Coming or going…

Training Primary Care NHS GPs Coming or going...

Political knock-about is a bit of fun but I’m getting to the point where I’ve had enough of the Tory Leadership palaver.

Reopening negotiations with the EU is probably going to be like opening an oyster with a tooth-brush. Until we know the upshot of that, neither of the wanna-be’s can promise one more copper on-the-beat, one more tax cut, nor one more flying bacon factory.

Whatever fiscal headroom we might have, if Brexit goes wrong, it will be swallowed up by contingency spending to keep the wheels on.

The sensible thing to say would be;

‘… once we are extricated, we’ll take stock, announce a budget and use fiscal levers to keep afloat, or stimulate the economy.’

The leadership fandango is turning into a cross between Flog-It and Bargain Hunt.

The combination of the leadership thing and Brexit is causing serious operational problems. Ministries have ground to a halt.

The best No18 has been able to manage is an announcement about NHS and Alexa. Spooking everyone with data worries. There’s an old axiom in politics;

…if you’re explaining, you’re losing.

It’s simple; every month, 43 million people use the excellent NHS website, by web or phone. Now, they can use it by shouting at the tin on the table.

Your data is only of interest to you. Your data compared to mine, is of little value. Population data is the new oil. We don’t have to know who you are and you don’t have to use it.

Can we park that… because there is much more important stuff.

The pension mess, resulting in consultants refusing extra sessions, is causing huge problems for Trusts, already under pressure. Whilst some workarounds are emerging, there is no solution on the horizon.

If you think the winter crisis is over, think again. June saw the highest ever numbers coming through A&E… yes, the highest, ever.

No one seems to have any idea about demand management, root-cause, perhaps we should ask Alexa.

One Trusts reports seeing 3,000 more patients a month, than they did last year.

I think we should ask why?

My guess would be the answer, at least in part, is social care; on its knees. Nearly a million frail elderly people who used to get support and care, no longer get is because, to fulfil their statutory obligation to keep in budget, LAs have raised the bar, on eligibility criteria, so high, even Renaud Lavillenie couldn’t get over it.

Add to that the fact we have been waiting for two years for a green paper, on the future of social care and frankly, we have a national scandal on our hands.

Not my words but Westminister’s Economic Affairs Committee’s


headlined: “Time to end a national scandal”;

“… with each delay, the level of unmet need in the system increases, the pressure on unpaid carers grows stronger, the supply of care providers diminishes and the strain on the care workforce continues”.

Is it any wonder A&E fills up. Medical beds get full, surgical beds get pinched for the overflow and Bob’e yer uncle… yer aunt’s new hip gets cancelled.

I used to say there are four million people on waiting lists. Apparently, I’m out of date. It’s now 4.4m.

Add to that… workforce. Not enough peopled no quick fix. You know the story.

Now, the question is, will the new PM sweep into Downing St and fix this? Well, I wouldn’t hold yer breath.

The political preoccupation is still going to be Brexit and we could be facing a general election before the year is out, or a referendum.

If I’m wrong and we sail through a renegotiation, the preoccupation will be on legislation, regulation, trade negotiations and keeping the show on the road.

Whether we remain or leave, I’m afraid for the foreseeable, the NHS ain’t gonna know if it’s coming or going.

Have a good weekend.

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Reproduced at by kind permission of Roy Lilley.