Fourberie…

Training Primary Care - NHS - GPs - Fourberie...

We have a full house.  All the parties have published their manifestos except the Brexit Brigade… theirs is a ‘contract’.

I feel there’s an obligation to read them, review them.  Give them marks out of ten.  Over the years and over forty elections, I’ve done that.  Not this year.  I’ll leave it to the Health-Nuff-Kings and the likes.

It’s not that I’m lazy.  It’s not that I’m not interested… it’s just that I think I’ve grown up.  It’s taken me more than 50 years of election watching… but I’ve finally grown out of manifestos, they’re mostly hoodwinking and this time around outright bamboozlement. 

None of them are written in collaboration with the NHS, they are there to attract votes from the gullible.  Electoral snake-oil.

The principle issue facing our nation; the terms under which we will leave the European Union… or not.

Government has not published an up-to-date comprehensive, economic risk-assessment of what happens if we tip out, slide-out gracefully or get stuck.  What happens to the economy?  The most succinct and independent view I can find is here and there’s no good news.

Spending promises are pointless until we know the impact of Brexit.  

What we do know is, since the birth of the NHS in 1948, up to 2018, the NHS managed with an historic average of 4% funding-uplift, a year.  Since 2018/19 it’s been hovering around 1%… hence we are in a mess.

Manifestos that don’t promise a 4% real-terms, year-on-year, are useless.  With 2/3rds of Trusts dragging legacy debt most new money will be deployed in a circle, to get back into balance.

People?  There have been huge efforts to get more GPs.  It’s failed and not for the want of trying.  Manifestos that say; we will ‘recruit more GPs’, or more nurses are a fraud on the public and ignore the problems.

We have to realise; being a GP is not the job it was.  Young people can do more with a degree-education than grind out 12hr shifts, back-to-back.

There’s a dip in the number of 18yr olds leaving school and the national average for the percentage of A level students at the end of 16 to 18 study, achieving 3-A grades or better, at A-level, was only 13%, so the NHS is in competition in a small pool of wanna-be lawyers, teachers and boffins.

Manifestos that say there are 40,000 nurse vacancies are way off the reality; vacancies are measured by job adverts and an advert for a nurse might disguise 5, or more, real vacancies.

Add-in the uncertainty of migration to work here, plus paying an NHS surcharge, for your family to use the services you have travelled around the world to work in, doesn’t do it for me and I doubt it will do it for anyone else. 

Manifestos that do not mention the up-coming NHS People Plan are missing the point.  

Expect a Bermuda Triangle of the PP, HEE’s fumbling and braggadocio-manifestos, all saying different, ill-informed and wrong things about the future of the NHS workforce. 

50k more nurses all paid for by a bursary? That’s about £1,350,000,000  Plus funding for the training placements and which uni’s have course capacity?

New services?  How many hosptials does the Prime Minister think he’s going to build, now?  Does he know?  

The answer is six that are allegedly shovel ready, being built, not with new money but NHS’ savings.

To accelerate building needs revisions to planning, design, contracting and costings that means no one will be cutting a ribbon anytime soon…

… and there are serious issues about the building industry’s capacity.

Anyway, there’s no guarantee the economy will support the costs and new services means more staff and we don’t have any.

Manifestos without a nailed on social-care solution are for the shredder.  

The Tories are proposing a cross-party approach… a sure way to kick it back into the long grass.  All the rest are throwing money at the ‘now’ and not investing for the future.

About 900,000 people who once got care support no longer get it because, to save money, local authorities have raised their eligibility bar.  

Putting that right; if a care-package costs £350 a week, I guess, will add-up to about £16,380,000,000 for one year, plus the existing expenditure.

Dementia… I heard, on the news, the Tories are going to throw millions at research.  Why?  Every pharmaceutical company in the world is working on this.  A pill would be worth gazillions to their share price…  

… no gimmicky, government intervention will change anything, better give the money to the carers.

Car-parking concessions?  They are already in the NHS guidance.

Manifestos… just fourberie.

News and Comment from Roy Lilley

Contact Roy – please use this e-address roy.lilley@nhsmanagers.net

Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.