David Cameron has made the Health and Social Care Bill into a confidence vote, just as Blair did, which if history repeats will lead to a brutal suppression of dissent, the silencing of whistleblowers and more buried scandals. The Lib Dems should be deeply concerned about this, but they’ve been briefed to give a positive spin on their contribution to the Bill’s improvements, to mask driving the getaway car.  See below – and please comment!

The first point is obviously bollocks, given that Andrew Lansely has just given an exclusive interview to the Health Service Journal on ‘Why Competition is Crucial for NHS reform.’

Health and Social Care Bill: Top Lines for Lib Dems to Remember when doing Media Interviews:

 No more competition:

Liberal Democrats were clear that the NHS mustn’t be treated in the same way as the gas, electricity or utilities markets. That’s why there’s no longer any mention of promoting competition in this Bill. Instead, the number one priority hardwired above everything else is the interests of patients.

No favours for the private sector:

Labour rigged the market in favour of the private sector by giving them ‘gold plated’ contracts and paying them £250million

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 Lansley goes over the top

You’ve got to admire Health Secretary Andrew Lansley’s lack of insight. Having united every Royal College bar the surgeons against his reforms, his website insists: ‘Andrew frequently visits hospitals and GPs across the country, listening to clinicians and NHS professionals and is well respected across the medical profession for his knowledge fo (sic) the NHS.’ And there’s more: ‘Aside from being appointed as the Secretary of State for health, Andrew’s proudest career achievements thus far include transforming the public’s view of the Conservative Party’s commitment to the NHS.’

This detachment from reality is not entirely Lansley’s fault. He tours the NHS tirelessly on largely pre-announced visits where the bad bits are hidden and the staff are too polite or frightened to blow the whistle. Even the collective chorus of dissent over his Health Bill coming from nurses, midwives and doctors hasn’t thrown him off his stride. This, Lansley claims, is just payback for the government downsizing their pensions.

Only 1% of doctors responding to a BMA survey thought the pension proposals are ‘fair and acceptable’ and two thirds said they would be prepared to take some form of industrial action. But Lansley

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More Chaos theory

When MD  asked health secretary Andrew  Lansley to reduce his unintelligible 358 page health bill to 140 characters or less, he wrote: ‘Putting patients and their doctors and nurses in charge, accountable for the results they achieve.’  Some staff were initially won over by the promise of liberation from political meddling,  less bureaucracy and more control over how the money is spent. But while most now long to be liberated from Lansley, they’ve now realised there is no freedom  if you’re  shackled to an unelected  economic regulator,  Monitor, and an unelected National Commissioning Board.  Worse still, the complexities of competition law and competitive tendering are likely to make the NHS more bureaucratic, not less.  And it’s the economists who’ll be in charge, stupid.

If Lansley had wanted evolution, rather than revolution, he would simply have slimmed down the existing Primary Care Trusts, put clinical staff on the board alongside the best of the NHS managers and let them figure out how best to spend the  money and focus on the quality and safety of care. By throwing all the cards up in the air, he’s created chaos, uncertainty and the perfect storm for another Mid Staffordshire scandal.

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Dear Dr Hammond,

I am writing to you early this week as we are about to announce the results of our latest survey on the Health and Social Care Bill. I’d like to again thank the very many of you who took the time to respond; you have no idea how much this has helped me to determine how the College moves forward, as well as providing me with personal assurance that we are doing to right thing for our patients and our profession. We received more than 2,500 replies, and nearly three quarters of you who responded said that you felt that it is now appropriate to seek the withdrawal of the Health and Social Care Bill.

When asked if the College should call for the Bill to be withdrawn as part of a joint approach with other medical royal colleges, more than 98% of you strongly supported or supported such action. Even without a joint approach, more than 90% of you still said that you either strongly supported or supported the College in proceeding alone in calling for the Bill’s withdrawal. I expected a good return, but I am staggered at the level of response.

The results are

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Hotline Fever

January 1 saw the launch of a new whistleblowing hotline – 08000 724 725 – for NHS and social care staff. It’s free, publically funded and available at weekdays between 08.00 and 18.00 with an out-of-hours answering service.  It’s run, for no obvious reason,  by the Royal Mencap Society. The charity understands the importance of protecting vulnerable patients but whether it has the advocacy and employment expertise to support staff  in what is often a suicidal career move remains to be seen.

Health Secretary Andrew Lansley is very keen on his new gimmick – “This will play an important role in creating a culture where staff will be able to raise genuine concerns in good faith, without fear of reprisal” – but it beggars belief that he can glibly promise both confidentiality and protection from retribution given how whistleblowers have been hunted down in the past (see Shoot the Messenger  Eye ). As soon as concerns are raised, the NHS pretty soon draws up a list of who the secret snitch might be in an attempt to shut him or her up. Threatening, counter smearing, paying off and gagging the source is far easier than investigating the allegations.

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