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Blithering’s Day of Rage


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Friday, 23 June 2017

Blithering’s Day of Rage

Sir Trevor Longstay raised his voice and turned a darker shade of puce than usual: “You’re going to have to sort it out, Rummage. We run a tight ship here. I won’t have us knocked off course by these snivelling, rebellious Trots.”

Dr David Rummage looked like a man struggling to endure a particularly painful rectal examination. “Well, I don’t really see what I can do, Sir Trevor. It’s not really my…” Rummage tailed off helplessly.

Liz Wanhope intervened. “I think what Sir Trevor means, David, is that in your capacity as LMC chair you may be able to exert a positive influence on your GP colleagues and possibly persuade them to defer their protest or bring their concerns to the next stakeholders’ meeting.”

“Defer, my arse,” said Sir Trevor. “I’d horsewhip the lot of ‘em.”

Martin Plackard adopted what he imagined was a sympathetic expression, somewhere between a smirk and a bout of colic.

He glanced at Sir Trevor who had paused to avert the risk of stroke.

“First of all,” said Plackard, “I’m sure you’d like to join me in congratulating Sir Trevor on his new role as lead of the Blithering Accountable Care System, in which capacity he is responsible for, er…”

“Banging your bloody heads together,” said Sir Trevor with a thin smile.

Plackard gave a nervous, girlish laugh. As no one else looked as if they would like to join his fawning party in congratulating Sir Trevor, he moved swiftly on.

“So as he so amusingly puts it, Sir Trevor is here in an enabling capacity to support us to aim to kick-start the implementation of the preliminary plan to deliver integrated person-centred care in line with the objectives of the Blithering Forward View.”

Plackard paused as the tap tap of Sir Trevor’s propelling pencil on the boardroom table grew louder.

“Or to put it another way,” said Sir Trevor, “we’re here to sort out the £75m hole in the trust’s finances, haul the CCG out of special measures and knock some sense into the rabble I had to drive through this morning.”

Rummage winced again. “About that, Sir Trevor,” he said. “I’m sure the scratches will come out with a bit of polish.”

Sir Trevor’s return to Blithering under orders from the top brass at NHS Improvement had not been auspicious. Encouraged by Day of Rage protests elsewhere in the country, Blithering’s primary care staff were out in force engaging in their own protest at underfunding. As part of Being Quite Cross Day, a group of activists had gathered in the CCG car park and Sir Trevor’s Rolls Royce had sustained scratches on the wing as it ploughed through them.

Things had calmed down since the ambulance left and the rest of the protesters had melted away, but Sir Trevor was demanding answers.

“Well, Rummage?” he said. “What are you going to do?”

“The Halford’s in the retail park is open late this evening. I could pop down there after the meeting,” replied Rummage.

“Not the bloody car, man”, growled Sir Trevor, “the dissident doctors.”  

Rummage explained that the CCG’s New Deal for General Practice wasn’t going to plan. The deal was that GPs would only get funding for “working at scale” if they made equivalent savings for the CCG. Development funds would be forthcoming when GPs solved the CCG’s financial problems or never, whichever was the sooner.

“How are they going to do that, short of selling off their premises and sacking themselves?” Rummage asked.

“Sounds perfectly reasonable to me,” said Sir Trevor. “These people always want something for nothing. They need to understand that cost-cutting is an investment in their future.”

The awkward silence that ensued was broken by Plackard. “On a more positive note, we’ve received some excellent news from NHS England’s strategic naming directorate,” he said.

Plackard went on to explain that following a reorganisation of the national team the former commissioning directorate would from now on be known as “strategy and innovation”.

As a result, Plackard said, there would be “far-reaching changes”. Pressed for an example of a far-reaching change, Plackard pointed out that in addition to his existing title of director of social assets and digital leverage he would assume the additional title of executive director of inspiration with immediate effect. 

Seeing that Sir Trevor’s propelling pencil was on the move again, Plackard played his trump card.

“I think I have a solution to David’s little problem,” he said. “We can tell GPs that NHS England is getting rid of commissioning altogether and putting them in the driving seat. Let them know that if they stop complaining and get on with working at scale, collaborating and so forth, they’ll soon get their hands on all the cash.”

Sir Trevor frowned. “But they’ve only changed the bloody name, Plackard, about 20 people are affected. It’s hardly the last gasp of the purchaser-provider unicorn,” he said.

“Indeed, Sir Trevor,” said Plackard, turning up his smugness to unbearable, “but they don’t know that, do they? At the very least it will buy us a few months of peace and quiet.”

Sir Trevor turned to Rummage. “I think Martin may just have dug you out of a hole, Rummage. Now run along and tell your cronies the good news.”

“Oh, and one other thing,” he barked at Rummage as the careworn GP made for the door, “be a good chap and pick up a tin of Turtle Wax from Halford’s on your way. You’ll be needing it for our next meeting.”

Editor: Julian Patterson


Clive Spindley
Clive Spindley says:
Jun 24, 2017 10:53 PM

loving it, well far more entertaining than digital health, woof woof