Saturday, 6 October 2007

The interim report


The interim report Our NHS Our Future by Prof Darzi can be read at the DoH website here, as always many pages are taken to say very little of any concrete meaning. In fact Prof Darzi thinks it is groundbreaking to say that the NHS should be 'fair, personalised, effective, and safe'.

His summary is amazingly meaningless, would anyone imagine that Prof Darzi would say that the NHS should be 'unfair, ineffective, and dangerous'? Of course not, despite the fact that the government reforms are creating a dangerous, ineffective, wasteful and totalitarian service. The motives behind Darzi's report are obvious as he strongly hints at reconfiguration and more privatisation via the disingenuous patient choice propaganda. It seems that he is avoiding the reconfiguration of acute care for now as that would be a killer for Gordon Brown with the election only just around the corner.

Darzi is a disgrace to the medical profession as he pretends that his 'review' has been widely consulted with the medical profession in his terms of reference:

"Working with NHS staff to ensure that clinical decision-making is at the heart of the future of the NHS and the pattern of service delivery"

The review document is full of the same old New Labour propaganda too, ignoring some shocking health outcomes in the UK such as cancer mortality and maternal mortality, and then whitewashing over how good the New Labour reforms have been for us all. He blows the trumpet of the private sector:

"Independent sector providers have also helped extend choice, add capacity and spur innovation. They have increasingly become a fixture of NHS provision, with three-quarters of a million NHS patient care episodes performed by the independent sector to date."

In fact this is a massive stretch of reality. The independent sector has helped waste a lot of money doing very little work indeed, it has undermined good local services that patients want to choose, however the 'patient choice' agenda has forced patients to choose things that they simply don't want.

Darzi ridiculously talks about patients feeling like numbers and not people, and fails to link this with our Stalinist government policy in the form of Choose and Book. Patients want to be treated at a good local hospital and not treated like a stupid piece of meat by a patronising over controlling government that forces numerous top down policies on them like Choose and Book.

Darzi next turns his attention to health inequalities, and demonstrated well that is rather foolish to let a bum surgeon loose on something so far away from his area of expertise. Public health doctors must be livid with the drivel that he produces in this chapter, even I can appreciate that there is a lot more to reducing health inequalities than NHS policy, this massive area encompasses the whole of government policy and must be tackled in an over arching manner. I fail to see how privatising primary care will reduce health inequalities.

"have asked the Government’s Chief Medical Officer, Professor Sir Liam Donaldson, to develop a standard quality framework and proposals for systematic measurement against this framework. I have asked Professor Sir Bruce Keogh, the NHS Medical Director, to advise on how best to implement it within the NHS."

How worrying is this, yet more targets and frameworks produced by political stooges, will they ever learn? So much money is being pumped into more quangos, more regulation and more reform. When will the reformed realise that they are part of the problem?

His next topic of ignorance is Hospital Acquired Infection, amazingly he does not even mention the problem of falling bed numbers and a lack of rooms to isolate MRSA positive patients. He simply mentions the standard gimmicks that the government has already talked of, and throws in the idea of punishing hospitals that do badly. The understanding of this issue is utterly pathetic and when the government is already driving some hospital trusts into the red as it is, how will it help to fine the struggling ones when they cannot afford to deal with these serious health issues?

Darzi also throws his hat into the MTAS and MMC ring:

"Despite the highly publicised problems with the Medical Training Application Service (MTAS) recruitment system, I believe that the principles of the Modernising Medical Careers (MMC) programme developed with the professional bodies and regulators are sound. It is the implementation that has fallen so far short."

My God, words fail me; maybe Prof Darzi thinks that the principles of communism are sound, it is just the implementation of communism that is the problem. A valid parallel to draw I feel. The disturbing talk of an 'NHS constitution' was more than a little scary:

"In my terms of reference, the Prime Minister and the Secretary of State said that, at the end of the Review, a decision will be taken on whether there is a case for an NHS Constitution, as part of a new and enduring settlement for the NHS as it approaches its 60th birthday. The objective would be to enshrine the values of the NHS and increase local accountability to patients and public."

What on earth is the point of yet another group of committee types getting together to produce yet more glossy paperwork that will be used to back up government reform. The NHS was actually founded on the principles of 'free care, care available to all and uniform quality'. It seems that Darzi is adding nothing to this, but trying to modify them so that more reform and privatisation can be illogically justified. He finished of his limp document with more talk of how easy it is to get involved, strange how it has proved the very opposite so far.

So the summary of Prof Darzi's glossy document? It is clear that we have a man who is not suitably qualified to be reviewing the whole NHS, even if he did it with proper consultation and over a decent amount of time. Unfortunately his review is only consulting small number of people that have been hand manipulated by the government, experts on health care and health policy are ignored, while government friendly compliants are used as evidence of how popular primary care privatisation, polyclinics and reconfiguration will be. His top down reform is calling for more regulation, more Quangos, more punishment for the cash strapped failing trusts and more glossy paperwork to be produced to overwhelm the growing army who are discontent with this agenda of systematic NHS destruction.

The majority of us just want good local services, that are not driven into the ground by the inefficient internal market. We are happy with our good local GP service and do not want tacky impersonal privatised polyclinics. Unfortunately for the majority of us who want a good local un-privatised services, we will not be consulted or listened to by Darzi et al, they want to continue dishonestly privatising the NHS and this sham interim report is yet more proof of their corrupt motives.

1 comment:

Dr Ray said...

Well written.
Its good to see some original output; everyone just seems to be copying everyone else at the moment. I was looking forward to commenting on this report myself but, as far as I could see, he didn't say anything. I suppose the poor schmuck hadn't written his report when he was suddenly asked to present it a week early so he just recycled so old government propaganda or just put his signature to something "they had prepared earlier"
Shame on him. He doesn't have the confidence of the profession and Joe Public have never heard of him.
Still it is very satisfyingly going horribly wrong for the bunch of scheming bar stewards. Both Darzi and Brown look like they are sinking in a pool of shite of their own making.