Posted by: Witch Doctor | July 13, 2010

Healthcare and the Pure Market


This blog started because of the MTAS mess.

It so happens that some years ago, before deaneries were called deaneries, The Witch Doctor had some input into what were then known as University Departments of Post-Graduate Medicine. This consisted of a full time dean, a GP, a secretary, a couple of other clerical staff and a few clinicans who were “helpers” and were called by names such as “Clinical Tutors” and “Specialty Advisers.” There were a few other medical odds and sods around but all of these people had a clinical job to do as well.

The idea that private companies might be brought in to run parts of post graduate training would have seemed quaint at that time and would have generated a bit of a laugh among us all.

Things changed and Post Graduate Medicine became Deaneries.

The Witch Doctor severed her links with post graduate medicine about that time and thereafter didn’t know much about what was going on.

Deaneries mushroomed in size.

Just before the MTAS mess finally erupted, The Witch Doctor was taken aback to find that a private outfit, “The Work Psychology Partnership” had been brought in to write a training manual “Recruitment to Specialist Training” This was the consultancy charged with the nationwide up-skilling of the selectors for MTAS.

No doubt a nice little earner for The Work Psychology Partnership.

And so it seemed that money destined for the training of doctors was finding its way into a private company whose specialty was psychology, and that the “service” the company was giving was a kind of experiment.

Post-graduate medical training was being turned into a commodity.


This, thought The Witch Doctor, is ridiculous!

And so she began to look into private companies that might be benefiting from public money destined for the NHS. Not the companies that provide essentials like bed-pans, commodes, instruments and medicines etc, but the “soft” unproven services provided by consultancies of various sorts.

Sure enough, she found them.

You will too if you look.

The sort of industries that are edging towards what economists would call THE PURE MARKET.


“the contents of all bottles of water are much the same as tap water. In fact some bottled water is obtained from the tap. The bottle, the design, the labeling and the hype will decide whether a little corner of the customers brain will be enslaved or not.

Sure, if the bottle reminds you of a piece of Tiffany glassware, buy it – but just remember the product is the bottle. If you buy it for the contents, then part of your brain has lost a few glass marbles.”

Public funds intended for the NHS seep into companies to produce services such as time-management courses, appraisals, citizens juries, leadership courses etc etc.

And that is when she discovered the Common Purpose leadership courses and although active within the NHS and universities, this outfit tends not to target many medical staff.

Most doctors have never heard of Common Purpose.

Incidentally, she noticed the other day that an eminent retired doctor Sir Cyril Chantler, who has close links with Common Purpose, Doctors’ Net UK, is Chairman of King’s Fund and Chairman of UCL Partners is speaking at a Common Purpose course called Generation Infinity.

(Sorry, permission has to be granted before links are make to the Common Purpose website, and WD is not for asking!)

You get the gist of this?

Privatisation of the NHS and post-graduate training can creep in without anyone really noticing. Patients certainly won’t notice because they are not sure of the importance of all the non-clinical activities that go on behind the scenes.

And then, of course, there is PFI……

If you search you will find many other commercial reservoirs for your money that you thought was destined to go directly into patient care. Some may result in some benefit to patients but many will not.

Unproven activities, experimental and even nonsense activities within the NHS are becoming commodities.

Some are Pure Market commodities.

Presumably governments are of the view that if there is a dearth of manufacturing in the UK of sound, useful, tangible products like ships, coal and vacuum cleaners, then employing people in these soft, squelchy activities boosts the economy and keeps people employed.

With this in mind it is now worth looking at the coalition’s plan for the NHS.

Allyson Pollock’s view is that the “new” reforms will dovetail seamlessly with those of new labour.


“Despite catastrophic failures in the banking sector, the market is far from in retreat in the NHS. Reports in advance of a white paper suggest the coalition health secretary, Andrew Lansley, could be about to hand over the bulk of the NHS budget, around £80bn, to private corporations which will buy hospital and community health services on behalf of GPs.”

It appears that private companies such as Assura Medical, Tribal, BUPA, are licking their lips in readiness for a feast.


“Kingsley Manning, business development director at Tribal, which also already provides commissioning support services to some parts of the NHS, cautiously welcomed moves which the firm said “could lead to the denationalisation of healthcare services in England”.

Manning, a visiting professor at the business school at Imperial College London, added: “There is a significant opportunity to improve commissioning in the NHS. We can help because we make the investment in the technology and skills needed to save the NHS money. We have done so with many primary care trusts [PCTs], saving millions.”

And, of course, there is money to be made from the NHS information revolution:


“Patients will be able to access ‘plethora of data’ on hospitals and doctors, says health secretary”

This will be really, really good news for Neil Bacon (Common Purpose Graduate) and his team at iwantgreatcare.

Won’t it, My Black Cat?

Go off and read the whole report and tell this old witch how exactly they plan to liberate the NHS, and who they are liberating it from, My Black Cat.


And while you are at it, have a look at Armchair Daddy’s experience of a toxic meeting on commissioning.


And have a look at this:


And then, My Black Cat, consider this:

If you were running the country and you wanted to boost the economy in precarious times, you would want to keep full employment so everyone had money to spend so you would probably create soft, squelchy unnecessary industries. You would want to identify a solid industry too that at present was under-utilised in producing profits for the private sector.

That industry, My Black Cat, is the huge Health Service Industry, as yet untapped in the UK.

That is why no government in this country will stop dabbling with the NHS and attempt to privatise it or at least great chunks of it.

What doctors, witches, black cats, patients, and Uncle Tom Cobley and all need to do now is ensure patients are well looked after within the NHS with all public money destined for direct patient care used for just that and nothing else. This money must not be siphoned off to provide for clients, the worried well, and the business community in the name of “patient choice,” “commissioning,” “feedback,” “leadership courses” “the patient experience” and that ridiculous spinning top of “360 degree appraisal” etc. etc.

It must not be siphoned off into business activities which are edging towards The Pure Market.

When do you suppose The Human Kind will waken up to Creep, My Black Cat?


wordpress stats

redapple.jpg POEM OF THE DAY……………………

The Witch Doctor – Link to a random page





© Dlundin |


  1. I must be very dim, I still find it hard to believe that doctors and nurses never seem to get asked what THEY think is needed to do their jobs properly. Do these consultancies siphon off the money knowingly, or have some delusion they are actually doing something vital?
    Sometimes the burden of deceit weighs quite heavily. Could that be why Zenna Atkins, soon to be ex OFSTED & Places for People, Common Purpose leader type, made some sweary comments about how every school needs a rubbish teacher ( ) then had to come on BBC radio this morning defending & ‘explaining’ her comments. Never mind though, she is soon going to work for GEMS ( ), an educational provider. Well done Zenna & kerching, chasing that government funding is something she excels at – especially as I think that GEMS is branching out into another field (maybe not in UK but give them time)…healthcare…..
    ( )

  2. Colacube,

    You are coming up with some interesting stuff that even My Black Cat has missed.

    She wonders whether you might start a blog of your own. In the meantime she is enthusiastically following up your links.

  3. Yes, my heart sank when I read this story and realised that once again, private companies were being tipped to come to the rescue.

    I wonder if anyone in government is going to consider this story before they continue to promote private enterprise as the way forward for health?

  4. […] illustrates how The Change Agents of Industry operate A Pure Market, and generate vast riches for themselves, My Black […]

  5. True, South Africa’s high incidence of illnesses such as AIDS and tuberculosis (what Mr Fleming calls the “tailwind of disease”) and poor public health system means that demand for private care is growing especially strongly at home. Life Healthcare – which owns or part owns 62 South African hospitals – has been benefiting from double digit revenue growth since it de-listed back in 2005.
    But in markets such as Turkey the private health care sector is more fragmented, which means that barriers to entry there for would be new entrants such as Life Healthcare are relatively low. can give better picture over it.

Leave a Reply

Please log in using one of these methods to post your comment: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s


%d bloggers like this: