A guest article from Innocent Abroad
Recently Iâ€™ve been involved in a local campaign to save a well-loved doctorsâ€™ surgery (its previous partners have included AJ Cronin, the author of â€œDr Finlayâ€™s Casebookâ€). The problem arose because the partners needed to sell their premises, as one of them was retiring.
The Primary Care Trust decided that it wouldnâ€™t treat this as an accommodation issue, but insisted that the doctors gave notice and then bid in open competition for their own jobs!
This led to considerable anger amongst the patients, 500 of whom turned up at a rowdy public meeting (in the middle of August, too). This led the Trust to concede that the Panel which would award the tender should include three Patient Representatives. We formed an Action Group which astonishingly received considerable support from our local Conservative candidate (a barrister) while the parties ignored it completely!
Well, all that may be of only local interest, but as â€œTipâ€ Oâ€™Neill once said, in the end, all politics is local. More generally, it has led us to ask â€“ where has the extra money that has gone into the NHS in the last ten years actually been spent? And the experience has generated a feeling amongst us that, while the bureaucrats deigned to hold a public meeting, they donâ€™t feel accountable to us, but rather to Whitehall. Despite this, there is still enormous goodwill towards to the concept of the NHS â€“ people still want socialised medicine in this country, but they want it delivered a lot better.
None of this is new â€“ after all, Kidderminster elected an independent MP in 2001 on the hospital issue â€“ except that it shows that GP surgeries are equally capable of jolting people out of their usual passivity.
It is a measure of the disconnection of all the parties that none of them seem able to grasp the issue. Labour believes in centralised management, whilst the Tories (and to some extent, the Liberal Democrats) are hamstrung by those in their ranks who donâ€™t believe in socialised medicine anyway.
Why we have to have an appointed Primary Care trust is beyond me. If Labour and Tory can agree to create an Armsâ€™ Length Management Association to run social housing hereabouts, with elected resident reps on its board, why canâ€™t they use this model for the NHS? Why are appointed â€œnon-executive directorsâ€ a better guarantee of a quality service for health-care than elected patient representatives? (In the event, it was the non-executive Director who chaired the Panel who was far more opposed to our doctors getting their jobs back than any of the Trustâ€™s own officers.)
Another way of dealing with the democratic deficit would be for local Councils to take over Primary Care Trusts. After all, theyâ€™re supposed to work closely together to deliver health and social care. And while all this went on in the Chairman of the Local Government Associationâ€™s own ward, he left it to his political colleagues to work with us. After all, one of us might have asked him why he didnâ€™t want to take over the incompetent Trust and give it a dose of Westminster City Councilâ€™s famous efficiency!
Innocent Abroad is a regular contributor to pb.com