Let’s Get Ready to Rumble…Field vs. Gerada – The Rematch

Guest blog by Stuart Carroll 

Boxing fans have enjoyed some bumper showdowns this summer.  Most recently, we saw King Amir Khan spark out a chinny ZabJudahwith all the ease and comfort of a Home Affairs Select Committee ripping chunks out of former Metropolitan Police Officers more redolent of Inspector Clouseau than Lieutenant Colombo.  This followed a flabby heavyweight square up between the sluggish Tyson Fury and overstuffed Derek Chisora – a fight that the Department of Health should seriously consider advertising as part of its anti-obesity and healthy eating campaign.  With iridescent promise, we witnessed the bluster and guster of David Haye badly stultified by a text book Wladimir Klitschko and the revelation (arguably excuse) of a post-match broken toe that, despite looking just as much hacked as the phone of yet another News of the World victim, conferred all the credibility of a “humbled” Rupert & James Murdoch testimony.  And all this against the backdrop of the “grudge match” between the earthy George Groves and immodest James DeGale.

Yet the pugnacious business of health policy has also enjoyed its own summer dust ups.  The main event – the now amended Health and Social Care Bill (HSCB) – has sported clunking fists (Number 10’s realisation the DH was not on top of its brief), white towel moments (nervy Lib Dem jitters), crunching body blows (pressing “pause” and hitting “listen”), bloody noses (Andrew Lansley), in-between round posturing (lightweight cheap shots from HM’s Leader of the Opposition), and damp squib palm slapping (could John Healy really be any less anonymous?).  Despite the controversies and colourful press conferences, the HSCB has survived 12 brutal rounds of jabbing and sparring, and finally been handed a majority points decision by Referee Steve Field – Chair of the NHS Future Forum.

Time to hang up the gloves?  No chance.  With all the persistence of a bulldog chewing a wasp, Dr. Clare Gerada, the Chair of the Royal College of GPs (RCGP), is calling for a rematch.  The quarrelsome Chair has warned that the college will back the British Medical Association’s (BMA) call for the HSCB to be withdrawn unless the Government makes a raft of further amendments to address the “very real concerns” of GPs – concerns around competition still being at “the heart of the bill” and clinical senates leading to increased bureaucracy.  Re-enter Professor Steve Field who has reacted bellicosely to Dr Gerada’s criticism and essentially likened the broad-brush of her comments to “below the belt” politics.

I am backing Professor Field.  After all, what more does the RCGP want?  They had their chance to be listened to.  I can’t help but think that even the world itself would not be enough for some anti-HSCB protagonists.  The unprecedented independent report from the NHS Future Forum has been taken very seriously, and arguably saved the Health Secretary his job.  Number 10 has ordered over 180 amendments to the original HSCB; a significant change to the remit of Monitor as a regulator of quality rather than competition; a redefinition of the role of competition in the NHS; and extra moves to deal with any potential problems to do with cherry-picking.  As for competition itself, Professor Field is right to point out that competition is not a disease and in fact already exists whether that is between GP surgeries or in the delivery of end of life care in hospices.  It is increasingly clear that HSCB opponents are quite simply anti-competitive.  As for concerns around bureaucracy and clinical senates, I can only shake my head with some incredulity.  The likes of Dr. Gerada were previously lamenting the HSCB for not adequately including and consulting healthcare professionals.  The Government responds by taking up a sensible idea to secure greater clinical engagement and still the non-reformers are not happy.  Unbelievable stuff.

As a GP recently said to me, “I would love to know who all these concerned GPs are that Gerada keeps going on about.”  Indeed, from the vast majority of GPs and healthcare professionals I have spoken with, many of whom have genuine and perfectly understandable concerns, the prevailing view is more supportive of Field than Gerada.  I can’t scientifically or statistically prove it, but my hunch is that this is true across the wider NHS and most healthcare professionals.  In other words, I think ideologically driven politics is still at play.

As for the BMA, what can you say?  I think someone really needs to change the broken record as some of us are developing tinnitus, which is certainly not good for the nation’s health.  This all from an organisation that is up in arms about Government plans to ask 6-figure earning GPs to throw a bit more cash into their gold-plated pension pots.  What world does Hamish Meldrum and his BMA chums live in?   Some people, including members of my own family and most of my friends, do not even have the luxury of a basic money purchase pension never mind the 6-figure salary.  I am not exactly a “let’s eat coal for breakfast” or “let’s tax the hell out of the rich” kind of guy, but I really would love to see Dr. Meldrum explain to “Barry and Dave” down the job centre the great injustice that is the Government’s frankly necessary public sector pension plan.  Yes, doctors should be well rewarded, and in my opinion they largely are thanks to Labour’s cha-ching GMS sign away, but some of the BMA’s rhetoric is staggering.  Does theUK’s eye-watering budget deficit never feature as part of BMA board discussions?  I suppose Lord Hutton’s report is another Government paper the BMA has consigned to the wastepaper basket.  They must get through some serious corporate recycling.

The truth is that the likes of Dr. Meldrum and Dr. Gerada are now displaying all the leadership of a boxing promoter who refuses to accept the judges’ decision.  I could not agree with Steve Field more when he says “it is extremely disappointing”.  A gentleman to the end, the Professor should be congratulated for his temperate language.  It is beyond extremely disappointing and frankly smacks of political sour grapes and a sort of “clinical militancy”.  At times, I think Dr. Meldrum is just Bob Crow in a white coat (another one with a 6-figure salary and gold-plated pension although in Crow’s case someone hell-bent on never seeing the tube run with an uninterrupted service ever again).

As I blogged in my “depressed reformers” piece a good few weeks ago, it is a crying shame that the health policy debate continues to be overtaken by political manoeuvring and phantom concerns about things that don’t really exist.  Should there by any rematch or further listening, I know which corner I will be in.  After all, it’s time to KO this nonsense once and for all.

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