Saturday 8 June 2013

Politics. hypocrisy and wasted money



‘Monitor’, the new Health service Regulator, is going to investigate the spate of closures of NHS Walk in Centres up and down the country. This has been going on since 2011 and was first noticed by ‘Pulse Today’ a website for G.P.’s which I’m finding more and more useful.

According to ‘Pulse’ back in 2011, Primary Care Trusts were paying out large but undisclosed amounts of compensation to the private health care providers who operated these centres so that the contracts could be terminated early:

“Of 68 PCTs to provide information to Pulse on the contractual status of their Darzi centre, more than one in eight (13%) have either terminated their contract or are planning to imminently, with many others renegotiating deals for financial reasons.”

The site went on to list PCT’s which were ending contracts in their areas;

PCTs which have terminated or plan to terminate Darzi centre contracts:

1.      Stockport

2.      Plymouth

3.      Barnsley

4.      Heywood, Middleton and Rochdale

5.      Calderdale

6.      Northamptonshire

7.      Salford

8.      Sandwell

9.      Peterborough

In fact it’s a sorry tale, a mixture of politics, hypocrisy and wasted money. It's about a government closing down what the previous government created.
Lord Darzi was a surgeon and advisor to the Blair Labour Government, who recommended in a report 'Our NHS, our future', published on 4 October 2007, that G.P’s services should be shaken up. As a result there was a chorus of condemnation from Doctor’s, which has continued until today.

The result was to;

• establish at least 100 new GP practices into the 25% of PCTs with poorest provision, and

• develop 152 GP-led health centres (one in each PCT) in easily accessible locations, offering a range of services - including pre-bookable appointments, walk-in and other services, where registered and non-registered patients can access a GP between 8am-8pm seven days a week.

And that looks pretty good to me – a lot of people at the time (and now) wait 2 weeks for an appointment, usually with someone who isn’t their Doctor, at a time that isn’t that helpful for them. The walk in centres also had accessible nurses – very helpful for many minor problems.

The problem was that as Lord Darzi was a successful private health entrepreneur, he envisaged that these would be run by private, for profit operators, and they were. Firms like Master call, Virgin, Primecare, Malling Health, Care UK all jumped on the gravy train. So, Primary Heathcare Trusts were forced to pay for them, using money they didn’t want to spend and that money was lost to the NHS.

The Doctors who protested so loudly were concerned that they would lose patients (money) to the new, convenient providers. Whenever possible they highlighted the cost and ‘low’ take up by patients, although my local walk in centre is packed out.

The thing is all our G.P. practises are also private, for profit operations, paid for by the state, just like all the other providers. They just happen to be run by Doctors. So this was never a privatisation – this level of healthcare always was private – which is half the problem.

The response of Monitor is not just due to a concern for patient choice – it’s being leant on by some powerful lobbyists. These are quotes from ‘Pulse Today’ (31/5/13);

“Catherine Davies, executive director of co-operation and competition at Monitor, said: ‘It is in the interests of patients to find out why walk-in centres are closing and whether the closures are affecting patient choice and competition.

‘Walk-in centres are very popular with patients and the potential impact of such closures at a local and national level needs to be better understood.’

NHS Partners Network chief executive David Worskett - which represents private providers in the NHS - welcomed the review.

He said: ‘This is something we have been calling for since the start of this year. We have become increasingly concerned that in some areas, walk-in centres are being closed or are under threat of closure even though they may be providing valuable access to primary care at times of day, or for groups of people, for whom the much more restricted opening times of conventional GP practices are too inflexible.’”

‘NHS Partners Network’ may be a bit anonymous but it represents a bunch of powerful organisations on the hunt for big profits. There are some other big lobbyists too – the Government has been moaning as have consultants about how many people just turn up at Accident and Emergency. The Walk in centres were designed to stop that.

However, Monitor is going to have to be quick - now our current conservative government has reorganised the health service again, the PCT’s have been abolished and replaced with CCG’s, those are G.P. led procurement agencies. Unfortunately that isn’t nice old Dr Finlay of Tanachbrae. This is something I highlighted on my old Blog when the CCG’s took over on 1st April:

“The British Medical Journal has done some important work – shortly, ‘buying’ healthcare for NHS patients is going to be the job of G.P’s Commissioning Groups, as if this were actually some kind of a market.

Except that, according to the BMJ, 36% of those G.P’s running the groups have directly conflicting commercial interests – that is, they run companies or businesses supplying healthcare services or products – like out of hours Doctors services.

They aren’t allowed to vote on decisions to purchase their services or goods, but they can speak during the debates and are there to influence the others.

C.O.R.R.U.P.T. spells corrupt in my book.

It also creates two tiers of Doctors.

Rich and poor.”

Check it out on:
helpmesortoutstpeters.blogspot.com
 
The future of the Walk in centres as a whole is looking pretty bleak now – the CCG’s are not their friends. At least 40 have already closed, the rest will probably be going soon. Add up the cost of it all – the building costs we paid for all these centres, the recruitment of nurses and doctors, the redundancy payments, the compensation for early termination of the contracts – all wasted money.

And by the time the G.P’s have shut them all down, the NHS will be looking to open something else to take the pressure off the A and E’s.

And the G.P’s will be moaning about how busy they are.

I probably should have a series of articles about how horrible patients are soon – just to balance things up a bit.

 

Neil Harris

(a don’t stop till you drop production)
helpmesortoutthenhs.blogspot.com

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