Monday, 17 January 2011
The White Paper - dangerous rubbish
The White Paper chitter chatter is high on the news agenda this week, the full version is due to be unleashed in a couple of days time and apparently it is not rain forest friendly as regards its paper consumption. That tells its own story, this latest 'reform', 'modernisation', 'shit storm', call it what you will, is extremely complex and it is not going to be light in the bureaucratic department.
It is yet more rapid change, and this comes with the inevitable reform fatigue, combined with an immense amount of money wasted on the new bureaucracy (reportedly in excess of 3 billion). It also puts a hell of a lot of money in the hands of Primary Care, Secondary Care is at its mercy and this is where the danger lies. Do not believe all the talk about better outcomes, this is just the smokescreen for the mass privatisation that is being ushered in undemocratically.
Competition does not necessarily drive progress. In fact as regards Secondary Care and hospitals, competition can be catastrophic. Hospitals function best as integrated services consisted of all the bits working effectively in cooperation with each other. As soon as private firms are allowed to cherry pick the easy bits of work, something that will be ensured by the new regulatory framework, then certain hospital services will be starved of cash and will be shut. We only have to look to the USA to see that competition and choice are far from the Utopian solution that certain politicians and academics would have us believe.
The end result will be the crumbling of our hospitals. An Accident and Emergency department cannot survive when a hospital loses its Obstetric cover, its Orthopaedic cover or its General Surgical cover. This is all fine for a patient who wants an elective hernia operation or an elective joint replacement, the problem comes when one has a life threatening infection, or a hip fracture, or an appendicitis, then you just want a good safe local service and if that is threatened, we are in very sticky waters indeed.