Wednesday, March 26, 2008

Slightly Adulterated Naked Greed

Talks a lot of sense that Pa Broon

This afternoon the Public Accounts Committee grilled NHS Chief Exec David Nicholson about the GPs' pay deal (watch again here).

Whether it was President Sarko's imminent arrival to speak in Parliament, or whether it was general incompetence fatigue, PAC members were strangely muted. It was left to Glaswegian Labour MP Ian Davidson (reportedly the Pa Broon of Labour politics) to lift the mood by asking Nicholson if the GPs huge pay rise was not "a manifestation of sheer unadulterated naked greed"? When Nicholson said no, Pa quipped that it must be only "slightly adulterated naked greed". Ho-ho.

The facts are well known to BOM readers (eg see this blog, and this), so here's the picturebook recap from the National Audit Office report discussed this afternoon:

1. The GPs pay deal has ramped costs, with total expenditure virtually doubling between 2001-02 and 2005-06:

2. The pay deal cost £1.76 bn more than planned...

(Actually, this afternoon Nicholson claimed it was only £400m more, but that was because they'd since discovered they were were already spending £1.4bn pa more than they'd actually realised... er... )

3. The average pay of GP partners increased by 58% in the three years to 2005-06 to well over £100,000 pa. But the increases they passed onto their staff- like salaried GPs and nurses- were much less (which is what caused Pa's outburst)

4. GPs' productivity has slumped. We all know about the loss of Saturday morning surgeries and the traditional Out-of-Hours service, but looking more broadly, the ONS estimates productivity is down by 4% (ex their highly dubious "quality adjustment"):

Pa wanted to blame the GPs for all this- their lack of "public service ethos".

We disagree. As we've said before, this whole mess is down to bungling by the Department of Health: they gave away the store to people who were quite reasonably pursuing their own interests. Plus, of course - as the chart shows - the GPs have actually performed pretty well compared to the rest of the NHS, where overall productivity is down a massive 8%, even after taking account of an extraordinarily flaky "quality adjustment".

This afternoon, Nicholson and his wingmen tried to explain it all away by arguing that this "ground-breaking" contract, along with its Quality and Outcomes Framework, has opened doors firmly shut since 1948: the NHS now has a once in a lifetime "opportunity to take it forward".

We're not holding our breath.

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