The Cardigan Diaries (5th March, 2007): Central credit and local blame

So much has happened this week. Best and worst sort of times. Picture emerging far from clear, but looks like the dogs of war have been unleashed.

DH and PH taken several hits, but the department too hitting back at its least favourite people (currently GPs) As the Chinese minister in about 1949 once commented, “Hmm, the French Revolution: it’s a bit too early yet to know its full effects”

Bad news first for Patsy Hewitt. After the Liam Halligan interview in Dispatches(you tube available on dr crippen) she now has this from her top managers (the ones who are supposed to be on her side implementing her policy)

“Hewitt is a disaster, she keeps tweaking things, she's got no idea of the bigger picture, she's indecisive. She's an utter disaster for the NHS,' argues one chief executive of an acute foundation trust in the North.

A Southern-based chief executive puts it even more bluntly: “She doesn't know her arse from her elbow.”

A Midlands-based chief executive also hits out at what they see as Ms Hewitt's insincerity. 'She does not come across as sincere. She sounds condescending and won't admit to her mistakes.'

Makes the doctors sound quite moderate Go on Sign the petition- you know it makes sense

Meanwhile more bad news for the NHS. Patricia Hewitt boldly said “Waste and inefficiency in the NHS is intolerable” Meanwhile, on Tony’s orders, she allows Richard Granger (qv )and his consultancy chums to piss £12.4 billion into the wind. Private Eye run a superb supplement in their current issue (No 1179 ) “System Failure!”
£12.4 billion could pay for:-
26,000 real medical doctors for 10 years
65,000 nurses for 10 years
and maybe a few midwives as well
The NHS deficit for 2006-2006 23 times over
Every hospital built since 1997 three times
over200 years of the “currently too expensive” drugs for Altzheimer’s disease
500,000 courses of herceptin for breast cancer
Reversing 20 years of planned cuts in the social care budget?
All these could be bought instead of the Government’s NHShITe . However choices have to be made as we’ve seen before and if it’s a choice between enriching consultancies or serving patients, it’s no contest under this mendacious government.
The full extent of Labour’s NHS cuts are coming home to roost. Their Sketch writer sums it up nicely, particularly this quote,

“Meanwhile, Mr Milburn was employed as a perfectly normal Labour health secretary, where his duties took in the whole gamut of modern medicine, from closing beds to wasting billions on PFI schemes.”

However that nice Mr Nicholson has suggested that the “temporary local difficulties” caused by closing hospitals can be sorted by better local consultation and some honeyed words such as, ‘adapting’, ‘developing’, ‘evolving’ or ‘specialising’. So much better than closure, cutback, downgrades, housing redevelopment or any of the other words that ill informed local media might use about the changes. The result will be the same and Michael Mandelstam’s excellent book explains why. There truly is no local accountability in the NHS and Primary Care Trust bosses are responsible directly to the SOS herself. As the Rev Dr Green might say, “The wages of spin are death.”

These bosses in both hospital and primary care trusts are not enjoying their experiences at all. Central credit and local blame is beginning to rebound on the DH and this week’s HSJ shows just how fed up the bosses are.

And more bad news from the NHS. Just as the management start talking up the role of “clinician engagement” they decide not to pay us. Minimal or no pay rise across all health service workers this year and an effective pay cut (negative income growth) on GPs.
So nice to know just how valued the workers are at NHS central.

The HSJ’s editorial “The sense of fin de siËcle disintegration that former Department of Health human resources director Andrew Foster first put a name to in an HSJ interview almost a year ago is clearly now widespread.” is probably the best summary of this week’s medical news.

Murdering medical careers, making medicine crap, medicine mangaged by C***s, has attracted llots of attention here and at Dr Crippen's site. The RCGP has done better for would be GPs with this system than other specialities have done for their trainees. Apparently the college has runs trials of the system, and validated their selection procedures. The knowledge test and the person specification are apparently reliably described.

Tomorrows meeting of the Academy of Medical Royal Colleges should be an absolute corker, as if these massively senior doctors (Royal College Chairs and Presidents)decide against MMC then doctors truly will be revolting.

We still have the Medical Regulation white paper to review which we’ll do next week- It’s not as bad as it looks.

Meanwhile this week I've been to the Local Medical Commiittee, RCGP council meeting, and done 4 interviews for a new partner. Oh, and seen the patients as well.

Julian Tudor-Hart had an eightieth birthday celebration at Glasgow University and sadly I didn't have energy left to get up for it.

Dr Cardigan wishs him a very happy birthday. He also heartily recommends his latest book.