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What goes around comes around…

25 March 2011

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AMSPAR Chief Executive

Hang on, just want to check the calendar … it’s hard to believe we are so far into 2011 already. But they do say that time passes faster the older you get, and that everything comes around again quicker.

I’m old enough to remember the original Yellow Pages TV advert: the one where JR Hartley wearily wanders around the bookshops looking for a book about fly-fishing, to no avail. Finally his daughter whips out a copy of the yellow book and he no doubt spends a fortune calling numerous shops until he hits the jackpot – a copy of his own book.

Fast-forward 20-odd years and someone has now had the inspiration of updating the advert with a DJ looking for a vinyl record released all the way back in 1992 (I still don’t understand why these people don’t have copies of their own work). Fortunately, another daughter is on hand with the ‘Yell app’ on a mobile phone to save the day.

The advertisement aptly illustrates the old adage: ‘what goes around comes around’. So it is with the health service. Here’s a question for you: in which document will you find the following passage:

“This work takes place firmly in the context of the clear objectives for the NHS and the organisational service and financial frameworks we have already established: the new models of service provision for self-care, primary care, intermediate care and hospital care; and the key priorities of cancer, heart disease and stroke, mental health, children’s and older people’s services. These are givens – they provide a basis for action and further work. The challenge now is to ensure that modernisation takes hold throughout the NHS.”

Which of these 2010 publications was it?

  • a) 
The Conservative Party’s election manifesto?
  • b) 
The Liberal Democrats’ 2010 election manifesto?
  • c) 
The Labour Party’s 2010 election manifesto?
  • d) 
The Coalition government’s 2010 programme for government?
  • e) 
The government’s 2010 white paper Equity and Excellence: Liberating the NHS?

Any guesses? No? Well, it is in fact a trick question. The passage is taken from none of the above, but from A National Plan for the New NHS signed by the then Secretary of State for Health Alan Milburn in 2000. But it could quite easily have come from any of the other documents. All the parties seem to say much the same thing, but the devil is in the detail of how this is achieved.

Now that the actual Health and Social Care Bill has been published, digesting the full implications will take some time. To date, ministers have been saying how important it is to devolve decision-making to a local level, yet in practice things are going in the opposite direction with the suggestion that the flu-vaccine ordering is withdrawn from doctors and that appointments can be centralised in call centres. How someone several hundred miles away is in a better position to offer appointments than the receptionist who knows the local area is beyond me.

We must remain wary of mercenaries who look set to seize the opportunity to make money on the side, and we need consistent, coherent policies if we are to make these radical reforms work. If not, we could simply find ourselves aimlessly moving in circles – much like JR Hartley in search of his book.