The bangers are great

primary_care_training_bangers

I popped into Sainsbury's the other day, had a look around and decided not to buy anything.  On the way out the manager come up to me and said;

'Did you buy any of our sausages?  They're on special-offer...'

I said; 'Sorry, no.  I don't fancy sausages... thanks very much.'

'Oh,' said the manager, '...that's too bad.  We want you to buy them.'

'Sorry mate, not today...'

The manager looked very upset.  '

We've spent years getting these sausages made to perfection and we want you to be our customer...'

'No, sorry mate...'

... and with that, another man came up and said; 

'I'm Sainsbury's lawyer.  I understand, despite all our efforts in making, preparing, packaging and shipping or prime sausages, you won't buy them.  Is that right?'

'Yup, don't want them...'

'Well, in that case,' said the lawyer, 'we're going to sue you...'

It's bonkers, isn't it?  Of course it is but it's the only near-enough-parallel I can think of, to up-sum what seems to be happening to the NHS.

Virgin had a falling out with a CCG and ended up suing them.  If I'm hearing right, they are on the verge of doing it again.

I confess it's a while since I ran a business but we used to say... how often should I be nice to my customers?  The answer; before somebody else is!

I'm trying hard to think but I can't remember; 'If you don't get it all your own way sue the customer',  ever being discussed?

It's not just Virgin.  Here's another story in a not dissimilar vein.

Novartis and Bayer are having a ruck with a North East CCG, taking a case against them to try to stop them offering wet Age related Macular Degeneration patients a choice between Lucentis, Eylea and Avastin.  

NICE has confirmed that compounded Avastin (i.e. the vials are 10 times smaller than when the drug is used to treat cancer) is just as clinically effective for wet AMD patients as the drugs that have a marketing authorisation for this use.

Avastin has a marketing authorisation but just for cancer.  Big-pharma's Roche are the ultimate rights-holders of both Lucentis and Avastin and have not applied for a licence for wet AMD use for Avastin for what strikes me as obvious reasons... 

The drug companies are taking the NHS to court to try and force us to use an £800 a-go drug, when one costing £40 a-pop does the job.

The GMC stuck its oar-in but have said it doesn't have a problem with doctors using Avastin, despite the licensing issues.

Back to Sainsbury's; 

'Ok, I'll buy some of your sausage meat and make my own sausages...'

'No, we're not having that.  You will buy our sausages because we make more money out of a packet of bangers than we do a pound of mince.

I guess if Sainsbury's were ever mad enough to give it a try, you'd tell them where to shove their sausages.

The problem the NHS has; we have to treat as many people with with wet AMD as we can and this is not as simple as switching from Sainsbury's to Tesco.  

The choice is limited but none-the-less, the NHS can and should have the choice of the drugs it uses, to do the greatest good for the greatest number.  That means patients... not shareholders.

Roche and Novartis tried this on in Italy and came unstuck.  France is using Avastin, as, I think, is Spain.  It looks like Sweden have it sorted.  Google the story.  It's all over.

The rules for looking after customers used to be simple; find out what they want and give them shed-loads of it.  Never break a promise and take a pride in what you do.

Call me old fashioned but I know who I'd do business with... or not.

...and for the record, Sainsbury's bangers are great. 

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