14th June 2011

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News and Comment from Roy Lilley


To the left is Harley Street, home of private medicine, wealthy consultants and lavender enemas. To the right is Chandos Street, the home of the Go-Johnnie entrepreneurial GPs.  From both directions an overwhelming smell of fermenting money.


In the middle; 11 Cavendish Sq, and Dean's Mews, once the Convent of the Holy Child of Jesus and now the elegant, perfumed peace of the King's Fund. 


Yesterday, Chief Listener, Gisa-Job Field, passed under the arch and Epstein's sculptor of the Madonna and Child, to the uber-modern, conference room to tell us what he had heard.

He's been busy, that's for sure.  But, not too busy to fill in his expenses form! Over six and a half thousand people attended Listening events, 25,000 emails but only 600 bothered to leave a comment on the website. 


The full report has four volumes (with intro's from the chairs of the subgroups telling us how much they all love the NHS......groan) dealing specifically with choice, competition, clinical advice and leadership, education and training.  They can be downloaded here. (Brief summary here)


What's the up-sum?


LaLa to retain his 'duty' to provide healthcare?  No, not quite.  Some really slippery language is used saying he should report to the nation, annually about what's happening in the NHS.  See for yourself here, page 5, para 13.


Consortia, forming at a slower pace (yes), to have more than just GPs doing commissioning?  No.  See page 4, here.  Adding professionals 'for the sake of it' is called 'tokenistic'. 


This leaves us with 'GP commissioning'.  The Prime Minister wants 'clinical commissioning'.  I'd have a small wager that when he makes his speech at Guy's Hospital later today he will change this to include nurses!  And, I'll bet there will be independent chairs and LaLa will retain the 'duty' part of his job.


Mad-Dog Monitor to have his teeth pulled?  Yes.  See here, page 9.  The duty to 'promote competition' is removed and he gets a new job to protect and promote the interests of patients and develop integrated care. 


I suspect David Bennett will realise it was his talk of 'dismembering' the NHS that created part of the problem; he'll do the decent thing, and step down.  No one will trust him.  By the way, his vice-chair has been in the news and will probably do the same.


The rest?  Any qualified provider stays, and the Deaneries, homeless, under the Bill's proposals, are still homeless; hopeless recommendation here, page 6.  A mess. 


Will the Go-Johnnies still be able to commission services from themselves?  You tell me!  Have a look here, page 32. And here page 25.  Power to scrutinise is one thing.  Power to say 'no' is another.  I think 'Lovely Jubbly' is still on the cards.


Where does this leave us?  Well, with; the DH, the Commissioning Board, some sort of 'regional commissioning board' presence, Senates, Consortia Boards, perhaps 200 of them, each with Chairs, Doctors, nurses and Uncle Tom Cobley plus Health and Wellbeing Boards and Health Watch.  All to replace SHAs and PCTs.  Pass me a Hobnob........


LaLa wanted GP commissioning and a regulated free market in healthcare.  He's got none of that.  He could say; 'that's coalition politics for you'.  He would be wrong.  The Listeners are nothing to do with the Lib-Dems.  It is the people in the NHS that have torn his Bill apart and Hair-Cut-Boy-Clegg should not try and claim the credit.


Can the NHS have confidence in this Secretary of State, or is he bust?  What do you think?


Shouldn't LaLa say; 'I want to thank the Prime Minister for his support and the Future Forum for their work.  However, this is not my Bill.  The public and the NHS were not ready for what I wanted to do; it is time for me to hand the challenge to someone else'.  In all honesty he should step down, shouldn't he?  Otherwise he will constantly be cursed with questions like; "This is not what you really wanted to do, is it?  What is your hidden plan?"


I think he will try and tough it out.


Cameron wanted an orderly retreat and he's got it.  Now, shouldn't he say; 'By listening to the NHS we can prepare for the challenges ahead.  I accept the recommendations, and recognise, to implement them, I do not need this Bill.' 


For both men to do otherwise would be a foolish act of pride, arrogance and vanity.  

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