Thursday, 13 January 2011

NHS Reform – who are the heroes and who are the villains?

I was just settling down to write a short missive on the quandary of a parent contemplating flu vaccination for their young child when the BBC news started.

I was shocked to see that the headline story was about some hospital Consultants earning in excess of £100,000 annually in overtime. This was heavily criticised by various commentators on the news piece, with the reporter saying that these consultants were playing the system, and Professor Alan Maynard, an expert in health policy and former chairman of a hospital, said NHS trusts often faced a "challenge" managing consultants. ‘They don’t always keep to their job plans and then get to do overtime. I think there needs to be much more transparency about consultants pay’

Is this story politically motivated I wonder?

All this in the same week that the government’s plans for improving cancer outcomes announced an additional £750 million over four years by giving GPs powers to ‘save an additional 5,000 lives’ each year.

Health is always political, and none more so than now (both sides of the Atlantic), but I don’t understand why the spin appears to be so biased in favour of GPs who are being handed 80% of the healthcare budget in the very near future.

Have GPs suddenly become some kryptonite-challenged superheroes, snatching control of patients from the grasp of failing hospitals and greedy consultants? I really don’t think so.

Do GPs have blue tights and red underpants under their business suits or do they change in handy telephone boxes to save the NHS, give patients choice, cure cancer, control maternity services, keep the nation healthy and maybe morph before shimmying up some buildings at the same time? Mmm – not convinced.

Does there have to be goodies and baddies in the NHS and how come the GPs are the heroes and hospital staff the villains? Andrew Lansley, the UK Secretary of State for Health has decided to put all his NHS reform eggs in the primary care basket and I hope he won’t be disappointed with the outcome.

Effective and well planned clinical pathways are crucial to patient care and recovery. These pathways often include a GP, maybe a trip to the emergency department, a hospital stay, surgery, then nursing and maybe therapy to aid recovery. Each healthcare professional is equally key along this pathway.

How fascinating that The Health Services Journal, the publication most likely to have a really accurate finger in the NHS pulse, published the results of their analysis today, reporting that nearly 1 in 5 GP practices are underperforming across a significant number of quality and performance measures

I wonder why that little nugget didn’t make headline news today?


richard.blogger said...

"Is this story politically motivated I wonder?"

Yes, on my blog ( I look at the figures and discover that they are largely made up (or at best, exceptional). Think about it. The BBC say £600 for 4 hours, so for £100k that is 667 hours of overtime in a year (say 14 hours extra a week). Is that possible? Really? A surgeon commented on my blog and said the figures are closer to £200 for 4 hours, so to earn £100k the consultant would have to do 2000 hours of overtime in a year (say 42 hours a week extra).

The figures really don't add up. The surgeon commenting on my blog pointed out that consultants get extra pay for on call, but even taking that into account would not explain the £100k. There is, however, a performance award that consultants can get which is up to £75k and it seems likely that the bulk of this £100k is from that.

The performance award is to reward excellence, and I fully support it. When I am on the slab about to be sliced up, I would rather it be by a skilled surgeon, so please do throw money at him/her. However, the government wants to get rid of this scheme:

so I would suspect that this is just part of that campaign.

Frankly the BBC story is riddled with errors and I am amazed that it got on the news. I am sad to say, I think that BBC news has sunk to tabloid quality, and are just churning out press releases from the Department of Health.

Finchers Consulting said...

And not only is it shocking that this flawed story made it to the BBC news - it was the leading story on prime time viewing at 10pm. I also agree with you about rewarding consultants. I have been working on service improvement initiatives with Stroke units in North West London and have been incredibly impressed with the commitment and dedication of the stroke physicians and neurologists.

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