22nd July 2011

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Chorus time 

News and Comment from Roy Lilley
PPA 'Columnist of the Year' - Finalist


Exactly when did the fat lady sing? On the 10th March 1976.


Texas Tech sports information director Ralph Carpenter was
commentating at a close ball-game. His colleague Bill Morgan said; "this ... is going to be a tight one after all." "Right," said Ralph; "The opera ain't over until the fat lady sings."


Can you hear the fat-lady singing? I'm talking about the soaring lifting voice that makes the hairs on the back of your head stand up and reduces wine glasses to splinters. Apparently, at 556 Hz and 105 decibels, it can be done!


Shattering glasses, shattering dreams, shattering government health policy. She may not be a soprano but Lady GaGa is singing. Well, gargling in preparation, perhaps! The music is provided by a RCGP survey that we published several weeks ago (courtesy a reader, thank you). Ours was an early version. It has since been finessed and has just appeared in the doc's excellent trade mag'; Pulse . (You may have to register to read it).


As we had the survey first I don't feel too bad about referring to it. The top line findings are:

  • 85% of GPs are not 'reassured' by the post-listening revisions
  • Almost half didn't think revised clinical commissioning groups would improve patient care.
  • 60% said they did not want to be involved on a commissioning group board
  • One in five GPs said they 'strongly oppose' the direction of the Government reforms and 30% 'oppose' the reforms.
  • They rejected the idea reforms would improve cost effective care, lead to a more integrated NHS, or improve relations between GPs and consultants.
  • Nearly 80% of GPs said the revised bill will see increased involvement of the private sector in NHS care
  • More than two-thirds of GPs said the revised reforms would not reduce bureaucracy.

Of course LaLa will ignore it all and waffle on about Pathfinders. Did you ever wonder where the Pathfinders came from? Here's the answer. Not quite the rush of the willing we were led to believe. Understandably the rest had to either jump on the passing wagon or be run over by it.


It's clear; GPs do not want to 'do this' a point made ever more unambiguous by the rumbling bass notes of the BMA who have found their voice and voted to launch a public campaign to oppose the Bill..........in the middle of the holiday season. Groan!   When it comes to PR they are the British Muddling Amateurs.


The Bill will return to the Commons in September. Two days have been set aside to explore over 180 amendments across 360 pages of complicated legislation that makes the NASA's Orbital CCVT system look intelligible. On average, Parliament sits 7hrs 20mins a day. Work it out for yourself; given Parliamentary procedure and palaver it's a nervously short time for each complex amendment.


Hamish Meldrum, the basso profondo at the BMA has called the Bill 'hopelessly complex'. That's code for 'he understands the NASA thing, but not this'. If the Bill was to reduce bureaucracy it has managed to transform the DH, 152 PCTs and a handful of SHAs into the DH, the National Commissioning Board, 500 commissioning layers, residual SHAs as regional health authorities, the rump of PCTs as district health authorities, checks, balances, local authorities and hangers on, plus Senates.  Effectively quadrupling bureaucracy and costs.


There can be no one, save the bluest of blue-rinse Tory, with a BUPA gold-card, who can say we are in anything other than the Mother of All Mess. A bad Bill, craftily introduced by an unpopular Health Secretary, shrewdly and cannily amended to be the same but different, with no enthusiasts other than a class of GPs who are mistrusted for being on-the-make. Everyone is agreed; it will not cut bureaucracy, improve outcomes or save money. Already (according to the HSJ ´┐Ż) the reforms have cost a quarter of a ´┐Żbillion.


Will we hear the fat lady sing? I don't know, but I do know this; we need to hear a chorus from the professions, signing off the same song-sheet, in harmony and for once working synchronised and in tune. The problem is; we seem to be missing a conductor.


Have a good weekend.


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News and Stuff


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>> IHM - new code of conduct.

>>  Ever wonder where the first Pathfinders came from - have a look at this.

>>  A range of services to be put out to tender - Eight in total.  LaLa not waiting for the Bill, then?  

>>  Privatisation - under the radar.


>>  Another Alliance document - this time it is a 'positioning statement'?  Weird, it's more like a pre-listening Future Forum wish list.  Have a look.  I don't see how it positions them at all.  I've added some comments.


>>  It looks like the BMA are gearing up for another go at stopping the Bill - perhaps there is some co-ordination going on?  I doubt it.  None of these organisations can work together.  Just think how powerful they would be if they did!


>>  The Reforms: take two - a rare opportunity to read the wise words in the Lancet


>>  Stepping Hill - latest.

>>  Free Telecare installation - will it convince the doubters?

>>  Industry problem in elder -care - LAs and NHS to have a look.  Another report to sit on the shelf? 

>>  Future Forum being put back to work - looking at IT.

>>  GP patient registration - call for ID.

>>  Animal testing - requires better regulation.

>>  National Cancer Patient's survey - arrangements for this year.

>>  Who is paying the price for emergency readmissions - not everyone, it seems?

>>  The NHS should be run like UNIPART - says UNIPART boss. 

>>  Cartoon - US healthcare.   

>>  Management of blood exposure in police officers - the ones who are not having a free day out at a healthfarm!  

>>  Heatwave - kills 22.

>>  King's Fund - what's happening?

>>  Seven day working - will be Doc led.

>>  Lady GaGa is 'sick and obsessed with her weight' - the other one not ours!

>>   Dementia commissioning pack - DH latest.

>>  Being tall - raises cancer risk?

>>  Five cost cutting trends to watch - this is a US article but it could have been written here.

>>  Celebrity smokers - ugh!

>>  Obituary - Lucian Freud.

>>  We don't need no educashun - well you do where I live - education map of the UK.

>>  GPs face bill for millions - trying to keep 18 week promise.  This is a really important story that seems to have been overlooked in the 'is there a waiting list problem' saga.