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No sense in NHS strategy


No sense in NHS strategy

Anyone can see that to make efficiencies, you need investment and training, you don’t force mass closures

Independent proprietor Sid Dajani gets frustrated over Health Service management

It's a strange time of day, 3am. 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.

Unfortunately I’m appreciating all of this because I'm ill. Since January I've been a patient of the NHS during the week and a victim at the weekends. It’s a contrast like no other. Longer waiting times, being forgotten, lost blood results, and I'm not exaggerating.

Trust me – if you are desperately ill, collapsing, throwing up and fainting, and someone wants to take you to hospital, make sure it’s not the weekend. And if it is, lock them up and hide until Monday morning!
I’m not blaming staff. Like in pharmacy, I sincerely believe that the overwhelming majority of staff come to work every day determined to do a good job. A lot of people are busting a gut to do things right amidst a lot of things going wrong.

And what this government has done for the NHS, they are going to do for community pharmacy.
There is a much deeper malaise, with discontent fermenting, and dissatisfaction and despair brewing. Community pharmacy feels like the Edvard Munch painting and is ready to let out a collective scream.

Survival of the richest

The government wants to close down 3,000 pharmacies and will keep suffocating funding until 3,000 close, which means the main survival factor – the gold standard – isn't about being the best, being the patients’ champions, nor the most needed or the most professional. It is about the richest and the biggest because they can take the most hits.

We’re told that there’s an Integration Fund and an Access Scheme. Vague, no facts, no evidence, and no details are just about all we know. What we do have is a very poor track record and long memories, so I’m not instilled with confidence and I'm sure I'm not the only one who thinks every reorganisation we’ve had so far is not so much about reform but re-disorganisation.

The 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 she’s more believable!

They think we are stupid. They want to make efficiencies and say they want us to do more, but at the same time they want to cut numbers and access points for patients to get help. NHS staff, does this ring a bell?

Hospitals don’t have elastic sides. When they are full they are full, and pharmacies are the same. By getting rid of capacity, the government is reducing its choice of solutions and going down a one-way street the wrong way. I certainly wouldn’t admit to being a Conservative if I were you.

NHS in crisis

The NHS is ailing, social care failing, and hospitals wards are full. A&E is more clogged up than the arteries of a fat-guzzling, 50-stone man, and it’s easier to get an audience with the Pope than it is to get an appointment with your GP.

This is not a Rubik’s puzzle; if you close the front door you can’t let people in, get them seen quicker, make them get better and support them through their worst times of vulnerability. You don't have to be an economist – anyone can see that to make efficiencies, you need investment and training, you don’t force mass closures.

Who do they think they are kidding, and who’s being stupid? I’m frustrated by the Treasury seeing pharmacy funding as a soft target in hard times. It’s the Department of Health that is showing signs of stupidity, for there is no getting away from the fact that it is stupid to insult the profession you are trying to encourage. The insults are institutional and this government has proven one thing so far – it excels at making a dog's breakfast out of nouvelle cuisine!

I’m sure it'll make up the evidence to support its theories for closure, or it'll use the same researchers as at the least election. They’re the sort that ask a couple of people about something they know nothing about, multiply the answers by 10, take away the number they first thought of and allow ± 2 per cent for error. Then – bingo! – it will deduce either that there are “3,000 pharmacies too many” or “Britain thinks the NHS is treating too many Martians”. Take your pick. Both are untrue unless you’re a politician or a civil servant.

The lucky 3,000 will not be so lucky, I can tell you. Even if it’s someone like you and me, struggling with an avalanche of demand and trying to hit impossible response targets. The Department of Health will become more important than relatives and patients as pharmacy keeps looking over its shoulder, worrying about who will be next.

Fear of criticism, of retribution, and investment, will become rife. Plus fear of being cut short and developing any business plan. With no margin for capacity, no one to ask for help, understanding or support, only risk and error will be on the rise.

Something fishy

I have been invited to a symposium. I get invited to many because of my national and European role, but I rarely go. This one is entitled ‘Challenges of Quality Requirements for Fish Vaccines’.

Delegates are tantalised with this prologue: “Over the years, vaccination of fish has become an important method for the prevention and control of infectious diseases and has made a major contribution to improving fish health in aquaculture. This symposium will focus on the quality and regulatory requirements for fish vaccines with a particular emphasis on the work of the European Pharmacopoeia and on improving the development of study methods and quality control testing such as batch potency testing, the use of alternative in vitro methods, 3Rs and consistency of production.”

This symposium sounds just as quaint at 3am. I may go for a rest!

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