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.