Conspiracy or cock-up

The juggernaut of change.......

Generally, when it comes to Government policy, I am a cock-up theorist. Many many pieces of legislation are dogged by the force of unintended consequences.

However, when it comes to the NHS, I am firmly in the conspiracy mode, and have been for a considerable time.

Over the last few years I have been gently blogging about the way in which the NHS is being steered and the people involved. The list consists of three major groups, all equally culpable:

Politicians, Admin/Manager/Advisers and Clinicians.

The politicians are consistent, and down the years they are all guilty of actions deemed to endanger the NHS. There are too many to name all of them, but high on the list of shame include: Tony Blair, Gordon Brown and David Cameron (successive Prime Ministers); Alan Milburn, John Reid, Patricia Hewitt, Andrew Lansley (Secretaries of State for Health) and the supine House of Commons. I struggle to think of a single politician who has behaved to protect the NHS.

The administrators/managers/advisers group has been the driving force behind the organised project of fragmenting and privatisation by stealth. There are a long list of those heavily involved in the 'project' including Penny Dash, Mark Britnell, David Nicholson, Paul Corrigan and Simon Stevens - to name but a few. They have been behind the project, usually active for large healthcare organisations. Others who have leant support include Chris Ham, Niall Dickson from the "independent" charity - the King's Fund.

Finally the Clinicians: the Chief Medical Officers, Chief Nursing Officers and Assorted Tsars. The opponents who jumped ship at the first opportunity, the enriching and selfish end of the clinician sector, those prepared to front up the changes either for personal gain, or a lack of understanding, or ideological reasons. This long and unhappy list includes Drs Donaldson, Fradd, Chisholm, Dixon, Coffey and (most disappointing of all) Field; Mrs Beaseley is in there as well. A special place is reserved for the utterly naive Dr Darzi.

As I approach the end of my career, possibly hastened by Draconian pension changes, I look at this list of people who either willingly or unwittingly are destroying the service that I have devoted my adult life to, and I feel a combination of loathing and disappointment.

The Juggernaut of privatisation is heading our way, aided and abetted by the selfish, venal or misguided, and we will all be the worse for it.

For those who think that the new order of Healthcare in England will be better, don't believe it.

And don't get ill either.