TURKEYS VOTING FOR CHRISTMAS

By Chris Johnstone
Contact the author by e-mail at christopher.johnstone@ntlworld.com

So April has come and gone. I have spent the last three months in a post-QOF dwam. Now July is here and we have to start checking BPs again and the whole sorry cycle kicks off again. Already cash-strapped Health Boards and CHPs are eyeing up our riches and looking at ways of divesting us of our hard earned money. General Practice has become a much more attractive prospect since April. Managers may be irate at the amount we have upset their budgets. An article in the Health Service Journal for managers, spoke of GPs ‘winning points’ rather than earning them. The whole tone was one of GPs being given money for nothing. Now this may be difficult if you are a senior manager and your GPs have just added another £3million to your burgeoning overdraft, but if you are a rapacious private healthcare firm, you may look at it rather differently.

Some people believe that primary care is being fattened up for Christmas. No-one would buy a skinny piece of poultry for the big meal. Who wants a scurvy ridden, scrofulous bird? You want a great big, bloated turkey that can hardly move under its own weight, one that only just fits in the oven with three people pushing and whose bones you will be picking over well into early March. So it is with General Practice. If the government intends to sell us off, we have to be attractive. You don’t want a scrawny GP in your shop window.

In many ways we are lucky in Scotland, all the radical thinking is going on down south. Rampant PCTs, egged on by ther political masters, are explorings ways to divide up the primary care spoils. As single-handed positions become vacant, they are being handed over to healthcare firms to manage, employing salaried GPs and nurses by remote management. PCTs are being encouraged to eduacte present GPs who have done’poorly’ in the QOF, whether by choice or ineptitude. Those ‘failing’ a second time round may be ‘displaced from their practices’ and replaced by salaried doctors employed by the PCT or the same private healthcare firms running vacant practices.

But this gentle accretion of practices is too slow for this market obsessed government. New money for primary care has been released, but a large percentage of the money may only be spent on private healthcare, outwith the NHS. The government is actually setting targets for how much money must be spent on private healthcare. So even if the care is worse or more expensive, the money must be spent. This is truly Big Brother, excessive top down management and social engineering all rolled into one. If you were a private company bidding for GPs’ money, wouldn’t it be a lot easier if you owned the practice. It would make the bidding and pricing of services a lot easier. I am not making this up, this is happening in England as I type.

“Aah, but it could not happen here in Scotland,” I hear you say. On page 16 Rob Hendry describes the privatisation of dentistry by the back door. It has happened to dentists, it could happen to us. Would a Scottish Parliament, which is more Old Labour than New, let Tony and his cronies step on their hard-earned indepedence to manage their own health system? Well it might if it’s time in charge was discredited.

Already we are reading about how much better things are down south. Waiting times have been slashed and all the pundits and opposition are asking how is it possible for the English to have sorted out A+E and cancer investigations and waiting times and now we have a”worse service”. “Targets have proven to be effective and The Scottish NHS is failing” scream the headlines. This “evidence”will be used to either take health away from the Scottish Parliament or force the Scottish Executive to change its policy and open up Scottish primary care to market forces.

The fact that the English have had an extra 2% added to thier budget above the 6% that has been given to all of the UK will be ignored. The fact that we have free personal care, which has eaten into the health budget, will be ignored. This government has undermined the democartic will of the people by slanting the way it funds healthcare. It has introduced social and healthchanges without consulting the voters. There was no mention of any of these changes in the run up to the election, but as soon as the result was announced measures to privatise general practice were announced under the guise of increasing patient choice. This government knows it only has one term to go, it is now pushing through radical changes fasterthan we can blink. Enjoy your your QOF money. We have earned our harvest, but beware of what else we are reaping.

Other hoolet online articles by Chris Johnstone can be found at:
hoolet edition 51 - Enough And No More
hoolet edition 50 - Now We Are 50
hoolet edition 49 - The Policy Palsy
hoolet edition 48 - The Last Waltz
hoolet edition 47 - The Old New Contract
hoolet edition 46 - Teaching to the Converted
hoolet edition 45 - Turkeys Voting For Christmas
hoolet edition 44 - That's a nasty QOF
hoolet edition 43 - Calm Down, Calm Down, It's only the NHS
hoolet edition 42 - Perpetually Fooled Initiative
hoolet edition 41 - Crisis? What Crisis?
hoolet edition 40 - Doing What You Are Told
hoolet edition 39 - A History of hoolets
hoolet edition 38 - Where did it all go wrong?
hoolet edition 37 - Commodificationalising the NHS
hoolet edition 36 - The Cost of Everything and the Value of Nothing
hoolet edition 35 - Much Too Much, Much Too Soon
hoolet edition 34 - What Shall It Profit a Government?
hoolet edition 33 - A Long Career in Applied Cynicism
hoolet edition 32 - My Greatest Pleasure
hoolet edition 31 - Goodbye to the NHS
hoolet edition 30 - The National Health Service is Sorry
hoolet edition 29 - MMR More Media Rubbish
hoolet edition 28 - A Life of Pleasure
hoolet edition 27 - Barricade medicine

Other hoolet reviews by Chris Johnstone:
Bad Medicine
Armed Madhouse
The Bullet Trick
The Medical Detective
Plundering the Public Sector

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.