Saturday, 30 July 2011

White Van Ambulance Man

Nothing to do with books but it's blog or bang my head repeatedly against the wall.

I've just finished reading a bunch of articles and reports on what our newish government is doing to the NHS under the old slogan of "competition good". Naturally, competition has already proved bad and people are suffering - and that's after less than a year and before any of the really stupid changes are made.

An example of what I'm talking about: in recent years the UK has seen startling improvements in heart and stroke treatments and survival rates. To quote Polly Toynbee in the Guardian:

a patient with a stroke or heart attack is immediately identified by retrained ambulance staff, no longer mere drivers but paramedics equipped with ECG equipment. They know to take people not to a hospital a patient chooses but to a specialist centre, avoiding A&E delay, rushing them straight into an operating theatre for angioplasty or a brain scan and clot-busting drugs: 90% are treated within 150 minutes of calling 999.

Heart attack patients are home three days later, when they used to stay 11 days

Now we're going to open everything to competition. Already there's been a bid by one private company to provide ambulance services. In one quick move a vital component of a successful strategy is blown away. We've seen driving services (eg prisoners from jail to court) illegally awarded to private company (a better tender by Prison Officers Association was dropped for political reasons) - so now you're going to be driven by a minimum wager with no guaranteed training. His employer will probably have a deal with another private company running hospitals - so that's where you'll go.

Theoretically you will have a say. "Patients' Choice" is there to empower the consumer ... I'm sure, as you lie on your ambulance bench munching an oxygen tube you'll be able to look up details of success rates and costs between hospitals. As long as you remembered to pack your laptop as you collapsed.

Let's ponder these drivers a little. Given track records in these areas we can expect to see companies expanding from the security sector. It used to be "minimum wage and bring your own dog" to get a job with one of these stalwarts of safety - now I'm sure that white vans throughout the land are being washed down and benches from Homebase being screwed to the floor (there's a metaphor there) as cowboys galore realise it's easier to drive granny to hospital than to persuade her she needs a new roof. "I was just doing a bit of work down the road when I noticed you had a few slates missing, er were making odd noises like in that ad on the telly."

Remember the great privatisation of bus services? The misery and calamities for us poor sods who use public transport? Are we going to see private ambulance companies refusing to serve rough estates? Will we see one big company using half a dozen ambulances to block in a rival? Will Arriva Ambulances circle old folks homes like carrion crows? Will ambulance fares go up and satisfaction go down? Only it's not a half hour wait for a 53 and another late arrival at the office, it's life and death here.

Average time in hospital down to three days from eleven? Stupendous achievement - and a fantastic cost saving. I suppose the new bureaucracy (yes, there will be one) will assess a stroke as X thousand pounds, based on the three day rule. Which means private hospitals will turf people out as soon as possible, regardless of ongoing needs - and the rump of the NHS will have to pick up the pieces, as it does now with the botched births and all the rest that fall down from shiny out of town corporate healthcare facilities.

Don't convert all those white vans lads, a few of them will be needed for another facility. One where you drive a lot slower.


Nancycarol said...

Wow...I'm not sure of all the ramifications of your subject here, but sounds to me like the UK has some of the same problems the US does.

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