Can’t be bothered to blog about Jeremy Hunt – our new health supremo (fan of homeopathic medicine and supporter of a book calling for the dismantling of the NHS).
He’s simply been brought in to finish a job. A bad job. There will be no change of direction, but we will get more sympathetic words and a media-friendly face.
I don’t want to blog about Lansley either. Everything that needs to be said about him was said here – and more eloquently than I could do it.
I want to pick up on a theme I thought interesting earlier in the week. Regionalism. One of the key justifications of the Health and Social Care Act was to empower local health clinicians and managers.
There was to be no more centralised bureaucracy. Decision making was going to be devolved to local health economies, with new approaches being developed to meet the needs of the local population.
So far, so good.
But then one sees the jobs being advertised for the NHS Commissioning Board, which is due to start operation next month. And you can’t help wondering A. are we creating just another bureaucracy, and B. look at the size of those salaries?
£132,500 for a Director of Intelligence. I’m not intelligent but I bet I could direct some people who are. Where do I sign up? £115k for a Director of Customer Relations. Whoops, there’s me forgetting that the NHS has become a retailer again.
Furthermore, the Board is pumping out consultation documents and guidance like a Politburo, which seems to run counter-intuitively to the liberation theme.
And then there’s the slew of supra commissioning jobs that are being created in and around the CCGs, which makes you wonder how different they’re going to be from PCTs and SHAs after all.
Then let’s jump down to the South West. There’s a consortium of trusts getting together to renegotiate the national terms and conditions of their NHS staff. Now, in my mind, regionalism is OK if it leads to creative thinking and a way to make jobs more attractive and effective.
But, what do they want to do? You guessed it. Make jobs cheaper. So, we’ve got proposals to cut SPA time for consultants (despite the Academy of Medical Royal Colleges saying a consultant needs 2.5 SPAs in order to meet the requirements of revalidation) and reduce the hours of juniors (and move towards a ‘training-only’ contract, whatever that is).
If accepted, these proposals will quickly see the employers in the South West consigned to recruiting the least capable, most desperate doctors and nurses.
It makes one wonder whether the pre-existing ‘centralised’ system was so bad?
As Lansley sits around ‘leading’ the House Commons, which sounds like another terribly useful job at the tax payers’ expense, I wonder if he’ll eventually reflect on where he went wrong. And I hope he starts with the realisation that if you’re going to devolve decision-making and control, then A. you have to actually devolve it, and B. when you do, it cannot just be interpreted as a cost cutting exercise.