Posted by: Witch Doctor | February 14, 2012

NHS : A business opportunity? Part 2

So, My Black Cat, have you made up your mind yet whether allowing 49% of the NHS to become a private opportunity is a good thing?

It seems that:

Dr Una Coales, Dr Steve Davies, and Julia Manning are in favour.

Dr John Lister, Dr Susanna Graham-Jones, Dr Evan Harris and Tim Treuherz are against.

You don’t know what to think, because you had your paws over your ears…

You could have turned the sound down, you stupid cat!

The Witch Doctor will help you make up your mind…….

Do you remember when you were a feisty adolescent feline and took to chasing alley cats during the witching hour?

Do you remember the time you got into a BIG SCRAP with them and cast off one of your nine lives?

Well, let me tell you what happened then…..

Your antics cost me an arm and a leg in vet’s fees! However, in return for me breaking the bank to get the vet to resurrect your other eight lives, The Witch Doctor had certain expectations about what to expect in return for her money.

Her expectations were fulfilled.

She took you to her local vet who knew us both well and so there was continuity of care. You want continuity of care when the money comes out your own pocket. He, a qualified vet did not delegate your diagnosis and management to a trainee or a veterinary nurse or other animal health care professional. He examined you, did the appropriate X rays, and indicated that you would need to be transferred to the vet hospital for surgery. Once there, you were met and seen immediately by another senior qualified vet, in spite of it being a Saturday afternoon. The Witch Doctor was given a full explanation of what the surgery would probably involve. The operation would take place first thing on Monday morning by a vet who had particular expertise in the procedure. On the Sunday, the same qualified vet who examined you on Saturday phoned The Witch Doctor to reassure her that you were comfortable, not in pain, eating and drinking. This was all in the service.

Continuity of care.

Following the surgery on the Monday, The Witch Doctor received a phone call from the vet who performed the operation to reassure her that you were round from the anaesthetic and to tell her exactly what had been done, that it had gone well, and discussed the prognosis.

And so on……..

The point I’m making, My Black Cat, is that at each stage, even although others were feeding you and taking care of you during the course of your stay, The Witch Doctor knew exactly who was in charge and she was kept fully informed by that person. There was absolutely no delegation of responsibility.

The Witch Doctor expected this service.

She received it.

She paid thousands of pounds for it.

Now then, My Black Cat, the government’s intention is  that up to 49% of the money in any NHS hospital comes from private patients. What would be the expectations of these patients?

They might for example want a single room that was kept spotless, and looked rather like a four or five star hotel room. They might want a large screen TV, Wi fi connection, a choice of good food, well cooked and well presented. They might want china teapots and doilies on their plates of biscuits for afternoon tea, and their trays bedecked with linen teacloths. They might want fine Egyptian cotton sheets and pillowcases on their comfortable beds and the room temperature should be just right. They will want everyone to be smile and be “nice”.

Of course.

That’s the easy bit.

They might want more than that.

Much more.

This is what they WILL want.

They will want to know exactly who is responsible for every aspect of their care. They will want these people to be well qualified. They will want excellent, “caring,” nursing and doctoring.

They will want to know who is in overall charge of their medical and/or surgical care. They will want to see that person daily.

They will want a consultant who is responsible for seeing that everything is well coordinated and who will be held accountable in court if necessary if things go wrong.

They will want that consultant to keep them informed every step of the way.

In essence, they will want a consultant delivered service.

This is because they are paying for consultant and nursing time, excellent care, communication and above all responsibility for that care.

They expect it, because it is costing thousands and thousands of pounds.

Now, there is an argument that these private patients may drive up standards within the NHS.

But how?

There are not enough doctors in the system to ensure that degree of time, care, communication and responsibility for both NHS patients as well as the private patients who will bring in 49 per cent of a hospital’s income.

Will the NHS patients be given priority over private patients in these matters?

No. Because hospitals will be competing with each other for private patients in order to fund better care for all.

Are they going to recruit and train more doctors to consultant level in order to make care equitable?

How long will that take?

Are they going to recruit and train more nurses?

And others?

This is but one aspect of the problem.

There are many others.

But you can sharpen your brain and work them out for yourself, My Black Cat.

I wonder if Sir Liam Donaldson, our previous CMO saw privatisation such as this coming our way  five years ago at the time of the very first posts of this blog, and it was one the reasons why he persisted that we need more doctors in spite of a government select committee challenging him on this.

Eh, My Black Cat?




The Witch Doctor – Link to a random page





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  1. Dear WD,

    Thanks for the link, I missed it on the telly.

    It was very interesting to see Una Coales in action. I agree that it is headache inducing, and clear that neither politicians or public have much grasp of the issues. Sound bites fit TV better than sound debate.

    (I was also amused to hear Dr Lister say “Fill their boots”.)

    Medical numbers are to be cut at the Deaneries shortly, so Consultants will be in short supply, and the numbers in General Practice to be expanded. The way to get a square peg into a round hole is clearly a big hammer.

    Dr Phil

  2. […] Dr Phil in his comment following the last post, has picked up on what is really happening at the coalface. “Medical numbers are to be cut at the […]

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