No Synergy in Sight (Allyson Pollock lectures part 2)

After the heady heights of fame, back to sober reality, and it doesn't come much more sober than the current state of the NHS. As I already informed you, I was at the Allyson Pollock lectures up at Edinburgh University yesterday. It is so pleasant to listen to a lecture that is clear, informed and totally bumff free. A complete lack of annoying buzz words like 'rationalisation' 'fit for the 21st century' and my pet hate 'synergy'. Who in the name of the wee man thought that one up, I'll never know.

Joking apart, it was also a very alarming lecture. I left rather green about the gills at the end; the reason being that Prof Pollock had been talking about the new GP contract and what it was going to allow private health firms to do.

To give a very brief summary, GPs used to have a direct contract with the NHS. The contract would be between the NHS and the GP and that was it. Simple. The new agreement means that the NHS can have a contract with a provider of healthcare; that can be anything from a single GP, to a multinational company. This nearly happened up at Harthill GP practice, where SERCO were trying to move in. After an almighty fuss, letters to the Herald and protests from the locals, it was agreed that one of the GPs who was already in the practice, should be allowed to take over.

Now you might ask; what does it matter if a multinational takes over, so long as they provide the care? Well, here's why it matters; primary care is about 80-90% of all healthcare and it is the area that pharmaceutical companies are particularly interested in. They pay out big sums of money to companies like SERCO to promote their drugs, and the healthcare company in turn, helps them to meet their sales targets. But it gets worse still. Up in Stracathro, a new ACAD has been built (Ambulatory Care and Diagnostics Unit). It's really a kind of glorified outpatient unit and will do minor operations. Netcare, a South African company, have been brought in to run it. Now, the ACAD has been given money to do 15 000 operations per year, for three years. But what happens if there aren't 15 000 patients to go there? Well, Netcare get paid exactly the same. So in order to maximise the usefulness of the ACAD, NHS Lothian is going to have to scrabble about to find enough patients to send there, so that it doesn't lose money.Now you might think that it would be easy enough to find 15 000 patients, but here's the rub; Netcare will only take them if they're minumum risk patients that are pretty healthly. They won't take patients that really are sick. So the NHS absorbs all the risk and the private company takes all the profit. I don't think even Maggie Thather would agree with a private company that wouldn't take normal marketing risks. There'll be more on this subject, when I can face thinking about it. In the meantime, the third and final lecture is this Monday coming, the McEwan lecture hall, 10-12. GO!!