27th June 2011

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One voice

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


Over the week end the e-mails, twitter and the airwaves have been chock-a-block as everyone seems to have cottoned on to the fact that the Government's response to the listening doh-dah is not quite what it seems.

In an ostentatious display of 'listening' the DH have listed just over 180 amendments to the 360 page Health and Social Care Bill. The amendments are cascaded throughout the Bill. The NHS is a whole system, therefore the amendments to the Bill have to be seen in this context; intertconnected. 

It is impossible to read just the amendments and judge their impact. The whole Bill has to be carefully dissected, line by line and the changes interwoven word by word, sentence by sentence. It is a huge forensic job 

There is a Parliamentary Bill Scrutiny Committee Hearing coming up this week where some of the organisations representing you will be asked to give MPs their view on the amendments. I say, in the time frame they have been given, it is impossible for them to do so. What is more they should say they cannot do it and ask for more time.  

There are those who say delay to the passage of the Bill would bring more chaos and more job losses. To them I say; wake-up! PCTs are a demoralised mess brought on, largely by the haste of the Big-Beast, encouraging change before reform was agreed by Parliament. Jobs are gone, morale is gone, talent is gone and so has his credibility.  More chaos? What could be worse than chaos enshrined in law because no one understood what was to come and no one had the honesty to say they didn't understand what was going to happen. An NHS hobbled is one thing. An NHS crippled is quite another.  

This whole 'listening-thing' has descended into chaos. The only sensible course, for the organisations concerned, such as the BMA, RCGP, RCN, Royal Colleges, Confed, IHM, is to say to the DH we simply cannot judge the impact of the amended Bill without more time. With summer vacations coming up, can they do the job inside three months?  

They should set up a joint working group to properly analyse issues and get legal opinion on such issues as the SoS's ongoing 'duty' (It is not at all clear to me that he does retain it), the issues around competition and the Mad-Dog (My brief analysis is; his powers are attenuated but basically unchanged) and much more. The complexity around the future of 'any willing/qualified provider' is a task in itself. Here is a flavour of the complexity. 

This affair has become an Alice in Wonderland, Hall of Mirrors with the DH rapidly descending into a into a collective roll as a shrill Queen of Hearts. 

Why is Number 10 in a rush? Cameron must have a Bill, up working and delivering improvements to the NHS by the time of the next election.  

You, your job, your future is being pushed, shoved, bullied and brow-beaten into something we know-what-not. It is your NHS. It is time for the organisations who represent you to show courage. Collectively they should act and tell the DH they need more time.  

Contact them and tell them you want to see a copy of their interpretation of the impact of the amendments to the Bill...............fat chance.

All this is a special test for the Confed's newly appointed Mike Farrar. Managers have borne the brunt of the job losses and opprobrium from LaLa and Cameron. He takes over an organisation with a reputation for being the back-door of the DH. Let's see what he says standing outside the front door.  

This is a real test of leadership for the people you have elected and pay for as leaders. It is time for them to speak with one voice.

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US perspective on CCG

This is the most important document you will read this month!

Ten suggestions on GP commissioning from the US.  This is a really good read.  Thank you Andy (Reader) who sent it to me.  If the DH don't take note they are more crazy than we think they are!

Download here.


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