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The barbarians are here

The new listening exercise will 'liberate' the NHS in the same way a burglar 'liberates' property from your house

Future Forum, my foot!

Editorial constraints prevent me from being more Anglo-Saxon.

The Future Forum is a series of meetings and consultations that are taking place to discuss clinicians' views on the new White Paper, which is amazingly termed 'Liberating the NHS'. The only way this can be liberating is in the same way as a burglar can be said to be liberating property from your house or car.

Professor Steve Field has been asked to chair these meetings, and there are a carefully chosen selection of people who will sit on these fora, and eventually write the report to the Government. I'm pretty sure that some special adviser in the Department of Health has already written this report, and it is merely waiting for the imprimatur of Professor Steve and his chums. There will be some quotes (carefully selected) that can be inserted at the last minute to give the appearance of faux-truth.

I have had a letter from the Future Forum chair. Actually, if you look, everybody has. It is a 'Dear Colleague' letter. In the last paragraph, he urges clinicians to avoid being cynical, and believe in the listening exercise. It is good that Steve has recognised that not everyone agrees with him and his selected band of zealots.

But are we being cynical? In the dictionary definition of cynical, it says that being a cynic is someone who disbelieves another believing them to be motivated by 'self-interest; distrustful of human sincerity or integrity'. That seems to be very much the case. Most of the people on the Future Forum panels are either representing vested interests, or have already stated a view that is strongly for the White Paper. That includes Professor Field himself.

I am very cynical. I do not believe this is an independent body, and that the variety of people on the body will express the full range of views about the White Paper. It is an exercise in neutralising anger, buying time and appearing to listen.

The recent evidence of how to write an independent report can be gleaned from those written by the Lords Franks, Butler and Hutton. They were all essentially about international war-making.

Firstly, choose your chairman. This is essential as the chair will be vital in determining the outcome.

Secondly, choose your 'experts' so that none of them can go off message. The group writing the report must have a balance of men and women, nationalities and sectional interests.

Thirdly, set the remit of the report. Make sure that the debate is on the details, preferably relatively minor ones. At no stage allow the whole bill to be discussed.

Ensure that public consultation is limited, and preferably with selected audiences, and behind closed doors.

Finally set a time frame that is politically convenient, preferably at a time when people are busy with other things or cannot get opposition organised in time. Use of Parliamentary recess time (when MPs aren't sitting) so that helps your cause.

Hey presto! Report written. 'Consultation' has taken place. Everyone thinks the bill will be brilliant. Back slapping all round.

Meanwhile the NHS slowly dies.

There must be three people who are spinning in their graves as a result of recent Government Policy changes. Bevan, Beveridge and Butler. Labour, Liberal and Conservative.

We are seeing the great post-war consensus of universal health, universal welfare and universal education fostered by these giants being finally laid to rest on the altar of capitalism, consumerism and conservatism. They are not here to defend their legacy. In fact very few people are there to protect their achievement.

The barbarians are here.

The Jobbing Doctor is a general practitioner in a deprived urban area of England.

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