Had I eavesdropped on recent conversations in Whitehall about the NHS, this is what I might have heard:
‘We can’t offer more funding because – well – we don’t want to. It’s costing a bomb and people just keep getting older. Turns out when we talk about 7/7 access, it makes patients want more. Who knew? We can’t privatise it because people keep noticing when we try. Bloody lefties. We tried giving all the problems to CCGs and saying they were GP-led so they’d get the blame, not us, but it’s still not working. So it’s time to ramp it up a notch. After months of blue-sky thinking, brainstorming and input from self-appointed friendly experts, ministers, I give you… the Sustainability and Transformation Plans.
This is a restructuring, NOT a reorganisation. Totally different things
‘We said no more reorganisations in the last general election campaign. So let’s be clear, this is a restructuring, NOT a reorganisation. Totally different things. Totally.
‘Here’s the plan. We throw health and social care together in one big pot – they are our biggest headaches after all – cost a fortune! Then we carve the country up into big areas. We can call them “footprints” – people will have images of following in the footsteps of giants, that sort of thing… very trendy.
‘Hmm? Will it matter that they cover such huge areas? Of course not. I mean, everyone has the same healthcare needs, don’t they? And social care isn’t really an issue, because we know how rich old people are – they’ll just pay themselves, or their families will look after them for free.
‘So we get everyone who provides health and social care within each footprint in a room, and lock the door, because we don’t want the press or those people who rave about transparency getting in. We’ll make sure the people in the rooms are saying what we want – Sunday opening, 7/7 agenda, 24-hour GP care, help for the elderly, blah blah.
‘Doctors? Oh they always want their say. Get a tame GP or two into the room, which ticks that box. The further we can keep LMCs and the BMA away, the better. If LMCs whittle on about being “the only statutory body to represent all GPs” then nod and frown but do not let them in. Same with the consultants – we can say it’s all community based and they won’t have a clue. And we don’t need to involve patients, just keep telling them how much extra we are investing, works every time. Smile and wave, boys, smile and wave…
‘Extra funding? Well, there’s a couple of billion kicking around but that’s needed to bail out acute trusts. They’ll have to reorganise… er, I mean restructure… to solve cash problems.
‘Here’s the best bit – we don’t give STPs statutory status, so they can do what they like and no one can complain! They can make the cuts we don’t want to, and the huge deficit is their problem, not ours. We can do some head shaking and tutting if it goes down badly.
‘You worry the public might get wind of it? Easily solved – set a super tight deadline, and hey presto! Decisions made with no pesky campaigners, before anyone even realises. Responsibility for health and social care handed to someone else. That’s the NHS sorted. Would you like to hear my ideas for Brexit?’
Dr Zoe Norris is a GP in Hull. You can follow her on Twitter @dr_zo