I share this because everyone I know who works for the NHS seems to agree with it:
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Mny thanks for this, Richard. Even though I knew what it said before they said it, it can’t help to be reminded of one, and it is only one, of the many reasons no one should vote Tory. I hope this gets a lot of attention.
Let’s not forget that it was the Tories in the early 1990s, pursuing their ideological fixation with the supposed benefits of market forces, who forced the “internal market” on the NHS with the aim of making it more competitive. This cost millions to implement — the big consultancy firms had a field day — and I’ve never seen any figures showing that benefits outweighed the costs. Certainly I never met anyone who works in the NHS who felt that the outcomes were worth the massive disruption they all experienced.
The folly of the internal market concept was very obvious in one job I was involved in. My role was to co-ordinate accounting methods and reporting so that Nursing Colleges could be transferred out of the NHS and into the Further Education stream. This meant that trainee nurses had less practical on-the-ward training than before and had vastly less exposure to the culture of the NHS. Needless to say the Nursing College staff were raging that they, their conditions, rights and pensions were being transferred into Further Education Colleges.
One region I was involved in was rural and had previously been administered by a single local Health Board which provided all admin services to the area and ran area-wide accounting, procurement, stock, and reporting systems as well as central payroll, HR etc services. Under the Internal Market set-up, there were now three bodies — the Health Board, an Acute Trust and a Primary Care Trust each with their own separate systems, management teams and clerical staff. As the new Trusts were set up, they had freedom to buy IT equipment and software, so pretty soon there was a zoo of kit and programmes and massive interfacing problems.
However, the medical work continued pretty much as before: GPs in the Primary Care Trust still referred patients to the single acute hospital except now the Acute Trust invoiced the Primary Care Trust for the work done. In no time invoices were being issued by the three parties to each other, Credit Control Departments were chasing up late payments and cheques were being issued which racked up bank charges when banked.
As for an internal market, there never was one before or after the Tories intervened, but the admin costs went through the roof and the one-off costs of external consultancy were massive. So who gained from this nonsense? Certainly not the patients, they would be unaware that much had changed, not the clinical staff who continued to provide their services as before, so it boils down to the Tories’ friends — the big consultancy firms, the hardware and software suppliers, the banks etc. Surprise, surprise!
The so-called ‘market’ in the NHS was an ideological imposition on the NHS designed to sink it
It’s some sign of its resilience that so fa5r it has not