Thursday, 7 April 2011

Healthcare reform: confusion heaped on confusion

It's said often enough but that doesn't make it any less true: you really need to be careful what you wish for.
When David Cameron set up his nice new British government nearly a year ago, he equipped it with a Secretary of State for Health who had already spent five years as the opposition spokesman. Just what the doctor ordered, you’d think – someone with real understanding of his brief. Particularly as he’d been married to a GP. The opportunity, you’d think, for some good domestic debriefing.

Lansley: leaving us all bemused. Himself too, perhaps
But a year on, the gloss is coming off that shiny government. In particular, pretty well everyone is against the flagship reforms of the NHS that Lansley has championed. Most people oppose them because, quite frankly, they’re incomprehensible. Nobody, apparently least of all Lansley, has any idea what they’re intended to achieve. They ought to be good, because they’re going to cost about 12 billion pounds, but they’re so confused, it’s hard to judge.
The only people who seem to be in favour are a number of GPs. Of course, if the reforms go through, they may be able to triple their pay packets simply by denying hospital care to the rest of us. It’s a bit like farmers being paid not to grow crops. The differences is that we can all probably live with a bit less alfalfa, but being denied healthcare can have a limiting effect on career prospects. On any kind of prospect, actually.
So unclear are the benefits of the reform, that not just the Labour Opposition but their coalition poodle partners, the Liberal Democrats, are having second thoughts. Most telling of all, it looks as though David Cameron and other senior members of the government itself are seriously concerned. So a three-month moratorium has been imposed.
It’ll be interesting to see what happens next. Most of the people I meet from the health service are beginning to express a glimmer of optimism that the reforms might be dropped altogether and, ideally, Lansley and his team sacked. It seems that the early hopes conjured up by having a minister with experience of the field may have been misplaced.
As for the reforms themselves, we should perhaps have seen a hint of their inherent weakness in a simple linguistic flaw they contain.
The idea is that the bulk of the money spent by the health service would be handled by groupings of GPs. But just to call them ‘groups’ would of course be far too obvious and simple for the swanky lot that form our government. Instead they've gone for the much grander term ‘consortium’.
Unfortunately, ‘consortium’ is Latin and therefore behaves sneakily. What can you expect of words invented by the ancient Romans? These are the people who had gladiatorial combats, crucifixions and the inclination to invade other countries at the drop of hat. Not tolerant and civilised like us.
I spent yesterday with a bunch of NHS people. I heard the word pluralised correctly as ‘consortia’ though, inevitably, also as ‘consortiums’. Then there were those who thought that ‘consortia’ was itself a singular, as in ‘local GPs will have to form a consortia’, which naturally led to the creation of the curious plural ‘consortias’.
When we can't even agree on the words, what hope is there for the substance of the reforms? 

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