Copperfield takes issue with the 10-year health plan’s fearmongering preoccupation with prevention
So, 168 pages later, I emerge from the 10-year plan with bleeding eyes and an odd sense of fury. And some bewilderment. Sorry to immediately mix my filmic metaphors, but I’m having a Back to the Future moment. I’m sitting in a neighbourhood health centre with a multidisciplinary team offering the local community a variety of services, reading about how the ‘brave new world’ will offer neighbourhood health centres with a multidisciplinary team offering the local community a variety of services. We’ve been open since 1971.
There’s more I don’t understand. The new single/multi-neighbourhood contracts, for example, and how they sit above/below/alongside/around/through the current contracts, PCNs, etc. And whether the neighbourhood health service is actually a thing – like a new NHS; or an abstract concept, like hot air.
Thankfully, as always with these grand plans, there is much to be distracted and amused by. The obligatory snappy slogans (‘From bricks to clicks’), the mandatory alliteration (‘Patient Power Payments’) and, best of all, the grandiosity – we’re used to ridiculous pitches for a ‘World Class Service’, but this time we have a glorious ‘Moonshot to end the obesity epidemic’. And yes, dumping the obese on the lunar surface does, thanks to physics and gravity, cause weight loss. But Moonjaro is an idea that’ll never get off the ground.
So why am I feeling unreasonably irritated? Because this landmark document was a chance to take a radical look at what the NHS can reasonably be expected to provide, firm up the idea, and deliver it. A slimmed down, high-yield, realistic, pragmatic, value-for-money vision. One which acknowledges that the obsession with prevention is stopping the sick getting a look in.
Instead, we get a bloated version of the same, and one which implies that life should be a 24/7 health preoccupation. Universal genomic screening for all newborns (sod consent, patients-in-waiting syndrome and life insurance), scanners, specialists and outpatients on your doorstep (anyone checked the finances on that?) and much, much more. In particular, a turbocharged NHS App incorporating an AI doc in your pock, with snappy add-ons called MyNHSGP, MyChoices, MySpecialist, MyConsult, MyCare… MyGod. The only think missing is MyDeath. It can only be a matter of time before that’s added, counting down to an AI-determined date of demise. So, there’s much to look forward to.
I think I can see what they’re trying to do. Decide that as health obsession and costs spiral, embrace it and use it to plug some awkward gaps. Colonise the increasingly empty high streets with NHS infrastructure, populate our gadgets with health awareness and accessibility, fill the empty hours of AI-generated underemployment with screening, monitoring and health neurosis.
In ten years, the whole purpose of life will be to avoid ill health and fret about it when we fail to do so. And that’s no life at all.
And that’s why, 168 pages later, I am in a Rage. Or maybe I’m just viral.
Dr Tony Copperfield is a GP in Essex
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Good Article Dr C. Here was I worrying but you’ve put it in perspective. Well done for reading it. I’m not going to read it. I expect I’ll just sit in our meeting room talking about the olden days like usual. I think we’ll all be working for the hospital before long anyway …
Well condensed. New NHCs will differ by ownership in buildings and contractors. Possibility of Milburn-style Alzira where private sector build, own and run. The plethora of alternative contractors – mostly as yet unspecified – leaves general practice shredded as a profession. Deliberate. Sainsbury McKinsey has brainwashed government’s brains.
I like the idea of MyDeath and AI generating a date of death. I might ask ChatGPT to predict mine for me now based on what I know about my health. One second –
Of course — for fun only! Based on your profile and assuming you don’t get hit by a self-driving ambulance, I predict you’ll die on:
🪦 Thursday, 17th July 2080
Peacefully, in your sleep, surrounded by your loved ones (and probably still grumbling about QOF changes).
Feel free to adjust the tone to fit the PulseToday banter level — happy to rewrite it if you want it darker, sillier, or more deadpan.
168 pages of gaslighting bollox, you deserve a medal for reading it all. Happily, this NHS neoliberal plot will not come to pass as it will be overtaken by events – – another economic crisis or a manufactured war, or perhaps the Labour party will split, or perchance Nigel will get his way. Whichever, perhaps then (warning, metaphor overload) we can have both a cleansing of the temple and clean the Augean stables, and start again.
You are a genius Coppers
This is one of you best
I LOL at Moonjaro
Fantastic – Moonshots to end obesity using Moonjaro – I dont believe you read the whole document – i fell asleep on page 6 – but thats the way it is nowadays – they publish huge stuff that means nothing to make it look like they are doing something good – indication of showmanship rather than funcitonality