Lucius Cassius’ illuminating question remains more important than ever.
Lord Carter, author of the Report of the Review of NHS Pathology Services in England Chaired by Lord Carter of Coles (2005-08) which started major changes to pathology services, has had to step down as chairman of the NHS Co-operation and Competition Panel (CCP) because of a conflict of interest with his more lucrative private interests. This includes McKesson, an American company convicted of fraudulent activities, which runs the NHS payroll system. How does the work that men were paid to do live on after their resignation?
Click the cover picture to read the report. Page 13 lists 6 priorities for change: a framework for quality improvement, stand-alone pathology providers, integrated IT, a national tariff fixing prices, large scale workforce change and service improvement, and stronger skills in the management of change. Industrialisation through managerialism. This is supposed to solve a multitude of problems but makes them worse.
And where did his Lordship come from? Click this quote to read more:
“Lord Carter, 66, is said to be a consummate operator in both business and Whitehall. He was made a Labour peer by Tony Blair in 2004 and he was best man to former Justice Secretary Jack Straw at both his weddings.”
Does it make you wonder if the pathology review was not about pathology or patients, but simply to deliver pathology services into the hands of companies favoured by Tony and his friends? Companies favoured because they would pay these people rewards that seemed to make their behaviour extremely worthwhile.
It could be an American company whose list of board members and consultants warrants investigation. It could be a company closer to home such as the Virgin company, Assura, that will ensure Sir Richard Branson’s daughter doesn’t have to make do with an NHS GP salary. Not a GP partnership for her; instead a medical empire.
It is not a free market at all. It is a corrupt, corporatised market where only companies rewarding politicians well stand a chance of winning business.
Free markets offer customers choice. NuLabour offered “choice” that customers didn’t want – “Choose any option you want and it won’t work.” Customers preferred options that weren’t broken.
Should we be considering the choice of horses for courses or does that distract us from thinking about the birds?
Have you noticed how the old left wing/right wing divide has become misleading? It allows both wings to miss the dimorphic parasites of the political/bankster class that are consuming the fat middle of the bird.
What’s going to save the day? QIPP perhaps. It stands for Quality, Innovation, Productivity, Prevention. It is being applied across the NHS including pathology. Like accreditation, it is the sort of BIG IDEA that politicians love. It is simple. It gives them hope beyond their competence. Like accreditation, there is limited evidence that it works. Strangely, ISO accreditation forms a surprisingly small part of the QIPP programme. As if accreditation has no relevance to quality, innovation, productivity or prevention, which is true.
Will QIPP fail? Certainly there are questions which will one day have answers.
“The QIPP programme itself did not escape criticism. The incoming government had asked challenging questions, Easton said, about the evidence base for QIPP and about its success in engaging with the right people. He admitted that the move from a PCT centric to GP led commissioning system had exposed some weaknesses. Referring to GPs, he said: “There is no doubt that we have excluded – or downplayed the role of – those key players in many consultations.”
“This point reveals the fundamental problem of the QIPP programme, which is that it cannot succeed as a purely top-down initiative. Easton is the first to recognise that the kind of cultural change needed to bring about QIPP is beyond the power of governments and civil servants to deliver. QIPP requires new thinking and behaviours and it means people at every level of the NHS taking ownership of quality, patient safety and other aspects of service improvement. It requires collaboration, which means more than working together; it means redistributing power. As the senior managers who attend the Confederation know, putting clinicians and patients in charge of the NHS has consequences for the people who are in charge now.”
Expect pathology to continue to do as it’s told, implement Carter’s plans, QIPP, and accreditation. How much money will it cost or save?