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February 8, 2012

Medicine Balls, Private Eye, Issue 1307
Filed under: Private Eye — Dr. Phil @ 9:07 am

 Lansley goes over the top


You’ve got to admire Health Secretary Andrew Lansley’s lack of insight. Having united every Royal College bar the surgeons against his reforms, his website insists: ‘Andrew frequently visits hospitals and GPs across the country, listening to clinicians and NHS professionals and is well respected across the medical profession for his knowledge fo (sic) the NHS.’ And there’s more: ‘Aside from being appointed as the Secretary of State for health, Andrew’s proudest career achievements thus far include transforming the public’s view of the Conservative Party’s commitment to the NHS.’


This detachment from reality is not entirely Lansley’s fault. He tours the NHS tirelessly on largely pre-announced visits where the bad bits are hidden and the staff are too polite or frightened to blow the whistle. Even the collective chorus of dissent over his Health Bill coming from nurses, midwives and doctors hasn’t thrown him off his stride. This, Lansley claims, is just payback for the government downsizing their pensions.


Only 1% of doctors responding to a BMA survey thought the pension proposals are ‘fair and acceptable’ and two thirds said they would be prepared to take some form of industrial action. But Lansley knows doctors won’t strike and that the public aren’t bothered by the issue. Never mind that doctors renegotiated their pension agreements three years ago to ensure they were ‘affordable and fair’. In a recession, junior doctors aren’t going to win much sympathy by saying their annual pension will be slashed to £68,000.


More of an issue is making doctors work until 68. MD finds general practice tough enough at the age of 50. The thought of another 18 years trying to safely treat someone of 86 with seven diagnoses in under ten minutes is daunting. Or it would be if his job wasn’t disappearing at the end of March. The big threat to doctors is not their pensions, but that the NHS can no longer afford to employ all of them.  Many clinical staff are facing the axe, alongside managers, and it’s impossible to make such cuts without affecting the quality of care. Ask anyone at Mid Staffs hospital, past or present.


Lansley believes his Health Bill will keep up the quality in the face of cuts. He immodestly compares himself to Nye Bevan, fighting for vital reforms in the face of self-interested professional opposition. Those who are against him just don’t understand the Bill. Even Malcolm Grant, the chair of the NHS  Commissioning Board (NHS CB) finds it ‘unintelligible.’ The NHS needs to keep improving and clamp down on poor care but overall, survival rates for cancer and heart disease have risen dramatically. So why the need for such massive reform?


Anyone hoping for answers from the NHS CB – the unelected uber-quango that’ll run the NHS – may be disappointed. Last week, it published details of its ‘design’. 63 pages of wonk including such gems as: ‘The NHS CB will deliver improved outcomes through matrix working, by hard-wiring into the ways of working’  and ‘The NHS CB will have a consistent approach to leading change and transformation running through the matrix working approach. The change model will have two components:  massive improvement approach; and having clear principles for the application of that approach.’ All that disruption for this?


Lansley has at least set up a Whistleblower hotline, curiously run by Mencap, for those who wish to raise awkward questions (Eye 1305.). MD called  08000 724 725 and was told: ‘The number you have called will be charged at a rate of 14p a minute and will appear on any itemised bill. If you do not wish to continue, please end the call now….. Thank you for calling the whistleblowing helpline for health and social care. A Customer Service Adviser with you shortly… MENCAP is now closed.’ The line then went dead.


The NHS has to make 4% savings and, as the Health Select Committee pointed out, the chaos of Health Bill is making this harder. Patients will suffer and whistleblowers won’t be heard. But at least the hotline is bringing in money, even when it’s closed. Genius.