A little snapshot for you this week. It will give you a foretaste of how life will be in the new improved NHS, following the forthcoming injection of expertise and altruism from the private sector.
I’m sitting at a radiology PACS workstation, doing my locum session of plain film reporting which, post retirement, provides my pocket money - just enough to cover the odd pint of stout and my class A drugs. This is in the nuclear medicine department and in the background I can hear a colleague quietly tearing his hair out.
The PET/CT scanner has broken down for the umpteenth time in the past couple of months, and he’s trying to get someone to take the recurrent problem seriously. They are frantically trying to get it going again, while at the same time dealing with the anxieties of patients who have already been injected with radiopharmaceutical and who will probably not now get their scan. One of those patients has already been re-booked once, because his blood sugar was too high the first time round. Another patient has informed my colleague that he is a close acquaintance of the editor of one of the national broadsheets, and will be contacting his chum concerning his experiences at the trust’s hands.
He, the patient, will not have appreciated the background to the PET/CT service. Although the scanner is located in an NHS department, it is a cuckoo in the nest. The national PET/CT procurement programme was instituted by the previous government, and, as good socialists, they insisted that the new nationwide service must be provided by the private sector. So, contracts were awarded, and our chosen provider asked the radiologists to assess the equipment available and decide which was the best scanner. They did this, and the company concerned then purchased a cheaper one which, needless to say had not been at, or near, the top of the radiologists’ list.
The contract has now been running for three years or so, and an enormous amount of NHS staff time has been spent trouble-shooting the service in various ways, not least in picking up the pieces when the scanner breaks down and dealing with issues around the booking of scans. The apparent belief of both major parties that the private sector is more efficient than the public would not survive long if they spent some time in NHS departments like this one.
Of course, I can’t say with any certainty that if the radiologists had been provided with the scanner they wanted, it would have broken down less frequently. I would simply observe that with expensive medical equipment, as with most things, you get what you pay for. What I do know is that if the Labour government had just given us the money to buy the scanner and run it ourselves instead of throwing cash into a contract which appears to contain no enforceable quality criteria, we could have had a better service. But of course, the capital outlay for equipment would have impacted on Gordon Brown’s bottom line, whereas the eventually much larger revenue costs of buying the service from the private sector can be hidden. Just like PF bloody I.
And if our disgruntled patient goes to the press, as promised, it will be the trust and the NHS in general which is pilloried in the headlines, with tales of cancer patients denied a timely diagnosis and treatment. I wouldn’t even be surprised if the story used the perceived shortcomings of the PET/CT service to reinforce the case for NHS ‘reform’.
But of course, all that Andrew Lansley’s Health Act will do is to potentially reproduce this unhappy scenario by increasing the number of private concerns taking on NHS work. Providers with an eye to the main chance will be queuing up with the cheapest kit and the smallest number of staff with the minimum qualifications necessary to run their service, and no doubt relying on the NHS to cover up for their corner-cutting.
But perhaps this department has just been unlucky, and everywhere else in the NHS these private/public partnerships are working just fine.
Well?… Examples please?
