Monday, 19 April 2010

You couldn't make it up

As if the tale of the bizarre 'them and us' way that health service funding is run could not get any more convoluted and bureaucratized there is another player on the block. This week we were told that the result of the annual negotiations that are held between Primary and Secondary Care Trusts to thrash out how much the former will pay the latter for work done above and beyond the contract had a new result. Usually the sum arrived at is somewhere between the true figure of over-performance and zero and both parties retreat, grumbling, into their respective corners to work out an equally inaccurate contract for the next year.
This year however the leviathan that is the Strategic Health Authority - a body whose function is to set the overall plan for the way in which health services are run within the region - stepped in and fined each party a million pounds.
Yes - you did read that correctly. Each Trust, instead of either earning money for work done or paying for services received, did neither and had to pay this huge sum to an unelected third party where it will be frittered away on more needless administration. The result of course is that both Trusts now have even less to spend on healthcare and for the first time in my career I have heard the word 'rationing' as applied to the NHS. Not the very expensive cancer drugs or the post-code lottery of access that occasionally pops up in the news but real, sweeping rationing where 'need' and 'want' are distinguished and patients may have to pay for non-essential services: the example given to us was varicose vein surgery - as this can be thought of as cosmetic.
And here, during an election campaign, the government is not going to want this to come out for general debate - however wrong it might seem.
Strap in, folks: the US passes a healthcare reform bill to, at long last, start giving its people some decent healthcare; we however are dismantling and killing our system. Start saving now for this will only get worse.

Wednesday, 7 April 2010

Five a day? Try ten.

So eating five portions of fruit and vegetables a day only reduces your risk of cancer by 2.5%. Not worth doing then, clearly, as our no effort, instant gratification society will see this as reason to eat even fewer a day.

In truth the reduction is less than expected because five a day is not even close to what we were atavistically designed to eat in the centuries before the high fat, shrink wrapped, sterile, tasteless convenience garbage that passes for food all too often these days. Ten a day might come closer but even this needs to be seen as a part of a wholesale dietary change rather than the current perception that eating these portions as well as the usual junk will suffice.

But when we are still at a stage where supposedly intelligent newsreaders ask what exactly a portion is then we still have a long way to travel. Our ancestors on the forest floor knew a thing or two.

Tuesday, 6 April 2010

And they're off

So the phoney war is over and we are now due to endure four weeks of wall-to-wall unverifiable promises by the men in grey, who appear every four or five years to pretend that they understand and care what really goes on outside Westminster.
The health service should of course be a central pawn in this battle and numerous suits will promise that 'the NHS is safe with us'.
In reality none will dare to meddle too much with this jewel in the British crown but will nevertheless be unable to resist detrimental fiddling when the winner(s) is/are announced. But they will all ignore the elephant in the room - or perhaps they are genuinely so wrapped up in their own inflated rhetoric that they actually do not know. The service is managed and bureaucratised to distraction and the doubling of the number of managers over the last ten years appears not to have been noticed by those who seek cuts. Regulation has stifled innovation and progress and the army that drives this inertia-creating industry will be in no danger from the eventual winners.
And there lies the lost opportunity for vast savings and increases in efficiency and morale that cutting a swathe through these pen-pushers would create.
So vote for change, fairness, both or neither. It all adds up to more grey.