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The shocking truths of the Mckinsey report

By Ian Quinn

NHS London wanted a 'line in the sand', but in reality they realised that their plans - widely copied by other SHAs - were a lame duck, says By Ian Quinn.

After months of fending off politicians and health campaigners and clinging on desperately to the secrecy surrounding the now notorious McKinsey report, finally the truth was out.

NHS London said it was 'time to draw a line in the sand' and publish the controversial report behind their radical shift of care into the community. The confidential documents concerning the country's most powerful SHA's plans for 100 polyclinics and the creation of a new GP system was seen as a future model for the country, but its public release had absolutely nothing to do with lines or sand.

It had much more to do with the fact that new health secretary Andrew Lansley had just brought the authority's plans crashing down to earth.

Yet the biggest twist came not in the original plans of McKinsey, revealed in their full glory at last, but in the revelation that NHS London itself had realised that the hugely ambitious overhaul in care was not working.

In fact, perhaps the most shocking revelation of the McKinsey report and its associated documents revealed yesterday, was that NHS chiefs knew at least as far back as last November that Lord Darzi's proposals had been based on hugely exaggerated expectations.

Far from bailing NHS London out of its debt crisis, the documents reveal that polysystems have ended up costing more than they have saved.

Admissions to hospitals in the nine areas to open polyclinics since April last year have not fallen as predicted. The resources in primary care were not in place to cope.

These are the very same arguments that opponents of the polysystems plans, which have been latched onto by a raft of other trusts planning similar shifts in care, had been using all along-the ones that had been furiously denied by NHS London chiefs.

In fact, Pulse revealed just a few weeks ago that NHS London was encouraging trusts in the capital to spend up to 2m promoting the merits of polyclinics to patients, despite all the evidence pointing to the fact that patients themselves valued the continuity of care offered by the current system far higher.

Incredibly, the latest documents have the audacity to claim that the consultation surrounding polyclinics had ‘validated' Healthcare for London's ‘vision' and praised the establishment of a ‘high profile and highly successful clinical advisory group.'

It is true that this group contains some well-respected clinicians, including GPs.

But the documents neglect to mention that London GPs were so enraged with the plans that LMCS in Redbridge, Waltham Forest, Lewisham, Greenwich, City and East London, and many others, had submitted demands for the plans to be scrapped

All things considered, the new admission that NHS London for some time has realised that it got its calculations fundamentally wrong has taken away from the impact of the original horror surrounding leaks from the McKinsey report. In case anyone has forgotten, its recommendations including slashing GP appointment times by 20%.

Let us hope that as it assesses the wreckage of its plans, NHS London realises it's time to draw a line in the sand on that idea too.

By Ian Quinn is news editor at Pulse magazine

By Ian Quinn