I suppose I should have known. I was running through my internet sources today (one week after That Election) and checked the Department of Health. My “direct to dentistry” link came up with an error page, so I tried the DH Health homepage: “taken down for revision” it said. Gosh, they do take these changes of administration seriously.
Now everyone understands that a period of “purdah” exists for all public servants during an election. Look for example, at the Head of the NHS’s letter (6 April) to all NHS Chief Executives and Arms Length Bodies (the DPB in old money) warning them to avoid any act or statement that could give rise to claims of political bias in the run up to the election.
I’ve written before that behind the scenes, much of unseen Government carries on behind these locked doors during and immediately after the Election. Schemes, projects, draft policies and papers all continue to be developed ready to be dropped in their hundreds into the new Minister’s red boxes in time-honoured “Yes Minister” fashion.
This time there will be, of course, a new factor to be taken into account: the Coalition Government’s agreement that there will be ministers of both parties in every Government Department – and for the duration of the Parliament.
The tradition has been that coalitions are rather short-lived in Britain (unlike most other European countries with proportional representation, where they are a fact of life). However the Con-Lib agreement is to be bound for five years, which is a little scary, is it not? Imagine getting married and having to agree legally not to split for that length of time? It would kill Hollywood nuptials stone dead.
So the two partners will jolly well have to rub along together. It could, I admit, be a recipe for considered and responsible Government, or for utter stalemate.
As I’ve maintained all along, dentistry is unlikely to figure highly in anyone’s political priorities, and I don‘t expect the budget to deliver anything major in terms of the NHS, following Andrew Lansley’s early confirmation that there would be “real terms” increases in NHS budgets for the next five years.
In the slightly longer term, I would be looking out for any suggestion that dental ring-fencing was extended, or that the autumn Steele pilots were still going ahead. On the latter, there have been mixed messages – some suggesting that Steele progress would be stopped, while others saying that any contract changes would be “fully piloted with the profession”.
There will undoubtedly be pressure on local commissioners to extract value for money, but at the same time, it seems inconceivable that a standstill in public service pay will not similarly bring about a similar effect for NHS contractors. I also doubt we shall see future hand-outs of decontamination equipment, computer systems or other largesse.
Still on the subject of money, I noticed a recent dispute settlement on the NHA litigation Authority’s website: it involved a clawback demand for over £525,000, the largest I have seen. Coupled with a requirement to pay up within three months, this must be causing once contractor some headaches.
The case raised in my mind a series of issues – although of course I have no knowledge of the detail behind it. But why would such a sum only now (April 2010) be subject to review, given that it is more than two years after the contract ended (in February 2008)? It also seems that the PCT had quite close and detailed knowledge of the under-performance from the outset of the contract, yet was seemingly unable to take any decisive action. Indeed it allowed a significant “carry forward” of un-delivered UDAs into year two.
The PDS Agreement (for this was such) contains the same clauses as the GDC contract: namely, that the PCT can terminate arrangements following a breach where it believes that it is necessary to protect itself from ‘material financial loss’. Half a million sounds pretty material to me. It is certainly material to one practitioner right now.
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