By Steve Carne, Aug 9 2018 12:35PM
Steve Carne keeps getting dragged into the pit...
The image of vicious piranhas fighting for flesh, (made in desire for a dramatic context I confess in yesterdays blog about Babylon), seems to be ever more relevant and continues to grow as more corporate quibbling and quarreling now truly "disrupts" every layer of the once public service NHS.
Including the basics of supplies and logistical planning that supports the once joined-up network of hospitals and healthcare NHS units (clinics etc.) All under the guise of greater integration of course and using the Carter Review 2015 which called for something called the Procurement Transformation Programme (PTP) which has led to the Future Operating Model (FOM!) and its new rather confusing logistical planning landscape.
NHS Supply Chain Logistics is now being revamped (not a top-down reorganisation you understand nobody likes them do they?) at the end of September it seems - after DHL have run it since 2006.
And even though Health Care Supplies Association (HCSA) in 2016 thought that the commercial procurement arrangements with the outsourced service NHS Supply Chain were working well and should be extended NHS and they warned that "New NHS PRocurement structures may be disastrous" - NHS Procurement, NHS Improvement and Uncle Tom Cobblybollox and all have decided that it's best if NHS Supply Chain is revamped into something called the Future Operating Model (FOM) and 'has been designed to realise £615m of savings in real terms over the next 3 years (2018-21).'
Yes apparently the new structure is all about Towers. Category Towers. Stick with me as I attempt to climb the dark staircase...
So NHS resources - things to buy, sorry PROCURE - are now divided up into these Eleven Category Towers (which Lord of the Rings numpty thought that one up I wonder?) So below, courtesy of Dept of Health info pdf is a simple chart of these Eleven Categories. Bottom Right is interesting...
The Health Care Supplies Association (HCSA) says "the eleven tower system is hard to understand" - but they shouldn't be alarmed because apparently there are 200 very intelligent people employed to become the Intelligent Client Coordinator... fingers crossed.
Still with me?
Blimey so... what this is supposed to do (apparently) is save money through making more resources flow through less broken up chains of command - we assume. Sort of what it must have been like before the tendering competitive market moved in - back in the 90's - and festered until getting the boost it needed in 2012 with the Health & Social Care Act that did all the damage. The Dept of Health kindly offer a nice graphic to help us get the picture.
Trouble is ...
this is where the piranha-profit fish now get really pissed off cos they are missing a meal and they see other corporate piranhas munching into their prey. And DHL are pissed off enough to take the Dept of Health to court claiming that the tendering process is faulty because they haven't been given a big enough slice of the dish.
You see to make it fair the Dept of Health thought best if procurement companies were only allowed to take hold of THREE TOWERS at a time (joined-up thinking see?). DHL already have three towers - the procurement of large diagnostic capital devices, ward-based consumables, and infection control /wound care.
But what they are really pissed off about is the fact that after 13years of being the logistical handler of the NHS Supply Chain they have now lost out to UNIPART.
And it's a fairly big contract... look. Estimated £730million over 5 years...
So Unipart are happy no doubt trolling about twixt towers. And they do have good experience in the "Unipart Way" - oh yes that old Toyota Car Factory chestnut the Lean Management System is something they are enormously proud of. I expect NHS Managers up and down the country will be clapping their little hands because they understand that after their three-day "how can we show Compassion whilst burning the workforce" training course.
Well Unipart can keep their hands well away from my bottom thank you very much.
The whole point is...
What the hell are we doing letting all these multi-national businesses scramble our public services in search of ever-more profit? Just like piranhas the smell of blood money is overpowering and will dominate their motives and actions. How can they be allwwed to hold to ransom the Department of Health? Or any of our government departments?
How this all fits into the other NHS restructures and redisorganisations is the next step to understand. Campaigners are often told by politicians on both sides of the House that the NHS can't afford another Top-Down ReOrganisation. Seriously we can't afford not to once and for all take the big step and bring the NHS back into public control. The poor NHS has been and still is (frontline staff will tell you) being attacked and thrown into chaos by more and more corporate top-down changes usually requiring yet more top-down levels to provide muddy transparency.
The shrinking, cutting and slashing we have all seen over the last four years (more I know now) is nothing more than the government desired move to a reduced, poor-quality NHS based on the USA system with corporates like DHL and Unipart taking more control and more money out of the system with their in-fighting and board room battles.
And once companies learn they can use the courts to fight their commercial interests and "bugger the conequences" there is no stopping them. After all they can afford it. And the prize is probably worth it. Eventually local councils, public departments will have to give in just because they can't keep on paying costs.
Meanwhile people die. Paramedics and many many NHS staff watch them die. And they know there is a better way. It's not the Unipart Way. It's the Reinstatement of the NHS Way. There has never been a more urgent time for campaigners and public alike to understand that we are about to hand over the NHS to a bunch of piranhas.
The only way now is renationalise the health system - bring back the values of a healthcare system based on equality and the improvement of people's lives. In that there is hope of a better society and future.
The public service model NHS used to be a world leader in that.