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20th August 2013 

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News and Comment from Roy Lilley
Imagine you were God.  I know for some it will be easier than others....  If you were, what would you do? 

 

Make the local practice answer the phone?   Turn yourself into Angelina or Brad?   Fix the weather for your holiday.  End world famine, crime and anger?  Rewrite the Bible in 140 characters on Twitter?  Turn conflicts into a game show and let the audience decide?  Put Sauvignon Blanc on an FP10?

 

Suppose you were God and you wanted some tickets for the FA Cup?  You'd ring Greg Dyke.  If you wanted to complain about the BBC you'd ring Tony Hall.  M&S; Mark Bolland.  If you are God you can pick up the phone and speak to anyone.  Suppose you were God and you wanted to speak to the boss of the NHS.  Who would you ring?   You'd spin the Rolodex and call... who?

 

You might start at the DH.  You'd be disappointed.  The DH doesn't 'do' the NHS.  They'll send you a copy of the NHS Constitution or the Mandate, an annual 'things-to-do' list, but they don't make any of it happen.  They cross their fingers and hope someone else does.  Perhaps they would have in mind Job 6:8 "Oh, that I might have my request that God would grant what I hope for..."

 

God might think that a 'regulator' would be in charge.  If God rang Monitor I doubt they would take the call.  They would assume it was a hoax.  They think they are God. 

 

Monitor claim their duty is to protect and promote the interests of patients...  but not all patients.  Only the ones that go to Foundation Trusts.  God might assume Monitor is thinking of Exodus 23:27 "I will send my terror ahead of you and throw into confusion every nation you encounter..."

 

Patients that go to ordinary Trusts are in the parish of the Trust Development Association, or Authority or Agency, or something.   Their job is to assure the clinical quality of NHS Trusts and other stuff but not for patients of Foundation Trusts.  They are in-change of this bit but not the other bits.

 

That leaves God with the CQC.  Are they in charge?  Not quite.  Monitor protect and promote the interests of patients and the TDA does clinical quality.  The CQC check all the hospitals, care homes, GP surgeries, dentist, community hospitals and Bethlehem Maternity Stables to see if anything has gone wrong.  With the wisdom of Abraham, God might think, this is leaving it a bit late?  Stopping things going wrong might be a better bet. 

 

Does anyone have the number for God to ring?  By now God might be thinking of Exodus 14:3 'The Israelites are wandering around the land in confusion... '

 

Ordinary people, by now, might give up.  But, you are God.  One final shot; NHS England.  There would be no point in speaking to the man running it as he doesn't use the NHS.  Anyway, he will be on the golf course looking for GPs.  'What does this Carbuncle do?' God might ask!  Well, they do quality and stuff.  Isn't that the CQC and Monitor and the TDA?  Yes, but no, but yes.  But, mainly they are involved in commissioning stuff from parts of the NHS over which they have no domain.

 

Out of exasperation God might try a CCG, but they are easily confused with a CSU and LATs and anyway, they only know about their bit of the NHS and there are huge geographical variations.  Large chunks of what happens they don't make happen... that's done by NHS England.  Organised by the bloke that doesn't use the NHS.

 

If you were God, trying to figure out who to call, who is in charge of the NHS, you might be reflecting on Psalm 77:14,  "You are the God who performs miracles... display your power among the peoples".

 

If you really are God and you are reading this, please hurry up.


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>>  Plans to reconfigure pathology services are in trouble.  North West and South West Midlands are set to dump the idea.  Quite right too.  Near patient testing is going to put an end to half their work.  Or should; if the GPs can get their act together.
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