Health Matters | Paul Corrigan's blog

Regular blog readers will have picked up that this blog is following the case of the third sector versus the Secretary of State to be heard before the Panel for Cooperation and Competition within the next 30 days or so.

The story so far is that on September 17^th last year the Secretary of State said that he had a personal preference for NHS providers as the health and health care provider from whom NHS commissioners should buy their health care.

Whilst a personal preference is interesting in its own right, he has since gone on to try and impose that preference as the way in which all NHS commissioners take decisions to buy health care in their localities.

Many PCTs have continued to make their commissioning decisions in the best interest of the patients rather than following the Secretary of State’s personal preference, but some have changed the way in which they work to take account of it.

One of these is Great Yarmouth PCT. Unfortunately for them they were half way through a tendering process when the Secretary of State announced his personal preference, and changed their process in order to be in accordance with it.

This meant that a number of organisations from the third sector and the private sector that had initially wanted to tender for the work were told that they could no longer do so. Because they were not even been allowed to compete, they have taken a case before the NHS Panel for Cooperation and Competition.

That case is progressing at the moment. One of the important features of transparency about how the Panel operates is that it places evidence it has received on its web site.

The union Unison has helpfully put in some evidence in support of the PCTs and its tone and argument are very revealing, not just about this case, but about their understanding of the way in which the NHS and our whole society works.

In previous posts I have outlined the reasons why the health unions find a “top down” approach to running the service useful to the way in which they operate. They find it really useful to view the NHS as a set of institutions run by one person. Their evidence both makes this thinking clear, and goes a step or two further than they have before.

To quote:   

“The complainants allege that the PCTs actions will not allow them to secure the best providers in line with the PRCC. This definition is clearly subjective but the latest Government policy is the best guide to interpreting the phrase, and government policy is that the NHS is the “preferred provider” of care. The PCT has therefore adopted an entirely reasonable position in that it deems NHS organisations will be the best providers of care for Great Yarmouth”

This betrays their belief that national politics should be in command of the NHS with the claim that, when the Secretary of State decides what a word should mean, then, like the Red Queen in Alice In Wonderland, that is what it means. As they say “the latest Government policy is the best guide to interpreting the phrase“.

No. We do not live in that sort of society. “Latest government policy” does not provide a secure meaning for a phrase. “Latest Government policy” is one opinion about a phrase. Others have different opinions.

In our society Governments do not provide meanings of phrases. Where there is a dispute about the meaning of phrases there are judicial processes to go through to decide what society wants that meaning to be. The rule of law wins out over political power.

In a free society neither the Government, Unison or the Red Queen decide what words mean.