Bishop: "I'm afraid you've got a bad egg, Mr Jones"; Curate: "Oh, no, my Lord, I assure you that parts of it are excellent!"
They describe it as "good in parts", but also "bad in parts, unclear in parts" and "internally inconsistent in parts" labelling it as a "large curate's egg".
The BMA stresses the important of collaboration and co-operation between the primary (General Practice) and secondary (Hospital) care systems.
I think that the BMA are being generous at best and pusillanimous at worst. If you understand the core reason for the White Paper, which is break up and creeping privatisation on the one hand, and the shifting of power to the centre and responsibility to the front line, then it is entirely consistent.
We could have an absolutely first class health care system based on the current level of funding, and it would involve removing a whole level of bureaucracy and cost, and that would be to remove the internal market in health. At a stroke this would free up billions of pounds to be ploughed into front-line services.
Then, if we abandoned the central IT project "Connecting for Health" (see posts passim) and reallocated that money into effective local IT systems that would be hugely beneficial.
Both of these processes (internal market and central IT) are essential for the move towards an American style of NHS, where we have part-privatisation of services, and fragmentation of care. There is nothing in this White Paper to promote collaboration - it is all about competition (think about the privatisation projects like the Railways and the Royal Mail).
The irony of this is that it was a Labour Government - yes, a Labour Government - who started this all off, and the Tory/Lib Dems have merely taken it to its logical conclusion.
No, this is like the famous cartoon about the Curate, who when provided with a boiled egg and asked if there was a problem with a bad egg, said that "parts of it were excellent". The curate was being kind.
A bad egg is a bad egg and should be thrown away.
This White Paper is a bad egg.
3 comments:
"Pusillanimous," what a great word, it is a word I love but so hard to drop into everyday conversation.
I am following the debate about the white paper with interest in case something similar is introduced in Scotland.
I worry that people are sleep walking through the changes within the NHS; one cannot unscramble a curate's egg (I am not sure that works..but you get the gist).
Biggest problem is that a large percentage of the voting public have never needed to be treated in an NHS hospital, as they are young and fit. A clever politician realises that these voters want more cash in their pockets and so you can please them quite easily by doing just that. Decrease the "burden" of taxation. Unfortunately if asked about private healthcare most would also be in favour of it as on the surface, its cheaper. When I lived in the US I had excellent healthcare cover for less than I currently pay in NI due to my husbands employer (my hospital employer offered adequate cover. just not top notch). This was because we both worked full-time, had no children and had no health problems. We were a safe bet. However, I had friends who were self employed or working in bars etc who did not. Any hospital stay would have cost them thousands. They hedged their bets that they would not need treatment. Now under Obamas scheme they will be forced to take out below par compulsory insurance to plug the medicare blackhole. Thats what we have to look forward to- any basic insurance scheme will have to be compulsory and will be below par. Your ability to pay will no longer be a consideration. Those with a larger disposable income will opt to pay more for better cover- believe me, they will not want to pay more to top up the insurance of others. Insurance companies are not charities so they will not want to do this either. Look at car insurance- if you are a bad risk you are refused, offered less for your money (only TPFT rather than fully comp options) or offered an extremelt expensive policy. A bad risk is anyone who is likely to ever make a claim. If you are chronically sick then you will be even worse off than you are now, you will be a bad risk. Postcode lottery will be replaced by income lottery. Whilst this will free up beds in hospitals it does not bode well for our so-called "Big Society".
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