“When I use a word,” Humpty Dumpty said, in rather a scornful tone, “it means just what I choose it to mean– neither more nor less.” In our Alice in Wonderland world Lewis Carroll could be writing NHS CCG Clinical Commissioning Group board papers. last week we saw the long delayed Clinical Service Review coming to the board. https://www.dorsetccg.nhs.uk/aboutus/18-may-2016.htm
Sustainability crops up repeatedly. The casual reader might think the CCG has become all Green and environmentally aware. Maybe it has but the meaning here is quite different. It is a narrow and mean financial word: Is there enough cash coming from the Tories to run Dorset NHS? The answer is clearly no, so cuts must be made to cope with the underfunding.
This is dressed up in fancy concepts like transformation and single centres of excellence but the underlying imperative is money, or the lack of it. The NHS has been perfectly capable of running a full range of services ( Paediatrics, Obstetrics, A+E, Geriatrics) at District General Hospitals like Poole and Dorchester for over 60 years. It can do so if it receives an average of 3% growth a year ( 8% GDP). Ominously the growth since 2010 has been 1% with some of this diverted to apply a sticking plaster to the haemorrhage of funding inflicted on social services ( who pay for home care and nursing placements).
The fiction has been that the NHS will magically save 22 billion pounds by efficiencies ( another Humpty Dumpty word for cuts). The actual result has been the NHS nationally has run out of cash. So cuts mean the worst A+E waits ever, rising outpatient waiting times and overwhelmed GPs. There is a grudging bailout coming but this is linked to Transformation plans. Another weasly word for cuts.
I recall the then director of the post office squirming whilst being savaged by John Humphries on Today, trying to explain how cutting post office branches and reducing deliveries from two to one a day was an improvement. It was clearly nothing of the sort but rather a softening up exercise so a leaner service could offer more profit when privatised. This is happening now to the NHS.
Blame should not be directed at the CCG as if they were independent moral agents freely chosing to cut. In my opinion they are merely doing their paymaster’s and bosses’ bidding. This comes from the centre and is no accident. Noam Chomsky , a wise professor, is quoted thus : “That’s the standard technique of privatization: defund, make sure things don’t work, people get angry, you hand it over to private capital”
Dr Jon Orrell
