Sunday, 31 August 2014

Cognitive dissonance from NHS bosses planning changes to cancer care.

Under plans put forward by the government NHS Cancer and End of Life services in Staffordshire are being opened up to tenders from private companies, a contract worth £1.2 billion.

There is, say campaign group Cancer-Not for Profit, no business case for privatising the service citing figures from the Office of National Statistics showing that 90% of patients in Staffordshire are satisfied with the care they receive from the NHS run service. The NHS Support Federation says that 70% of the contracts put out to tender have been won by private companies, a testament, perhaps, to their greater experience of the tendering process.

The Clinical Commissioning Group (CCG) led by Andrew Donald claim the service needs to be ‘joined up’ to prevent patients from falling through the crack, under legal advice they have been instructed to consult with the public before putting their plans into action.

Cancer-Not for Profit have collected 10,000 signatures on a petition opposing the sell off and on Wednesday they held a public meeting at the Civic Centre; it proved to be a stormy evening for Mr Donald.

The meeting took place in the Jubilee Hall, a grand wood panelled space redolent of a civic self -confidence noticeably absent from the cuts haunted landscape of local government today. Down at the front of the room the four speakers milled around, Stoke South MP Rob Flello wearing a distinctive white suit, whilst half a dozen earnest young people fussed around with cameras and light-meters.

There was a fairly large crowd, not surprisingly really since the NHS is one of the few political issues that still has the power to galvanise the public. The age range was well above forty, a danger sign for any politician considering an assault on the NHS because this is the demographic that votes; mostly because they can remember when doing so meant something.

Andrew Donald, the Staffs and Surrounds CCG Chief Officer and Transforming Cancer Care EOL programme sponsor, a title that if he has it painted on his office door must have doubled the NHS signage budget at a stroke, the opposing captain so to speak put Dr Jonathan Shapiro a consultant with experience of a family member using the NHS cancer services in London in to bat.

A smart move in the sense that he had an emotive story to tell about his elderly father’s struggle to cope with a service that seemed to be focussed more on its own systems than the needs of patients, a fair criticism that can be levelled at some aspects of the NHS. He lost the audience though with a patronising analogy that placed the private provider as the ‘conductor’ bringing the disparate elements of the health care orchestra together tunefully that he hammered mercilessly, suggesting a bedside manner that was a little on the grandiose side.

Andrew Donald also ran with the line that although the service delivered was in general good it needed to be redesigned to make it more integrated and focussed on patient needs by getting the various providers to work together. He summed this up as the creation of a service delivering ‘patient seamless care; a piece of bureaucratic double-speak that could mean anything or nothing depending on who he is speaking to.

He was slippery to say the least when questioned from the floor as to why this new service could only be created by bringing in a private company, saying at one point that opponents were ‘assuming’ that one would be brought in, although the ONS figures suggest any other outcome is unlikely. Mr Donald also didn’t take kindly to being questioned about the CCG’s patient consultation, saying huffily that they had put together a team of ‘patient champions’ although he was unable to say what these people actually did apart from being force fed CCG biased information.

Rob Flello MP, taking the crease for the Labour Party gave a rather off the peg speech about an NHS that was ‘cracking at the seams’ due to government underfunding and called the privatisation of cancer care the ‘biggest auction in NHS history. He was more animated in the panel discussion asking several questions that made Mr Donald squirm inside his expensive suit. It was hard not to feel though that his hands were tied by the fact that the plan could be forced through before the election leaving an incoming Labour government unable to reverse it for fear of being sued and that his party though it is often at the anti-cuts dance has been rather timid when it comes to taking to the floor.

Rachel Maskell, head of Health for UNITE savaged the plans as an attempt to ‘drive profit from the sick’ and contrasted the way the NHS owned by the public operates and the secretive practices of many of the private companies set to bid for the contract. Dr John Lister of Coventry University also attacked the lack of democratic accountability in the tendering process and the limitations of the public consultation conducted by the CCG.

The real meat of the meeting came when it was opened up to questions from the floor, poor Andrew Donald must have felt like a batsman who had taken to the crease only to find himself facing a bowler using grenades. Time and again questions about the lack of transparency in the tendering process, the possibility of patients having to ‘top up’ the cost of their care and the existence of a preferred list of bidders bounced over his startled head.

In an exchange that drew a sustained burst of applause near to the end of the meeting Jan Zeblocky of the local Green Party accused him of ‘cognitive dissonance’, receiving the message he wants to hear not the one he’s actually been sent, regarding public support for privatisation. It was an apt metaphor for a CCG acting in the name of a government that seems to have been deafened to public concerns by the din of its own ideology.

Fittingly the last word of the meeting came from a woman with a cut glass accent who called out ‘what right have you to take away the NHS people have paid for,’ what right indeed. It was, if you’ll pardon the cliché, the voice of middle England and the government would do well to listen to it before assaulting the NHS people have paid for.

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