What’s fair isn’t always what’s possible

Posted on May 9th, by geoff in CT blog. 1 Comment

By guest blogger BOB FERGUSON

By the time this reaches cyberspace it may be academic, although the principles, if not the personalities, remain important. Jeremy Hunt’s proposal that NHS commissioners (CCGs) should be rated on their overall performance – “more scientific rigour in terms of assessing the quality of commissioning … is going to be a critical next step” – begs a couple of questions.

First, obviously: then what? I expect – and more importantly, CCGs that are found wanting will also expect – that, like NHS providers in similar circumstances, they will be given a helping hand to make the necessary improvement. Unlike their social care counterparts, who when lumbered with a low-end rating are left to find their own salvation. Where the distribution of resources is concerned, t’was ever thus: no contest.

But we’d also like to know why local authorities have been excluded from the plan. Norman Lamb had already outed Eric Pickles, over at the Department for Communities and Local Government, as the lone barrier to the regulation of council commissioners. So, had he gone native? No, because he carried the can for council funding he didn’t want it to resonate in the same sense that the sound of a dropped bedpan is said to unnerve health ministers. Put simply, he’d rather not risk so much as a tincture of blame for shortcomings in commissioning practices that might be exposed. You don’t have to be an expert on Machiavelli to recognise that he was just protecting his own back – behaving like a politician, in other words.

No statutory oversight, then. But that needn’t be the end of it. Who better to judge the performance of council commissioners than the providers who are routinely expected to enact the miracle of the loaves and the fishes, providing much from little? Why shouldn’t their associations grasp this opportunity to make a real contribution to fixing a system that was broken long before austerity came our way and take on the job themselves? Why not? I mean, it’s not as if they have something better to do.

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.

One response to “What’s fair isn’t always what’s possible”

  1. Tony Stein says:

    It’s not just the double standards of some being held to account whilst others are allowed to ‘wobble along’ but also the downright confusion of the system. More NHS funding is being used to deliver social care through a variety of back-door means. More control is slowly and inexorably being passed to the NHS for social care and yet the Care Act put more responsibility on LAs for the management of the social care market ( why not, they’ve proven brilliant at everything else!).
    The great concern has to be that whilst LAs are not held to account we have various political figures expounding the virtue of pushing more decision making down to a local level, so an already fragmented market will only get worse and, as you rightly point out, how are these then held to account. Social Care is the largest single issue managed by LA’s in cost terms and one of the country’s biggest problems. Isn’t it worthy of central government attention? Imagine a world where all commissioning was centrally funded, centrally billed, according to centrally determined policies with no duplication of inspection but more regular and consistent CQC visits……..but then it wouldn’t be as much fun would it…..

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