Thank the lord for the miracle of markets and free enterprise. Dr Crippen has beaten us to it again, but this one is too important not have a rant about.
Dr Rant has been alerted to Branson Pickle by whistle-blower John Spencer. Have a good look the website, and this bit in particular.
It is abundantly clear that Virgin Healthcare see ethics and legislation as a bit of an inconvenience, and they will circumvent these irritations in every way possible in pursuit of profit. They will also use clumsy and incompetent threats of legal action along the way to bully anyone who doesn't have several billions pounds worth of funding in their back pocket.
It would seem that the bearded one is an even fatter cat than us GPs are supposed to be. He'll be making a bit more than £250,000 per year and playing a whole lot of golf if his Virgin Healthcare shower of shite get their foot wedged in the door.
It is important that both patients and staff understand this:
As a taxpaying doctor who also relies exclusively on the NHS to look after myself and my family, I'm pretty fucking pissed off off I can tell you.
Dr Rant has been alerted to Branson Pickle by whistle-blower John Spencer. Have a good look the website, and this bit in particular.
It is abundantly clear that Virgin Healthcare see ethics and legislation as a bit of an inconvenience, and they will circumvent these irritations in every way possible in pursuit of profit. They will also use clumsy and incompetent threats of legal action along the way to bully anyone who doesn't have several billions pounds worth of funding in their back pocket.
It would seem that the bearded one is an even fatter cat than us GPs are supposed to be. He'll be making a bit more than £250,000 per year and playing a whole lot of golf if his Virgin Healthcare shower of shite get their foot wedged in the door.
It is important that both patients and staff understand this:
Patients will be worse off because continuity and quality of care will fall.
The staff will be worse off because your contracts will be inferior and you will loose control over what you do and the clinical decisions you make.
The tax payer will be worse off because they will cream every penny they can out of this and IT WILL COST MORE.
Richard Branson and his daughter will be better off.
As a taxpaying doctor who also relies exclusively on the NHS to look after myself and my family, I'm pretty fucking pissed off off I can tell you.
Dr Rant
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19 comments:
They should fire the Virgin exec for incompetence. The fact he couldn't tell he was being setup by an idealistic gobshite is worrying.
Virgin will soon get out like they did with Home energy, when the profits don't add up they "leave the room"........Typical Branson...taking the money and run.........
Frank, good to have you back, hope the weather was better than we've had here.
I agree with SHH, but the risk is the goverment are so hell bent on privatising the NHS they may put the money up to make it a viable option for RB.
Looks like the beeb is doing its bit to fuck you over as well.
http://news.bbc.co.uk/1/hi/health/7475985.stm
And it looks like the Guardian is with the gov. on this. Read it very carefully - along with the comments
http://www.guardian.co.uk/commentisfree/2008/jul/03/nhs.nhs60
The Guardian is not to be trusted is it - by anyone. As well as effectively spiking the Virgin story, they're subtley (sp?) joining in on the attack on you.
I hate the bastards anyway - they pulled a comment of mine yesterday. They really really don't want people to know what's going on. Too fucking happy clappy for my taste. If they don't think about it it isn't happening.
doesn't matte who published first.
This needs max exposure
John
max exposure! max exposure! max exposure!
well said limp dick...................
Dear Dr Rant
Thank you so much for linking to my site www.branson-pickle.com (I have returned the favour)
As a whistle-blower against Virgin it is very stressful to feel the full eye of Mordor turning against me so it's good to know there are some other naughty little Hobbits out there too.
Tomorrow I am posting another covert tape recording of Josh Bayliss (Virgin's top lawyer) telling me "It will be very harmful if this gets out" and going on to say that I shouldn't take my concerns to my GP "As he can't be trusted to do the right thing".
Then, after the weekend visitors will be able to hear Will Whitehorn (CEO of Virgin Atlantic and Richard Bransons right hand man at Virgin) say "I never thought the business (Virgin Healthcare) was a good idea in the first place" and goes on to say something about Virgin's involvement in the criminal BA Cartel that is so sensitive that Josh Bayliss threatened me (in an email I will also publish) with "criminal sanctions, including imprisonment" if I published it.
No - really!
If it wasn't true do you think Virgin would let the site stay up?
THis is the commercial version of the old GP quote, "Not worth the capitation fee"
Across general practice we average out the costs of expensive/high service use against the costs of healthy young people on our books. Overall the capitation fee (global sum) works out about right.
If private providers come in and cherry pick all the young, fit patients off us, and leave us with the old, ill, multiple morbidity, high service users then general practice will stop being viable.
The fact that a potential private provider like Virgin realises this shows exactly why private providers in primary care are a divisive force, and unlikely to improve anything.
Don't get old or ill if you are on a private provider's books? For all the faults of the GP service it does at least provide population coverage.
re "it does at least provide population coverage." yea if youre happy with the worst GP in the county, and happy to have no choice of GP unless you move house, happy to wait 3 days plus weekend for an urgent appointment, happy to be kept waiting 5 hours past your appointment time to be seen, happy to be screamed at by receptionists, happy to sit next to the local big time violent drug dealers in the waiting room, happy to be turned away in agony cos you are new to the area and not yet registered
status quo is bad it has to change
you Dr Blue know that as well as i do
http://notdrrant.blogspot.com/
no one
You are right on the issues you mention. Sadly Lord Darzi's reforms will not tackle the problem.
And private providers creaming off easy (low risk) cases whilst leaving complex stuff to the state will do nothing for anyone either.
But as Atkinson and Elliot describe in Fantasy Island and The Gods that Failed, private profit and the public sector picking up the risk is par for the course for a modern economy.
As you say it cannot continue
thanks dr blue
dr blue, though I tend to agree that Darzi's reforms may not solve no one's problems (with which I sympathise, having, earlier in my life, had some similar experiences and indeed worse), I am glad to see you accept and say that no one has a genuine case.
(He does tend to get slandered somewhat on blogs.)
Also, well, a more genuine element of choice among GPs would be good; I think we can agree on that. Also good would be measures to encourage GPs to set up shop (sorry...) in deprived areas, and moreover, set up good practices there. My last London GPs, who were very good clinically and very well esteemed, had done exactly that, and good for them.
My main concern regarding the Darzi Report is that if good practice and performance is to be rewarded then those in well-to-do areas will have little work and much reward and those in inner city areas for example will have lots to do and struggle to reap the reward.
Surely this will create an even bigger divide in patient services and care. The money should go to the under doctored areas (usually inner city) so that people can have better services and more choice over GPs and avoid surgeries having Closed Lists.
Dr. Blue, why does a whistle blowing incident against one potential provider automatically condemn all private providers?
If it is a given that the private sector skim cream, what does that make all the privately employed GP's?
Because niku:
Traditional NHS General Practice is massively efficient already. Management is mostly done by the GPs who also deliver the service.
There is no room to make profit by introducing efficiency, and their 'private sector commercial expertise' can add no additional value/cost savings in a normal situation where there is a full spectrum of 'case-mix'.
Only by attracting the 'business' of fit healthy young people who don't actually need the service, or by replacing doctors with nurses and hence degrading the quality of the medical service will they profit.
What they haven't realised is that in efficiency terms, GP ain't broke. What is broke is the way in which resources are allocated to account for need and to some extent the size of the pot available. We could do a hell of a lot with the money they're prepared to gift to the private sector to artificially introduce 'competition'.
GPs have mostly resisted the temptation to skim cream.
However the patients with complex/medically ill/frequent attender/long term psychological problems/needy patients are at risk in a commercial model of NHS practice.
If we get £75 per year for looking after such people who take £200+ of GP resources then the gibe "Not worth the capitation fee/effort involved" appears in various guises.
Commercial companies will be much quicker on this than GPs are. Healthy young people making little demand on a service are perfect for them.
The complex patients mentioned above are far more prevalent in poorer areas of towns. Sadly the GMS contract makes no extra allowance for difficult high need/high demand patients so working in poorer areas is a harder way to earn your money than working in posher suburbs.
Ultimately in economic terms man is a rational animal who responds rationally to incentives. (I'm borrowing this idea from John Kay's book "the Truth about Markets")Not always, and not always immediately but over time the activity of a system tends to come into alignment with the predominant incentives provided.
The NHS is currently providing the wrong incentives, for the wrong things, based on false reasons. The marketisation of health care actually makes all this worse.
Try A J Cronin's "The Citadel" and see the difference in what is done between Welsh Valleys GPs and a rich West London GP who panders to neurotics, and doubles his fees, to double the effectiveness of his reassurances!
"It is abundantly clear that Virgin Healthcare see ethics and legislation as a bit of an inconvenience, and they will circumvent these irritations in every way possible in pursuit of profit."
Quite so, Dr. This is why one should never appeal to ethics to get good service from a company, but it's profit line.
*sigh*
The government apparently has ethics and look where that's got us.
DK
Appealing to ethics for a good service (in the sense of 'what is the best care', rather than 'what I want') = professionalism.
Appealing to the bottom line in health care = suicide.
Good care costs more money that bad care and 'consumers' rarely know which is which.
If DK can describe a system in which 'consumers' can obtain good care from a profit-driven non-ethical system, then I am all ears.
Of course, if you just want somewhere with nice decor to 'drop in when you feel a bit iffy' on your way home from work, then that's a different story.
Sigh. Health care for the sick and consumer worried-well are two completely different things.
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