You may recall I had a bit-of-a-moment with the Chairman of the CQC, David Prior.  In my view things he said make him clumsy, cack-handed, thoughtless and crass.  He said underperforming hospital should be passed on to American and European management companies; 'to run them better'.   

He ignored why Trusts were in trouble and trashed any idea the CQC exists to improve them.  He ignored the fact the private sector is no better at running Trusts than the NHS.  An intermediary contacted me to see if I would be prepared to meet him.  Olive-branch?  Why not.  We scheduled lunch.  I've cancelled.  Why?

On Friday evening, on the way back from Manchester and a fabulous conference with the clinical pharmacists, I listened to the BBC's PM Programme.  Prior holding forth.  Most of what he said was fair enough; things aren't right, can't guarantee anything, there is a lottery.  Damaged culture, poor acceptance of whistle-blowers... nothing we need to inspect to know.  And, some places are world class.

He went on to say (09.30 mins in) he "... wouldn't want to go as a patient to Barking Havering and Redbridge Trust, or Heatherwood and Wexham Park... overall (the) two hospitals that have come out to be inadequate".  Inadequate? 

This is Monday morning; all over the weekend staff at BH&R and H&WPk will have been working with Prior's words ringing in their ears.  This morning people will come to work with Prior's words at the back of their mind... 'inadequate'.  They will think they are honest, hard-working, doing their best.  So do I. 

The management team will turn up knowing what Prior said and begin another week of 'inadequacy', turning round a hospital, which through no fault of theirs, has undeniable problems.  Again the chief executives will have to lift the morale and self-respect of an 'inadequate' team of staff that know their hospital is 'in the wrong place', a prisoner of legacy debt, churning management and recruitment problems.  Nothing to do with the CQC. 

Nervous patients will be turning up at their 'inadequate' local hospital.  Applicants will be thinking twice about a job at these 'inadequate' hospitals, making a career there?  Perpetuating the Trusts problems. 

It is one thing to say that hospitals are performing poorly, one thing to say we must fix it.  It is quite another to single out two hospitals that are heaving, straining, sweating and working their fingers to the bone to reach the wholly arbitrary requirements of the TDA and Monitor and invented quality standards, presently based on anecdote.

It is my opinion Prior is dangerous, a loose cannon.  The problem is; as a High-Tory he has open-door access to Number 10.  Here's something to ponder; is Cameron egging him on to traduce the NHS, or is Prior an eccentric embarrassment to him as well?

Dismiss all thoughts that the CQC exists to culture improvement, foster development or encourage anyone to do better.  From the top it's clear; it exists to insult, denigrate and put the boot in.    

Paul Corrigan (a NED at the CQC), advocates selling Trusts to the private sector.  However, I am astonished that the perfumed Jennifer Dixon (a NED), whom I admire as knowing about organisational dynamics, collegiate learning and the value of sharing good practice, is still at the table.  I should have done my homework, nevertheless, I deduce an ambivalence about her role?    

The CQC CEO has made clear he refuses to get into 'improvement work'... 'because it would be like marking your own homework'.  It seems the whole system is staffed and geared up to disparage the work of the NHS with no facility or desire to improve it.  The Machiavellians will say it is part of a sinister plot to soften the NHS up... sell it to the private sector.  I would have refuted that.  Now, I'm not so sure.

The Flat-Earthers are set up to find fault and fan it into failure.   It's a fair question to ask why?  The Foundation Trust Network are silent, the Confed, nowhere near the organisation it once was, has no clout to resist.  Future generations will ask; where were you when the NHS was demolished?  

I don't agree with inspection; who does?  For 15 years we have inspected the NHS, gained nothing and now the Flat-Earthers want more money (total �160m) to do more of the same.  Their new 'tools' are experimental, made-up.  Put lipstick on a pig, it's still a pig; inspection is still inspection. Reputations will be won and lost on a whim, suck-it-and-see and trying-out, rushed, ready-or-not ... without recourse or appeal.

Who would argue; CQC finances are exploding, their strategy a muddle and their chairman an embarrassment.  Time to break it up and make the CCGs responsible for the quality of what they commission.  Simple, local and a hell of a lot cheaper.   Establish the Academy of Fabulous Stuff where Trusts can go for help without fear of being insulted, penalised and belittled.  Prior might like to discuss this at one of our sell-out Health-Chat evenings, like; Gerada, Carter, Nicholson, Keogh, Jarman, Taylor, Carnall...?   

Prior told me he will be off work for six weeks.  He's having a hip operation.  On the day of his admission other patients with the same condition will be admitted, for the same operation, to Barking Havering and Redbridge Trust, or Heatherwood and Wexham Park.  Perhaps Prior should join them... I am sure they would be delighted to help him.