Bob Bury

The last word on the Health and Social Care Bill

Remember the Darzi centres (or khazi centres, as they rapidly became known to the Unbelievers)? These were the walk-in surgeries championed by Lord Darzi in his much-trumpeted review of the NHS. They were designed to give patients, particularly commuters, easier access to GP services – patient choice being, of course, the paramount concern.

Now, you may recall that a lot of people, well, pretty much everyone really, pointed out that duplicating provision in this way by insisting on setting up these centres even in areas which were already well-provided for by GPs, ‘nice’ though it might be, wasn’t perhaps the most sensible way to use resources which were already overstretched. But New Labour had the bit between their teeth, and clinics mushroomed across the country, including my home patch of Leeds.

Now they are closing them down.

I would pose the rhetorical question ‘why’, but it hardly needs asking. When walk-in clinics in the South were being closed earlier this year, the associate director of communications and engagement (sic!) at the relevant PCT explained the issue very simply: “The majority of patients who have been using the centres could quite easily have used another service…they created a demand which wasn’t there before.” In other words, exactly the problem which was predicted when the centres were first mooted.

The story was the same in Leeds – only 20% of the people passing through the doors of the new centres were the commuters for whom the service was designed, and most patients were already registered with GPs in the area.

You could, of course, make exactly the same point about NHS Direct. This too was the result of focus group politics and blind acceptance of patient choice as the appropriate parameter for determining resource allocation (and if you ask people whether they would ‘like’ to be able to ring someone up to ask if they needed to see the doctor or not, they’ll naturally say “yes”). No matter that anyone with significant symptoms will be told to go to the GP or nearest emergency department anyway, and that providing the service will take hundreds of highly-trained nurses away from the front line of healthcare provision, where they are sorely needed.

The patients have what they want, and their votes are assured. That’s the important thing.

And of course, we now have the Health and Social Care Bill, which will open up healthcare provision to ‘any qualified provider’, and ensure a free-for-all which will fragment the service and result in yet more wasteful duplication, making the essential coordination between services much more difficult or non-existent. Just as the last government were warned what would happen if they set up their new clinics, Andrew Lansley has been told what will happen if his Bill comes into effect. They didn’t listen, and nor will he.

Still, never mind. The patients will have chosen, and Mr Darzi has his peerage, and has retired (I assume) back into the relative obscurity of his surgical career. So all’s well with the world.

As Mr Jerry Nelson would say – arse! And I promise you, that’s (probably) my last word on the subject of The Bill, and it’s the appropriate word.

Bookmark and Share

Post a Comment

Enter this security code

Submit Comment for Moderation