We already blogged the NAO report on the abolition of GPs out of hours (OOH) care. From a taxpaying customer's perspective it was an Unmitigated Bad Thing- we've ended up paying £200m pa more for a worse service.
From the GPs perspective of course, it looks very different. In his usual robust style Doc Crippen explained to us what an unsustainable nightmare the whole thing had become, and I for one believe him. Particularly once I'd discovered that GPs rarely provide such 24/7 care elsewhere in the world.
So the question now is whether we taxpaying customers got good value from the switch to the new depersonalised third party OOH service? Yesterday the Public Accounts Committee grilled the three top Department of Health officials on precisely that question.
And what an uninspiring bunch they were...nearly as unfunny as the Three Stooges. Sir Ian Curruthers OBE is the Acting NHS Chief Executive, thrust into the bunker three months ago following the field execution of the unfortunate Crisp. He's clearly been dragged in from running an unsuccessful chip shop somewhere up North, and came across as someone not quite on top of things: the PAC Chairman summed up his appearance as being "underwhelming". His wingmen were no better, even though they are the guys ultimately in charge of all our primary care (ie all our GPs etc). It's frankly quite scary.
We were taken through an all-too familiar catalogue of muddle and incompetence:
- Is the new OOH service emergency only, or must it also cover on-demand unscheduled consultations (like Doc Crippen being summoned out at 2am for a chat about someone's tennis elbow)? Most of us presume it would be for emergencies only, but the department doesn't have a position- it's still thinking, even though the new system is already up and running
- Why have the costs been so much higher than anticipated? No real answer...that's a matter for the Primary Care Trusts, not us
- How's the over-run being funded? No real answer...that's a matter for the PCTs
- Given that OOH was so unpopular with GPs, and 90% have now opted out, why were they allowed to do so for the trivial sum of only £6,000 pa? Not our responsibility- down to the PCT negotiators
- Where did the £6,000 come from, given that the actual cost of replacing the OOH service seems to be closer to £15 grand? There was some kind of "economic analysis", but not our responsibility
- Why do the new replacement OOH services miss virtually all their critical service targets, including patient response? "Disappointing"...but er, not our responsibility
It's that old power without responsibility thing AGAIN. The Dept has set its top down Stalinist strategy, but then walked away from its implementation. We've ended up getting the worst of both worlds.
Why do we need the Dept of Health? We blogged yesterday about how we'd do better by winding up the Home Office, getting our money back, and doing our own local justice. But with the Dept of Health, we could just wind it up, get our money back, and spend it all on holidays. We'd be miles better off, both in our wallets and our health.