Going, going, gone!
Sid Dajani wonders whether auctioneering is more attractive than working in the NHS
It has been an enormous privilege and I have been fortunate enough to be asked to speak at several weddings, forums all over the world, and even three eulogies. Two of these requests came from patientsâ€™Â families, and at the last one the priest joked he was scared because it sounded like I could do his job! But an old university friend whoâ€™d been let down at the last minute gave me a unique invitation that I couldnâ€™t refuse.
We met at her local town hall, which was stuffed to the gunwales with people whoâ€™d donated prizes. There were dozens of them, and I know because I was the auctioneer.
I soon learned that I was at the mercy of donors and that being an auctioneer is like playing poker; you can only do you best with what youâ€™ve got to work with. â€œTen jars of home-made jam, sold to you sir, at the back. Two bags of dung â€“ whoâ€™ll give me a tenner?â€ It was a fantastic evening.
Other friends got into the swing of things and helped me by bidding for things that wouldnâ€™t sell. I went home with a puncture repair kit and six signed copies of the autobiography of a personality Iâ€™d never heard of. Thankfully there were some high- end donations too, like fishing on the River Test, a weekâ€™s stay at a Derbyshire cottage, jewellery, and a London hotel stay.
All in a good cause
The evening raised Â£12,000, which wasÂ a relief because it was Â£2,000 more than my friend was hoping to raise for a worthy cause. Afterwards, over a glass of Puligny-Montrachet, she asked if Iâ€™d be interested in doing it again. My reply was a stare sheâ€™d last seen when Iâ€™d sworn blind that I would never do something again.
That was at university, when pharmacology experiments used to involve testing topical drugs on ourselves. Iâ€™d been happy to have atropine drops put in oneÂ of my eyes, making one pupil smaller than the other. It caused great amusement at the annual ball that evening, particularly as unequal pupils are a symptom of a syphilitic infection. Never again!
As we chatted before my long journey home she also asked about the pharmacy funding cuts. I felt my left pupil startÂ to constrict.
Survival of the richest
I explained that the government wants to close down 3,000 pharmacies and that it would keep restricting funding until 3,000 closed, which means the main surviving factor isnâ€™t about being the best or the most needed. It is about being the biggest and richest because they can take the most hits. The strategy is vague and not evidence-based, making no sense at all.
Every NHS reorganisation weâ€™ve had so far is not so much about reform and reorganising but re-disorganisation. TheÂ only people to benefit are the civil servants. And where is the architect of this chaos, Andrew Lansley? Even Nessie has been seen more times in the past year, and is perhaps more credible!
We now have over 200Â organisations doing pretty much idential things and with no resource to create differentials
The number of CCGs is little shortÂ of an outrage. We now have over 200 organisations doing pretty much identical things and with no resource to create differentials ... even if they could think of any. Thatâ€™s 200 sets of chairs, 200 executive boards, 200 sets of overheads, and 200 sets of meetings about 200 more meetings.
Costs, you ask? If their administration costs come to Â£300k a year each, you can wave goodbye to at least Â£60m. Add to that, costs around contracting, commissioning, and the rest.
Then thereâ€™s the cost of healthcare trusts and others, and engaging with them, and we must be looking at well over Â£1bn. A billion â€“ for what? There is no evidence that a market in healthcare improves anything, and everyone is running on empty.
The good people working in the CCGs do their best, but everything I know about them is something for the confessional box. People working for them talk about the ludicrous waste they have evolved into.
It serves no purpose to have the huge overhead costs of the Department of Health and NHS England. In the quest for finding the last shilling down the back of the NHS sofa, how does anyone justify the enormous costs of two chairs, two boards, two bosses, double staff, overheads and coffee cups!
The NHS doesnâ€™t think twice about wasting billions on the farrago of ineffective reforms. Closing beds makes no sense if you canâ€™t send well patients home because social services are running on empty. But
it makes perfect sense if you factor in improvements in length of stay due to better care.
Likewise, stretching seven-day services with five-day funding and closing down 3,000 pharmacies, not introducing a national common ailment scheme, and increasing the risk of harm to patients through the dispensing process also makes no sense if youâ€™re trying to build capacity and maintain quality. Itâ€™s a shame Labour are so disorganised trying to topple Corbin and undermine democracy that they canâ€™t capitalise on whatâ€™s happening.
A fish rots from the head down; you donâ€™t need two working pupils to apply the same analogy to a government in charge of patients and the NHS. Perhaps if all else fails a career as an auctioneer beckons ...