Thread by @swardley

Lunch and a quick scan of NHS long term plan - longtermplan.nhs.uk/publication/nh… ... page 6 (summary) and rapid expansion of "personal health budget" - england.nhs.uk/personal-healt… - aka full scale privatisation of NHS under the cover of giving patients choice. Bye Bye NHS, you'll be missed.

... not that we really have an NHS, it is more of a franchise. Anyway, personal choice is the way to kill it off and embrace a market led insurance model. First health, police next - "Then he swiped his credit card to pay me for arresting him" - newyorker.com/humor/daily-sh…

.. but let us not sweat the little stuff like health, society, cohesion but focus on big things like staying in the EU. As we all know, the EC will save us. I can hear Juncker on the phone to May saying "you can't continue privatising the NHS, the EC is going to stop you". Lol.

Privatisation is always implemented under the guise of giving customers more choice. Ditto patient budgets is loaded with terms like choice. Of course it carefully avoids highlighting the issue of whether the "customer" has any real choice or not over healthcare ...

... the real 'choice" becomes exclusion i.e. you can afford these things but you can't afford these things. It's the same with rail transport, you have no real choice. Just wait until they introduce digital subscriptions with self driving cars and inequality into road usage ...

Me : I'd like to go to Hampshire.
Car : That's a gold membership zone. Unfortunately, you have bronze membership.
Me : But the best jobs are in Hampshire.
Car : Bronze members have access to Rotherham or Peterborough.
Me : Can I drive?
Car : Human driving was outlawed in 2035.

Me : So, how am I supposed to get to Hampshire?
Car : You could walk.
Me : Or cycle! That sounds healthy.
Car : Unfortunately your personal health budget won't cover cycling accidents.
Me : What does it cover?
Car : 2 aspirins per annum. You have no top up or insurance.

Me : I suppose I could get a train?
Car : You'd need a house first.
Me : Why?
Car : To mortgage it.
Me : Hmmm, any suggestions then?
Car : Have you been to Peterborough or Rotherham?

Me : I thought we are supposed to have freedom of movement protected by the EC.
Car : You do.
Me : So why can't I go to Hampshire.
Car : You can. Just not in a self driving car. Your digital subscription is too low. I won't drive you.
Me : And I'm not allowed to drive myself.

... hmmmm ....
X : Personal budgets are about responsibility. Don't you think people should be responsible for their own healthcare?
Me : Are you responsible if you catch ebola?
X : That's a disease.
Me : Do you know what the WHO no.1 killer disease is?
X : No.
Me : Poverty.

... personal health budgets are the drug induced brain fart of some Ayn Rand reading management consultancy who believes the "market has the answer". It'll be loadsa work and Porshes for management consultants in setting up artificial markets, strategy & processes.

X : Is there anything you like about the NHS long term plan?
Me : Loads. Oodles. Most of it seems great bar the "personal health budgets" and some questionable bits about "population based accounting" (the devil will be in the detail). I have many favourite bits including ...

X : What's good about that?
Me : It's extremely blunt civil service code for "stop following a political dogma of privatisation and let us get on with our jobs". I love it.

... It's almost as if two conflicting factions (e.g. treasury led management consultants hell bent on privatisation vs healthcare led civil servants hell bent on keeping an NHS) were forced to write it. There does seems to be some conflict underneath the compromise language.