11th April 2016

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Niall Dickson Boss of the General Medical Council in conversation with Roy Lilley
Fascinating career as a BBC Journalist, the Kings Fund and now Chief Regulator.
Interesting night in prospect.  Does the GMC really protect patients?
3rd May 5.30pm King's Fund - a chat and a glass of wine Details here.

Maybe 2020
News and Comment from Roy Lilley
I'm writing this at 5am (last) Friday morning.  I've been up since half-three.  I should have been on ITV DayBreak talking about the JD strike.  However, I was axed so that the nation might know more about Mr Cameron's tax affairs.
It's a strange time of day.  Quiet.  Just the occasional creak from the central heating.  The birds can't quite decide if it's time to announce the dawn.  To the east, a finger of cold light nudges into the horizon, turning the Vantablack into Payne's Grey.
A few years ago I might have known for sure the new day had arrived.  I would have heard the rattle of the milkman, the paper plop onto the mat, the gate creak as the postman delivered joy or impecunity.
There's milk in the fridge, in a plastic bottle... from the garage.  The papers... on my iPad.  Correspondence... e-mail.
The day no longer has clues to announce its arrival.  Alarm clocks on our iPhone, the news electronic, the world 24-7.
24-7... at the heart of the JD strike.  The new contract aims to make it easier for Trusts to rota Docs to work across 7 days, meaning most will work more evenings and weekends... when child-care costs are at a premium.
Docs work these hours now but get paid extra for doing so.  Under the 'new-deal' the premium-hours are reduced.  As well; changes to pay progression translate into taking longer for Docs, working part-time, or away on maternity leave, to get pay-rises.
Approaching half of all JDs are female, more likely to work part-time and be away on maternity leave, the 'equality' block in the game of Contract Jenga gets pulled.
The contract has equality problems.  The DH says they know and compensated for it by re-distributing the present pay envelope; everyone gets a 13.5% up-lift in their basic.  An expensive court case will decide what's-what.
Government is hell-bent on a seamless seven-day NHS.  It would have been a great challenge.  We'd be the first country in the world to pull it off.  We could have been proud.  Said; 'We did it!'    
The contract row has soured the challenge.  No more talks are planned.  We are watching a slow-motion car-crash.
'Car-crash' is a pretty lazy metaphor but it is apt and used by the King's Fund's Chris Ham writing in this morning's (Friday) On-line Guardian.
Ham says; "Observing the NHS today is like watching a car crash..."  Ham sifts his way through the problems; the money the staffing, the policies, austerity and challenges Hunt to quit like Duncan-Smith.
Pretty na´ve.  Unlike Duncan-Smith, the Tinkerman is an 'EU-Remain' ally of Cameron and after the Battle of Referendum is done on 23rd June, they will be standing, shoulder to shoulder, on the battlefield as the last whiff of cordite and smoke swirls around them.
Ham is saying what we've said since last summer.  The NHS is not adequately funded for the work it is obliged to undertake.
The NHS is not run by the Tinkerman any more.  Regular meetings at Number 10m means he and the bosses of NHSE and NHSI get their list of things to do from David Cameron, Nick Seddon, Oliver Letwin and Camilla Cavendish.  Hence you get daft statements like;
"Delivering high quality, safe care and maintaining a grip on finances go hand in hand. It isn't an either-or choice that NHS leaders should be making."
They've convinced themselves being tuff-and-tuffer is all they have to do.

The NHS will grind to a halt.  Everyone who knows anything about the workings of the leviathan will tell you the same.
The question is; do Cameron, Nick Seddon, Oliver Letwin and Camilla Cavendish really give a tuppeny toss?
I suspect their thinking goes something like;
"We are 'funding' the NHS' own 5 year plan.  Make them deliver it.
Delivering the manifesto commitment for 24-7 is a red-line.  A full walk-out will turn public sentiment against the JDs strike.  Ignore the noise...  it will come right and be forgotten by 2020, Labour pose no threat.

Forget the safe staffing palaver... it's no excuse.  Make 'em balance the books or send the CQC in to give them a good kicking... get this right, now and give us a soft landing in 2020.  The CQC was Labour's idea.
The NHS has to be bullied, cajoled and intimidated into greater productivity.  If that means cutting head-count, closing services, get on with it, now...    it will come right and be forgotten by 2020, Labour pose no threat."
It's now 7am and I'm going back to bed, pulling the duvet over my head, for the rest of the week... maybe until 2020.
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This is what I'm hearing;
if you know different,
tell me here
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