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From: Andy Hall on 11 Jul 2008 09:54
On 2008-07-11 13:45:52 +0100, DaveT <justask(a)private.org> said:
>>
> Read what I write before using me as a excuse, it was reported that one
> of the US companies that are worming there way into running not only the
> PCTs but are already running some of the private surgeries has been
> brought into legal disputes in the US I believe to point out the
> trustworthiness of these companies that are being handed the NHS to run.

I simply referred to what you wrote. It isn't a bad thing at all
that a company is taken to court if it fails to perform. I would far
rather have accountability of that nature than public sector lack of
taking responsibility and obfuscation.

>>
>>
>>> If I had, it would
>>> have been to argue that fines just don't cut it when corportations
>>> cause deaths by cutting corners in the chase for profits
>>
>> That's just silly hysteria. It's prfectly possible to negotiate
>> contracts that will address that and to measure them. There is less
>> motivation for a private sector company to cut corners unsafely because
>> of the resulting publicity.
>
> What rubbish, they get a fine (that the consumer eventually pays for
> them), publicity does not matter when there is no alternative, we are not
> talking about Jacobs Cream Crackers against Asda's own brand.

The principle is the same.

> The only one if ever a *person* is found guilty, is the one who ended up
> doing the dirty work not the ones who said how it had to be done or who
> got things in such a state it ended up with that person making the risky
> move. It should be the decision maker and the ones who accept that
> decision that should be prosecuted, might make them think a bit more
> about the full consequences of that brainwave they had. It should also
> mean instant dismissal by law, no side stepping within the company.
> Whistle Blowers are frowned upon and often are ostracised for the rest of
> their working lives after being black listed for doing it. When that
> attitude changes and all those who did not whistle blow are instantly
> sacked so committed people can be brought in. We will forever have the
> escape-goat business stature we have. Both in the private and public
> sector.
> I understand secrecy about the product being made but when lives are put
> in jeopardy no secrecy should be legally allowed.

Obviously. That is a matter of contract terms.


> The same applies with the PCTs
> It is now a waste of time trying to get information from your local
> surgery unless they know you very well because those that surgery hop
> only get the PCT blurb because the person you ask would be instantly
> dismissed if the PCT found out.

Which is why PCTs should be privatised or shut down.


> That is one very good reason for not having private surgeries it does
> allow for patients and medical staff to really get to know each other and
> find the ones that can be trusted. One of the complaints from a surgery
> that has been privatised was that they never see the same doctor twice.

That's a complete myth. Most GP surgeries have so many patients that
even for regular attendees the doctor really can't be expected to
remember the patient details. The important thing is accurate
recording and dissemination of clinical information.


> As a diabetic that should really concern you as the loss of personal
> involvement eventually you will need to know the doctor with contacts at
> your hospital the one who has contacts within the PCT

It would concern me if that were how things generally worked. The GPs
have their lists of locally based consultants. To a point that is OK,
but I have found it far more satisfactory to identify the consultant
that I want to see based on their published work as well.


> The one who is
> willing to do minor surgery on the spot we even have one who does
> acupuncture who also is good with muscular problems. By knowing them you
> can make an appointment to see that doctor when you need his skill
> without making umpteen appointment's chasing a trail of doctors.

I don't find that method satisfactory. I would far rather identify a
consultant myself (and possibly a second one for a second opinion) and
ask the GP to make the referral.


>
>> I am far more concerned about the NHS methodology of spreading available
>> funds as thinly as possible in order to maximise the number of patients
>> treated, while wasting a significant proportion on unnecessary
>> bureaucracy.
>
> There was an internal .pdf explaining how and who PCTs should answer to
> but it seems to have been removed from the net (I wonder why) as I can
> not find it now.
> It explained that no PCT should answer any questions without first
> getting permission *and the answer* from the main authority. No minister,
> MP, health worker has a right to ask and questions must go through a set
> course of channels. The information is not (contrary to what Panorama
> stated) available under anything like the data protection or the freedom
> of information act. So when that program states the PCTs do not know how
> many private surgeries there are they are just refusing to say, so one
> has to ask why. Where they frightened of the obvious second question.

The obvious issue is that the people in senior positions in the PCTs
prefer to make themselves inaccessible and unaccountable. This
disease has spread throughout UK public sector healthcare management
which is a strong reason for it to be wound down and replaced by an
arrangement where the government provides functing and npt provisioning.




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