[OccupySheffield] Andrew Lansley's thoughts on competition

[David Kirkham]

Hi Some feedback from Sheffield Save our NHS on Andrew Lansley's view on competition in the NHS, interesting information on Clinical Commissioning Groups.




David 
 
Occupy

  


From: To: sheffield.uncut at hotmail.co.uk;Subject: Fw: Andrew Lansley's thoughts on competition + some info on CCGs and information about Rotherham GPs role in commissioning
Date: Wed, 15 Feb 2012 17:34:32 +0000










The e-petition to Drop the Bill now (Wed pm) 
has over 140,000 signatures - more than doubled since Sunday thanks to 38 
degrees. Unfortunately 
parliamentary opposition to the Bill seems to be focusing more on getting 
rid of the competition elements. 
 
Lansley: Perhaps as a last 
ditch defense Andrew Lansley has written an article for Health Service 
Journal celebrating the role of competition.  I attach a copy but 
you don't have to open it!!  There are several extraordinary features - his 
belief that healthcare is all about new treatments and technologies; his 
assertion that other major countries are now seeing how essential it is to 
have comprehensive healthcare provision such as that provided by the NHS in 
order to maintain productivity and boost growth; and that the only way to get 
these treatments and technologies to the right patients is to reject centrally 
planned delivery (which he believes can only be based on past performance) and 
to create more informed and more demanding 
patients and health professionals who will agitate for these new treatments and 
technologies to be made available.  These "thousands of individual 
decisions to adopt a new technology – from, say, cassettes to compact discs to 
mp3 players – will combine to sweep away less effective services.  
And 
this individual creativity and innovation is best supported by 
competition."
 
The 
man is dangerously delusional. He has no understanding of people and 
care. He can't seem to make up his mind about whether the NHS is a major 
problem (his reason for the Bill) or something to be emulated.  There 
is no way such a system could work. Is healthcare really analagous to 
recorded music?  And what would happen when we got to the healthcare 
equivalent of HMV and EMI failures - not to mention the healthcare equivalents 
of piracy. 
 
Somebody 
on the website commends his analysis of problems: technology, ageing population, multiple pathologies, the 
need to shift towards a less hospital=-based model of care; but then 
says "You want to pick the guy up and shake 
him. His analysis of the solution is so facile, inept, one-dimensional and 
downright ignorant, I could scream. I could go on for hours, but let's pick just 
two: - his idea that central planning always equals service delivery based on 
past patterns of service.Codswallop. Tripe. Balderdash. I've worked in the NHS 
long enough to see massive reshaping and improvement in the delivery opf 
services in a whole shedful of areas (cancer springs immediately to mind). 
Centrally driven and led, with local engagement. - the idae that millions of 
individual market exchanges between patients and Drs drives big technological 
and service change is equal twaddle. Let's not forget the enormous percentage of 
patients who access services as emergency and unplanned admissions. The idea of 
competition being the driver there is bunk.  I could go on, but I won't. 
The man's bright but he's inept and arrogant and has spent too much time talking 
and not enough time listening properly."
 
CCGs: The Department of Health has 
published spending estimates for future Clinical Commissioning Groups.  The 
largest is for Peterborough and Cambridgeshire (Lansley's patch) but this does 
cover 2 previous PCTs.  Sheffield is also one of the largest. There are one 
or two tiny ones where particular practices or consortia are still insisting on 
going it alone.  There are currently 244 prospective CCGs, down from 335 a 
year ago.  One anonymous commentator writes "I'm designing a database of CCGs (not very interesting I know, long 
story) and it's remarkable how many have the same geography as the PCT. There 
are a few pockets across the country that look different, but many of these seem 
to be merging. Given the last 19 months, what an UNBELIEVABLE waste of time this 
has all been...."
 
Another offers an interesting slant: 

  "Two to three years ago GPs were complaining that 
  the bureacrats at the PCTs were stifling Pratice based commissioning and not 
  letting them implement their interesting little scheme which wouldn't save any 
  money but would improve the quality of care.  Eighteen months ago GPs 
  were saying great now we have control we can sack all these bureacrats and we 
  can implement as many of these little schemes as we want.  Six months ago 
  GPs were suddenly realised life was more complicated that they thought and 
  realised that they needed these bureacrats to help them implement their 
  schemes.  Now GPs are staring down the the double barrels of the shot gun 
  which is increasing demand and no additional resources. They are also 
  realising that the bureaucrats that used to protect them from such realities 
  are no longer doing so and that they have to make some big decisions. So they 
  are either walking away or clustering together into what looked like the good 
  old PCTs.

If there is anything good that has come out of this last 15 
  months it is that more GPs now realise that
a. Commissioning is hard
b. 
  Big savings have to be made and that means big changes
c. Their behavior is 
  a major contributor to both the problems and the solutions. 

What we 
  need to do now is scrap this bill and start again with another one that puts 
  hospital consultants in charge. If they can go through the same learning 
  process we may end up with a system that works"
Finally Rotherham PCT are now making available details 
of how Rotherham GPs are involved in commissioning 

at   http://www.rotherham.nhs.uk/about/board/clinicians-in-commissioning.htm and associated links.  It's not much different in 
structure from Sheffield but anyone from Rotherham might be interested in who is 
involved.
 
  		 	   		   		 	   		  
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