I'm back! I survived the RCGP conference. I am pleased to report I had a warm and cordial welcome and even BA contributed to a memorable day by getting me to Leeds and back, cheaper than the train, quicker and on time.
I took part in the media question time. It turned out to be a hoot! The robust exchanges between Lady GaGa and Prof Sir Simon Wesley, (A John McEnroe look-alike) the panel chairman, woke the audience up and dissolved them into fits of laughter when they realised he and Lady G are husband and wife. Heaven knows what breakfast time is like in their household!
I had a spat with a very polite bloke from the BMA with a sesquipedalian question. Apparently I'd upset him by saying the thread-bare, self-focussed, hopelessly led, vacuous, confused, split-loyalty BMA had let the reforms in by the back door. I thought everyone thought that; he didn't. Never mind. He got over it!
The previous day Conference had been treated to a visit from LaLite. He told his audience he wanted to be the most GP-loving Secretary of State in living memory; it was his mission to end the box ticking bureaucracy of QoF.
Now, GPs are a bright lot but like any other audience they are easily distracted. When they hear; 'GP-loving, memory, mission, and bureaucracy', they don't hear; 'end and QoF'. At that point Conference should, as one, have stood up and shouted 'Woooha! Wait a minute... end QoF and replace it with what?'
When a pickpocket bumps into you at the train station and apologises profusely for his momentary clumsiness and enquires, earnestly, as to your wellbeing, you don't notice his deft hand lifting your wallet. LaLite is the Apollo Robbins of healthcare. He is not after bureaucracy or loving you, he is after your wallet!
The whole idea of removing QoF is to remove costs. LaLite knows about the Circle of Doom; the fact that after 2015 all funding bets are off. The NHS is facing a black-hole of something like £30bn, maybe more. No one is going to suggest putting taxes up so costs must be cut.
I know, practice costs are going up and GP incomes are levelling off but LaLite will want more. GPs; expect a pay cut. GPs need an urgent alternative to the conflicted, confused and convoluted BMA to represent them without the clutter of all the Docs in other parts of the NHS chiming in with their two-pennyworth.
It's not just GP's cash LaLite has his eyes on. The NHS pay-packet is up for grabs. Seventy percent of costs are wages and salaries. Annual increments, linked to length of service and satisfactory performance, add £700m pa to salary costs. They are set to become part of the history of healthcare. The DH say; 'can't pay, won't pay'. Strange how NHS Scotland says it can and will?
LaLite wants the Pay Review Bodies (which are due to make their recommendations in February or March) to defer the planned 1% pay rise until he has negotiated seven-day working with Unions. The Chancellor's weighed-in; ".... and confirmed (HMG) want NHS pay to have stronger links to performance, quality and productivity".
Explain to me how a nurse on a ward can influence the quality of care she delivers if the numpties in the Board Room cut staff, reduce hours and screw-up patient to nurse ratios? Remember, the biggest pay-winners last year were senior managers who got a whopping average rise of 16.4%. The real pay cost inflation has resulted from The Carbuncle's upgrade of posts, post-reform.
What to do? All Trusts have the authority to set local pay and conditions. Unions don't like it as they lose their raison d'etre. Nevertheless, it can be done. In the early 90's I sat down with staff, great managers and some very far sighted Union bosses and introduced the first local-pay and conditions package in the NHS.
We created the headroom for increments by working together to cut costs. No one knows more about efficiency than the front-line. You just have to listen.
The clodhopping NHS Employers sound, to me, like they're the back-door of the DH and cut no ice. Trust Boards will be buffeted by cack-handed national negotiations motivated by party and politics in the run-up to the election. Right now there is a brief opportunity to take a serious look at how to use pay as a lever to bring people together, not a stick to keep them apart.
Boards, take note; it's time to look after your most valuable asset; your people. Circle the wagons
(there are lots of hyperlinks in the original that obviously haven't copied across)