Wednesday, February 22, 2012

Dancing along the third rail

"As we stand on the verge of possibly irreversible damage to one of the hallmarks of what it is to live in a civilised country, it is time to rise up and defend an institution that was built by our parents and our grandparents and which we owe to our children and our grandchildren to maintain and to pass on to them and to their guardianship"
Professor John Ashton, Director of Public Health, Cumbria

For expressing his views in a cogent, well-argued piece defending the public interest in the National Health Service and for signing a letter opposing the reforms, Professor Ashton is to be called in front of the board of the PCT to explain his actions, as the NHS management tries to scare critics into silence. If they can implicitly threaten this senior official - what hope for the more junior ones?

Like this waiting list clerk, who reveals the depths to which the PCT management will sink to get their waiting lists down  to ensure that they look good against government targets.
She was told to cancel operations for anyone who was already waiting over 18 weeks, and instead to fill that theatre time with people closest to breaching the 18-week limit. "I was told to call people who had already gone over the 18 weeks and pretend there was no longer theatre time for their operation, and not give them a new date... We would offer operations at very short notice to people getting near the 18-week deadline. You hope they'd say no so you count them as a refusal and knock them off... Did the consultants know? "One complained, really upset at not getting patients seen according to priority of need, but they bullied him and he was told to be quiet. They warned that Monitor inspectors would put us on alert."
And yet, while the government bullies staff and fights a desperate rearguard action against a demand by the Information Commissioner's Office that they release the national risk register - expected to detail the problems that may be caused by these reforms - they find time to stage manage a publicity stunt. Monday saw Cameron gather the Bill's remaining supporters - and those who remain prepared to engage with a government that abandoned listening for a bulldozer some while ago - for a summit at No 10. This involved around a dozen organisations and lasted an hour - meaning that it is unlikely that those attending were able to speak for more than two or three minutes each, as the Secretary of State and Prime Minister at least would have insisted on chattering for a while. As has been mentioned elsewhere, the increasingly long list of outright opponents was excluded in its entirety - cutting out the representatives of those apparently trusted to actually deliver the reforms, the GPs (amongst others). So much for no decision about me without me - that doesn't apply to our doctors.

Cameron has tied himself to the mast of these reforms and committed to them passing, come what may. That means he's now going to have every fault in the NHS laid squarely at his door. Dave - welcome to the third rail. Even if we haven't yet got to the bottom of events at Newcastle's Royal Victoria Infirmary last week, Cameron and Lansley can expect an increasingly rough ride. As the cuts start to bite into the NHS, no amount of spin and massaging of figures will help - the public will start to see the effect. Sadly, by then it may be too late.

No comments: