‘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
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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