One of the side-effects of being handed £80 billion of public money to spend, is having to account for it. The media furore that followed MPs’ expense claims is fair warning to GPs that any hint of self-interest in our spending plans will be mercilessly exposed. You might think that as Chair of your local consortium, you’re entitled to first-class rail travel, luxury London hotels, and fact-finding missions to America, but before you spend a penny of public money these days, you should consider how it will look when your local paper finds out.
In a post-Wikileaks world, secrecy is very old hat and although patient confidentiality will remain sacrosanct, just about everything else we do as public servants is now fair game for scrutiny and exposure. The new pathfinder consortia are not (yet) statutory bodies but if I were in one, I’d want all minutes of meetings in the public domain. Andrew Lansley’s mantra of ‘no decision about me without me’ sets the tone. We have to share all our decisions with patients and be completely open, honest, and accountable in the process.
One of the (many) reasons PCTs were deemed to have failed is that the press and public didn’t understand what they stood for, or even what the letters stood for. ‘Consortium’ is not a promising replacement—far too Latin and public school. So it’s vital in naming your consortium to come up with something simple that everyone understands. It should do what it says on the tin. ‘Pathfinder’ wouldn’t be so bad if it didn’t have such strong military associations with paving the way for invasion. Alpha GPs may like to see themselves as brave paratroopers dropping flares behind enemy lines, but I doubt the Daily Mail will. If we try to ‘liberate the NHS’ in the same way that we tried to liberate Iraq and Afghanistan—forcibly, without winning over hearts and minds— we’re all doomed.
Perhaps sensing this, the 54 pathfinder consortia have renamed themselves, but some have made the situation worse. When dealing with public money amid howls of protest that this is a backdoor to privatising the NHS and a chance for GPs to line their own pockets, the last thing you want to do is to make your consortium sound too corporate. The Fortis Group sounds like a hotel chain that sells nutritional supplements on the side; Hunts Health is an accident waiting to happen on the Today programme; Principia suggests an investment trust with insipid principles; Bexley Clinical Cabinet is where you hide the whisky; The Red House is a Jimi Hendrix hit, a novel, a film, a private school in Durham, and a cultural centre in Sofia. But a GP consortium in Hertfordshire?
The clear winner, however, goes to Cumbria Senate: ‘Leave whippet at door lad, whip on this toga and into consulting room, doctor’ll be wearing a plume, your name is Marcus Aurelius on t’records.’ Does all this matter? I think it does. To take the press and public with you on a whirlwind reform programme that, according to NHS Chief Executive, David Nicholson, is ‘so massive you can see it from space’, they need to at least understand the terminology. Primary care trusts belatedly renamed themselves NHS Bristol and the like, so that you at least knew what organisation they belonged too. None of the consortia names suggest NHS. They are just confusion waiting to happen.
But maybe they’re just being honest; maybe GPs are equally confused about what’s going on. As someone who could never quite define clinical governance, doesn’t understand the difference between commissioning and procurement, and falls asleep at the mere mention of ‘contestability’ and ‘additionality’, can I say I’ve absolutely no idea what’s happening. I think I’ll just pop on a toga, swig a whisky laced digestive tonic, and play Jimi Hendrix very loudly. Next patient please!
Dr Phil’s Rude Health Tour continues in 2011. www.drphilhammond.com
- Timmins N. NHS reforms run full speed into unknown. Financial Times website. http://tiny.cc/5zvxnG