What’s really happening to public services?

Meanwhile, down at NHS HQ (although it seems to have many HQs these days), GPs, pharmacists and dentists are all a little worried. As private sector contractors (in case you didn’t realise) they’ve all been handed the “more for less please” note given to the rest of the public sector. There’s an ongoing contracts review (think long saga like Beowulf) looking at how Joe and Josephine Public can get more out of our clinicians. But those current contracts are pesky things and are a little, well, binding”.

So whilst that small matter is sorted, there’s a plan to get CCGs to manage contract compliance. (That’s the bodies made up of mainly GPs). Except its likely to be CSUs who do the monitoring. (That’s the bodies made up of many of those “unelected and unaccountable a pen-pushers” so beloved by politicians themselves preparing to be outsourced). So poachers, turned gamekeepers contracting with dispossessed poachers to monitor the contracting gamekeepers. With more than £10bn of commissioned contracts, that’s got success written all over it.

And many of the gamekeepers (GPs in case you lost the plot) are set to retire in the next few years. After a lifetime of GP-ing (and dentist-ing too), give the collection of poisoned chalices they won in the last reorganisation, I bet they can hardly wait. Handed the silk purse named “health spending”, some GPs must have originally been delighted. But when reality bites, it will be CCG’s prioritising their local spending that closes hospitals, not politicians. And it’s your local GP (ultimately, anyway) that must balance the books locally not those pesky unelected, unaccountable public employees. Whilst I don’t remember voting for my GP, I would be confident s/he is accountable not only for their patients but also their own practice’s accounts.

The public sector is a business worth at least £250bn a year. Is this how the private sector would run a business of that size?

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