25 November 2020
Diary of a Corbynista
Health and Social Care
by Don Urquhart
We like to watch Scandi Noir. At the moment we are in the middle of a Norwegian series which is bleak and surreal. The heroine is the plainest of Janes which is unusual among such sagas and she has just punched her sister in the mouth while they are waiting outside the hospital room where their father is dying. But I don’t want to spoil it for everyone.
One result of all my TV watching is that it limits my horizons. I definitely do not want to take a holiday in Norway after Monster and Sweden is long gone after Wallander, The Bridge and the Dragon Tattoo. And don’t get me started on Denmark after The Killing.
So I get to thinking that Britain’s not so bad. Then onto my screen comes Sajid Javid. I don’t want to get personal but this man has enriched himself selling financial derivatives and has just returned from 10 months in a lucrative 2nd job at JP Morgan in time to tell us what is good for our health. I could go on but sleaze is so passé.
His Health and Social Care Bill has its third reading this week.
I attended a meeting of our local Clinical Commissioning Group (CCG) 8 years ago because my sister-in-law had been unable to obtain the support of a neurologist over a Bank Holiday weekend and had died. I never implied causality but was infuriated that the wonderful ICU people told me that there was no chance of getting a neurologist over any weekend.
Anyway the CCG members were put out that a member of the public had turned up at their meeting and I was ejected politely but firmly.
I also went to one of those meetings where the CCG claimed to be collecting the views of local people. There were plenty of presentations by management consultants and I formed the opinion that the CCG concept was a wet dream for such organisations particularly after I had gone through the minutes of a CCG meeting which were 90% risk analysis spreadsheets cut in every conceivable sequence and were therefore useless except as cover for the true impotence of the CCG.
Well now the CCG is to be replaced by the ICS (Integrated Care System) run by an Integrated Care Board (ICB) which can include private providers. That is anathema to me because I do not want private companies deciding how Health and Social Care is managed. It is a blueprint for corruption, whatever weasel words are put round it.
The Kings Fund is a fine organisation which casts a critical eye over our health provision. But they have taken the government sell that all will be done nicely:
The Bill includes safeguards, for example, decisions of the board and its committees must be made transparently with meetings in public and papers published.
No! The way to achieve transparency is to have the Boards run by public servants with no skin in the game. And there need to be real teeth in the auditing. The documents I saw from our CCG were an exercise in confusing and misleading outsiders.
Will any of this improve the care we receive? Well not if we have a Health Secretary keen to take us down blind alleys. Does he really think that GP’s avoid face to face meetings and what is it in his clinical experience that tells him that face to face gets better results than phone or Zoom?
Why does any of this matter? Well the NHS Service Levels are disintegrating.
A friend in his 80’s was referred by his GP to a private hospital for a cataract operation. They kept shifting the date until he mentioned money. Several thousand pounds later he has a date for his operation.
A lady I know was quoted £20,000 for a knee replacement if she wanted it done quickly.
And you see advertisements for private GPs everywhere.
Dr Cat Anderson asked the Any Questions panel how GPs were to be prevented from leaving the profession in their droves given the stressful nature of their job and the level of criticism they suffer. She was under heavy pressure and would not be surviving if she hadn’t started working part time in the private sector. I know this doesn’t quite hang together but listen for yourself. It is happening. And it looks so like Noam Chomsky’s warning that the government starves public services of resources to promote their privatisation.
Of course you have been able to pay to jump queues for many years. The beauty of the NHS was that you could obtain a decent level of healthcare regardless of your bank balance.
Now the government and the media talk of NHS winter crises, long queues at A&E, people dying waiting for ambulances as if they are Acts of God.
Who was it said “The Poor we have always with us”? Whoever it was he started a long stream of Tory propaganda.
“The Poor” don’t have to live in little damp hovels, without the basic essentials.
“The Poor” don’t have to go to the back of the queue for health, education, life opportunities.
But that’s the way it is and it is a political strategy implemented by people we have somehow voted in.
Meanwhile back in bleak lawless Norway our heroine has just nicked her mother’s remains from the morgue and reburied them in the forest. By most accounts their health service is better than ours but I still feel safer here.