The BMA's idea in its recent discussion document :
"A rational way forward for the NHS in England "
is , to get politics out of health and have a constitution and and a Governing body . Uh-Oh....
Sounds a bit like a new job security push to us at Userwatch .. The BBC of Health . And why in 79 pages is there no mention of "Mental Health" services?
Perhaps they are right though and the NHS can be "remade" into the image and services of healing people well.
The big disparity in their kind of thinking though is where is the real power of the patient ? At UserWatch we like to use the word "REAL" in a tangy way so its fizzes on the tongue as its supposed to . In their ideas we will all probably be called "stakeholders" or "cakeholders" - or "slice-eaters" or something which usually means fuck all because at local levels we cannot understand the fancy equations by which our services are planned or our lack of services are planned to be erased ..
The BMA do not like maketisation believing in the idea State knows best provided the populace will create the taxation vehicle to pay for all the quality that is needed . They see in themselves in their document as Top Down knows best .. This is old London planning bullshit excerting itself again.
Locality is where we all live and localities must have the power to plan their own fates . The taxation issue is very important to put back to the paradoxical British public who both love and hate their services and who both want quality and not to pay too much for it . That cakery-division started with Mrs Thatcher and has never stopped - in fact it propped up the middle classes themselves who are finding as administrators in the health services they might just have to compete with the rawer quality driver of the market which the patient OWNS .
Do the middle classes want services they can control and use and shape ? If they do then avoid the Top Down Londonistic way forward . Let the local equations of population need dominate the agenda and let the local distribution of health be distributed locally . Pilot the bloody ideas and get the Doctors locally to set up their own administrations and be given money directly from the exchequer to serve their own populations needs . And the Dept of Health ? Get rid of it . Favour local inspection and stronger use of local law . Oh dear it might mean the British dictatorship of Parliament might lose a bit of power. The web will become the massive way to distribute information and knowledge and good practice in the future which is already here . The Dept of Health are somewhere else in 1950 management land.
Meanwhile in North Birmingham we discover that for two years 2005 - 7 there was no Lead psychologist and the clinical team reduced the number of allocations into it for therapies to 2 a month per psychiatrist. This resulted in a peculiar manifestation of a "waiting list" which was (we can only say) artificially constructed to appear that the then reduced demand by Service Users who were being seen was at "parity" to the national average of about 20 weeks .
When this was examined more closley it was found that other Service Users with a need for therapy lay behind this "waiting list" . In those two years the Birmingham And Solhull Mental Health Trust was dealing with "Debt" . In others words not being suppied the money to properly function by Goverment and having to reduce recruitment. By 2007 The Trust entered a surplus of 1.8 million and guess where that came from ? Undersupplying the services to patients by not recruiting the skilled clinicians that were needed . The CEO once announced something like (to paraphrase) :
"We want our services to be so good we would recommend them to our friends and family "
Oh really ....... ? That like many Dept Of Health NHS ideals is as trustworthy as grease ...
We need local control of services and purchasing power of health services like we need breath