I seem to have lost my bet...

I genuinely thought that in the period between the Health White Paper and yesterday's bill, that the more silly and (in my opinion) totally wrong parts of NHS reforms would be quietly dropped.

Problem is, I know a bit about the subject, having chaired a couple of NHS trusts, helped develop PCTs and advised Ministers on the business of trying to run healthcare. I am not saying for one minute that I am the fount of all knowledge, and I have been proved wrong about as many times as anybody else, but........

The GP consortia that are already working in shadow form have all, without exception, blown their budgets. The doctors' trade union (British Medical Association) have woken up to the idea that Ministers want GPs to be the ones seen by the public to be rationing healthcare. The 2008 act (Labour in on the act) allows both NHS and private healthcare to be seen to be the same, and The Care Quality Commission is set up to regulate them as individual entities, and take it from me, working in the field, NHS bodies can only work in cooperation with other NHS bodies, dependent on the governance of others, something the regulations don't take into account. Ergo, NHS models are set up to fail in the quality regulations, where a huge NHS trust with seven large hospitals etc etc is judged by the same yardstick as a domicillary care agency.

You know what the real problem is? Not this government at all, but every single government that has come to power since Thatcher has seen The NHS as a toy to play with, to inflict ideologies on, using structural change as their legacy. I for one am getting a bit fed up of it.

I read today a quote from one commentator who said, rather succinctly, that in order to sink The NHS boat, managers don't need to sabotage it, they just need to take their eye off the ball for a second. (Possibly the second when they read their redundancy notices.)

In the meantime, NHS trusts, when they are seen to be failing, will be sold off to multi national companies for a song. No doubt the government will waive the historical debts too, as they always seem to roll over to the city. (The debts by the way equal the amounts spent on "reforms" over the years, according to an interesting report by the Audit Commission.)