Sir Gerry Robinson gets his diagnosis right.

Sir Gerry Robinson was well worth watching last week (this would have been sooner but Dr Rant’s internet access played up recently). You can watch it by clicking here. His diagnosis was straight and accurate.

It looked like Rotherham DGH had more or less got its house in order. However it was now about to be destabilised by external policies driven “by dogmatists not pragmatists”

Sir Gerry rightly picked up on the contradiction between “care closer to home” and the need to collect expensive kit and skills in one centre. He also rightly picked up that a DGH is a major part of its local community. The government’s current policy to break up and destroy DGHs is clearly misdirected. Indeed a lot of the government’s drive is to concentrate the most severe cases in very specialised centres serving large populations, is a response to the need to keep expensive kit and specialised staff in one place.

Yes some stuff could move to primary care settings, but actually a closer integration of primary care and secondary care would be of greater benefit to patients. The present move to pit primary care commissioners against secondary care providers is crazy, will increase management time and drive a greater wedge of fear and bureaucracy between the two sectors. Meanwhile patients are moved between the two sectors ever more quickly, but information moves ever so slowly. A letter, or discharge summary, from Rantingshire DGH and The Ranting Shack Surgery can take over 4 weeks to cover 4 miles.

The failure of NPunFIT for anything to even think about bridging this communication gap is huge. It is a top down system, drawn up without good local input, and not to meet local needs and specifications. For the cost of £20 billion we still do not have quick reliable communication between GPs and Hospitals. The Newsnight discussion between Sir Gerry and Sir David Nicholson (NHS Chief Pointy Haired Boss) was classic,

“Surely you must admit that the NHS computer project can only be described as a complete shambles?”

Sir David of course could not admit any such thing, but insiders say CfH will be dropped as soon as it can be passed off as a strategic masterstroke, and not an admission of failure. Meanwhile the cost of 60,000 staff nurses for 10 years is pissed away down a government black hole and as Sir Gerry remarked:

“no one will be held accountable for this.”

Sir Gerry made the Primary Care Trust Chief Exec look a little silly. The site of the new “polyclinic” was displayed proudly. A new £12million building was going up to provide care to people who feel “a bit iffy in their lunch hour.” The medicine would be provided by nurses, and it wasn’t clear who needed this, or why provision was being made for them. But it’s bang in line with government policy so we can summarise current government health policy as, “iffy medicine, by iffy practitioners, for iffy reasons.”

Dogmatism trumps pragmatism any day, and meanwhile really sick people are looked after in run down GP premises (which are currently starved of funds) and a DGH threatened with instability, and the creaming off of easy cases by various private providers, and being left with less money, and all the harder, more complex cases.

The government is simply running the NHS in a way that can only be bad for patient care. And that will squander ever more money on anything other than what will get the right patient to the right treatment.