Wednesday, January 09, 2008

The Commissar Just Doesn't Get It

The future of healthcare

Today's Grauniad carries an interview with Health Commissar Rockin' Al.

First off, he's already back pedalling furiously on that NHS constitution. Just last week Bottler proclaimed there would be a new constitution spelling out patient rights and responsibilities, a pledge repeated in his "major NHS speech" on Monday. But he clearly never told Al, who today says:

"I don't want the constitution to give lots of work for the lawyers so that the NHS spends more time in court and less on treating people."

Translation: this is a pretend constitution that will confer no bankable rights whatsoever.

Second, despite all the talk about empowering professionals, Al's going to ban GPs prescribing antibiotics. Apparently the reason that NHS hospitals have become plague pits is down to GPs, who hand out antibiotics like sweeties. They need to stand up to "pushy parents", and refuse antibiotics for worried nearly-well kids:

"GPs prescribing above average amounts could expect to be visited by antimicrobial pharmacists, who would give advice on prescription policy".

As readers will know, the feared Antimicrobacterial Pharmacist Squad is a shadowy organisation that likes to operate under the cover of darkness. Backsliding GPs can expect the 5am knock on the door.

Third, Al laid into Bottler's health goat, Lord Darzi, who reports direct to the Fuhrer, and is beavering away on yet another "NHS Masterplan". Al's not impressed:

"We don't have a goat problem in this department. Our goat is tethered."

Translation: I haven't the faintest interest in anything this alien quadruped might come up with.

The quadruped is apparently working on the basis of "centralise where necessary and localise where possible". Which bears an uncanny resemblence to Bottler's old mentor's ideology: "the market where possible, government where necessary". And just as John Smith had that wrong, so Bottler has this wrong.

The point about both markets and localism is not that they provide choice as a nice-to-have bolt on extra. It's not that choice can only be provided if it doesn't cut across Whitehall-knows-best "national priorities".

The central point about choice is that it drives perfomance. It's not some kind of output, but a key input.

Does Al understand that?

Was that a quadruped I just saw fly past the window?