The Fortune Practice10: Frank’s guide to NHS REFORMS

Dear Alex, Thanks for your email, sorry to hear you are so busy with all the CCG work, but it sounds like you are doing a good job. Here is the leaflet I gave my patients. I don’t know if … Continue reading

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The Fortune Practice 9: Happy Birthday NHS

A story continued from life at The Fortune Practice: Alex awoke in a cold sweat….she had been having a dream that she was living in the nation she had always feared, a nation where the press was no longer free, … Continue reading

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The Fortune Practice 8: Strike? 2

Dr. Prakash Mehotra,  GP Partner with Dr. Helen Gould, the founding partner of the Fortune Practice was thinking about how to contain and translate his thoughts before meeting with Helen and Donald, their practice manager.

Helen and Donald  were long term platonic lovers,  but you would know that if you had been following this story….

Prakash wanted the Practice to strike to mark it’s objection to the current government.

That was it. It would have been illegal to strike over the Health Care and Social Services Bill, this was the professions last vent of protest…

Prakash:“ the reason for my discontent, and my reason for striking is not about pensions. …that is a laughing stock and adds to the catalogue of our union’s misdemeanors in recent times” he said…. “I want the patients to know that I object to the passage of the Health Care and Social Services Bill, the Bill that destroyed the NHS. I want the patients to know that I fought that as hard as I could including striking against this government”

Helen was demure “I will not take industrial action that may harm patients”

“ We are a stable practice that delivers excellent continuity of care, we know our patients well….we can offer an on call emergency service only…if the patients knew they were opposing  the abolition of the NHS, they would support us, the public love the NHS, they don’t know it’s gone, it is our job as doctors to inform them”

Helen, like many of the profession was a conservative , paternalistic pragmatist…

“I do not support strike action, we have seen many changes in our careers, we have got through them and served our patients well…we just need to keep calm and carry on”

Prakash was fuming with anger. The Government had ploughed on with it’s changes under the passionate and deluded Lansley, they had buddied themselves with the arms of the profession most set to benefit from the changes and of course , class and society being what it was…these alliances had reached the highest courts in the land….The speed with which they had passed the Bill meant that there was no time for the public to get involved, despite the efforts of KONP and other groups and on their way they had wielded their keenest weapon…the divide and conquer sword..

With this tool they had divided the profession, and forced the even the Liberal Lords to bow out of the battle, to maintain their power in the coalition..and thus Her Majesty had to let the NHS fall out of the jewels that adorned her Jubilee Crown.

“When you are from a country that has no NHS, when you have seen what the NHS is for a nation, that is when you fight for it and love it so much” said Prakash

“ I am not for turning on this matter” said Helen “ My patients need me too much and after all the strike is about pensions, not the abolition of the NHS, ”

And so Donald lowered his love filled eyes and so Helen’s matriarch like demeanour won the day. The Practice would not be striking on the 21st of June. So how would Prakash and may be Alex? play their next card?

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The Fortune Practice 7 : strike? 1

A story continued from above about life at the Fortune Practice So, there was a doctors strike planned for june 21; What was Alex to do? Suddenly a light shone from above and she was transported to her early days … Continue reading

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The Fortune Practice 6

After much deliberation Helen would take 24 hr retirement…

Alex was getting her head round her CCG role:

OK, so as well as doing her day job as a GP , the first thing she had to grips was as there was no management anymore and the CCG was responsible for the organisation of a service and the management of the services that she was referring her patients to.

Andrew was getting ready to go out, he was not quite there yet, perhaps some quality time with the love of his life would help?

No chance, after a full day of surgery , Alex had her head deeply buried in her lap top: approving her  consortium’s constitution , writing an agenda for her meeting, as well as the minutes of her last, emailing some contacts to get a patient involvement group going…supporting her colleagues involved in other more clinical areas..

Alex was getting her head around her new role: she was a bit startled  and recalled the Conservative Party Manifesto published in January 2010

We want to free NHS staff from micromanagement, increase democratic accountability and give patients the power to choose the treatments that are best for them

We are stopping the top down reconfiguration of the NHS”

Surely what was happening now would have been a reasonable if the NHS hadn’t worked but in June 2010:

The Commenwealth fund reported that the NHS is second to netherlands only on the parameters of quality , efficiency , access to health care , equity and healthy living

Oh well..this is where we are, best do the best job , her reference point had to be the patients, not the profession…….

Now, the equally pressing decision of how to respond to the BMA poll about how to vote on striking over pensions….How selfish? But then after all…the cost of pensions and vocational training was one of the factors that had paved the way to the Act being passed and what ways of protest were there left from the profession?

Meanwhile Abi was happily watching the LMC decisions that perhaps one day , even in her own NHS practice…she could charge for her minor surgery efforts…things were looking very good for profit mongers in the NHS…


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The Fortune Practice 5

A story continued from previous about life at the Fortune Practice…

Abi waited for her interview; she felt  alive with a fervor after watching Andrew Lansley speak confidently, amongst his friends…Her, it had to be said, very pretty eyes were shining with that light…that non engaged light…reminiscent of people enthused by cults….

She was desperate to finish her training in minor surgery…one day she would get her provider’s licence. Everything seemed a bit in disarray at the moment in transition but hey, if the worse came to the worst she’d get a job with a private company and work that way…she had mouths to feed… she for one was glad the NHS had been destroyed… it certainly liberated her interests! And she would still be working under the logo of the NHS… a great brand…respected worldwide.

She entered the room;

“The reason I would like to be on the CCG is that…I believe that competition amongst providers will improve  health care   to my patients…I believe that putting GPs in charge of the services we offer to patients means that we can cut through the layers of bureaucracy we have complained about for so long..”

Abi had never seen that look on Mavis’s face before…Abi must have roused some interest…

“What would you say of fragmentation, inability to gather data, concerns over education…loss of quality and equity…conflicts of interests…the destruction of the trust at the heart of the doctor patient relationship ” asked Mavis

“Oh” said Abi “ I prefer to be pragmatic…. work things out as I go along..”

Abi didn’t get through the interview stage ….Alex and her boyfriend Andrew couldn’t help but titter!

They wouldn’t have been doing so if they knew what Alex was in for…

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The Fortune Practice 4

A story continued from previous about life at the Fortune Practice

Alex was in morning surgery, running late….

She had to get to London:  The 38 degrees conference was on. The  38 degrees membership had been polled: 96% of the membership said they were STILL interested in funding events that kept the  NHS alive…well if there was one thing she had learned in her 12 years of qualification….one had to listen to the patients.

She had done everything she could to prevent the passage of the Health Care and Social Services Bill, lobbied her patients, attended the BMA SRM and voted, stood on Keep the NHS Public stalls marched on the TUC march, twittered and most important had stayed informed…On that terrible day on the 19th of March 2012 she followed the Lords debate live on line…and, yes, sank into a well of gloom when finally the Bill was passed. Now there was a new hope , artists, doctors, journalists, campaigners, charities and the men and women of the street rising from the ashes ready to fight again. They were reorganizing, finding their feet…the next phase of the battle was about to begin.

Alex got off the tube and saw a double decker bus advertising Stonewall. Activism and protest were not dead…maybe even more alive under the Tories. If she had turned her head for one second she would have crossed Abi’s path. Abi was attending another conference nearby that she had somehow got invited to at which her much maligned Andrew Lansley was speaking….

The 38 degrees conference was chaired by a Guardian reporter in the old GMC building on Hallam street, how appropriate  that now they were here, the public  regulating the profession!

Every  speaker talked about patients, patients patients, that was her language. The public had been so poorly informed of the passage of the Bill…they had to know what was happening…

Alex’s gloom was turning back into active ferver and then Dr. Louise Irvine said “ the NHS is not dead, it’s frail like a chronic disease and needs to be managed…” “That’s what we’ll do we’ll nurse it back to health”  Alex thought “that’s what we’re good at. We’ll show that collaboration and dedication and love of the institution was better that the ethos of competition and we’ll make it  even better than it was before”…but how? The finances and the work they would have to do looked like it was all designed to fail and pave the way for a two tiered system that would force everyone to get private health insurance…let the Nation decide

The Nation loved and understood  their service….Never underestimate the public.

Alex needed to win the election in her CCG and get her voice heard

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