very high clinical value to the NHS customer aka our patients.

However it is not the patient who is in charge of the NHS it is the Party. Remember "no decision about me without me"? These are seemingly become more and more meaningless words with each day of top down reform bottom up liberation that passes.

You haven’t yet seen another layer of top down control via bureaucracy coming to control bottom up GP commissioning decisions via the Quality, Innovation, Productivity and Prevention Right Care Team? Not heard of this quango? Give it a Google (ooh no misses!) and you might land up here.

You might want to checkout a Right Care “bespoke” Health Investment Pack (HIP weren’t they formerly another bureaucractic nightmare called Home Information Packs once?) for your area. Go on give it a go for your PCT and look at all the pretty, pretty colours on all of the graphs.

You might want to look at About QIPP Right care and its 3 bullet points

Improved clinical involvement in commissioning.

Is that the same as we are telling you what to do?

Stronger patient involvement through shared decision making.

Is that the same as we are telling you what your only choice (if any) is?

Supporting commissioners with knowledge, information and coaching to consider the legitimacy of variation and thus whether the level of variation.

Is that the same as we are telling what to do in order to make sure you meet our targets outcomes?

And this is all to be “evidence” based? You can even have a HIP Guide for GPs if you choose to register something we think we shall decline.

Seems the more the war of liberation goes on the more the top down reform of healthcare goes on so that GP Commissioning Groups are going to be told what they can and cannot do by all those HIP Right On Care guys and gals at the new and rapidly evolving mushroom cloud that is the NCB.

You know all this makes perfect sense and you can find what all this is really about in the sentence:

"QIPP is working at a national, regional and local level to support clinical teams and NHS organizations to improve the quality of care they deliver while making efficiency savings that can be reinvested in the service and deliver year on year quality improvements."

That is a polite way of saying we will command and control you to reduce services and save money.

Praise be to the Party for its transparency of opacity when it comes to giving the troops on the ground what they need. More diktats and stats Herr Doktors?

At this rate we will soon be ready for another quick QraP.