Friday, March 24, 2006

Through the Looking Glass

According to Mrs Hewitt the gaping hole in the NHS balance sheet represents less than 1% of the overall budget and is primarily the responsibility of a handful of profligate trusts. But how much does she really grasp her brief. And how accurate is that brief in the first place.

Not very, I would contend. If the Ambridge and District PCT is typical, and I have every reason to believe it is, the problem is a whole lot worse than she makes out. Until this month the A&B PCT was working to a balanced budget. Then someone redid the sums and presto A&D are £6M in "deficit" and need a savings plan in place by April.

As a lowly GP I am independent, and able to whinge about this to my hearts content. It is plain to even the most porly informed casual observer that the PCT will not be able to recover the "deficit" without significant cuts in staff and services. Oho, say the politicians, of course they can. They just need to cut management costs.

Except that A&D's Chief Exec left over a year ago to bail out Darrington PCT who lost their Finance Director and Chief Exec to a similar cash crisis. Their commissioning director left to work in the private sector a few months ago, having seen the writing on the wall, and having tired sufficiently of defending the indefensible.

Together with other staffing and managerial losses that leaves the PCT being run by one man and his dog. And to cap it all, by October it will have been reorganized out of existance.

Still, on the plus side their nice IT man has come to kit us out to run "Choose and Book", a throw back to John Reid's time in the Department. This stunning innovation will allow us to offer patients choice when referred to Hospital in the future. Sadly, with Hospital trusts in even worse financial shape than PCTs their choice is likely to be between four failing hospitals instead of the one half decent one we used to have before the era of "reform" and "unprecedented investment".

People keep asking where the money goes. I have a sneaking feeling it mainly goes straight back to the treasury to pay for past "deficits", and to the Private firms running all our new PFI funded Hospitals and Independent Sector Treatment Centres, all of which are funded at a premium when compared with existing NHS facilities.

So why does nobody say anything.

Simple. PCT and Hospital Trust managers are NHS employees answerable to the Department in the final analysis, and if they bring unpallatble news to their masters they stand to loose their livelihoods.

I sugegest it's time for all Trust managers to stand up and be counted. Instead of drip feeding the inevitable job loss figures one trust at a time, why not all do it together, say on April 2nd, I'll even give you all a slogan. "NHS Funding- it's no joke!"

So how about it boys and girls. If you did I can promise you the support of at least one GP.

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