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Good value for money?
• IT seems certain that in the matter of appointing UnitedHealth, the primary care trust’s selection procedure was fundamentally flawed.
In a recent letter, Rob Larkman, the chief executive, listed the criteria against which bids would be assessed as follows:
i) service delivery plan (in effect the bidder’s ability to deliver the service specification);
ii) affordability;
iii) financial robustness;
iv) value for money.
In this connection, it is my belief that the PCT had a duty to deliver the best possible0000 primary care and, on the assumption that the present proposals were sound, the bid best satisfying criterion i) might have met this requirement.
If it had also satisfied criterion iii), this would have been a further performance endorsement.
As for criterion ii), affordability, on the basis of the available statistical and other relevant cost information, the PCT should have been able, prior to tender, to have arrived at a fair, realistic and top line cost per patient against which to assess the bids.
If the highest scoring bid was within this top line figure it would have been affordable, should have been accepted and would have been “value for money” as a consequence.
In this connection, it has to be pointed out that the inclusion of iv) as a criterion was not only spurious and unnecessary but could only have served to vitiate any “rigour” in assessing bids against the other three criteria.
Moreover, in the light of the PCT’s obligation to provide best possible patient care, if none of the top quality bids had met the criterion of affordability, a correct course of action would have been not to accept any of the tenders but to continue with the present arrangements while a proper re-examination of the current proposals by an independent agency could be carried out.
Clearly the whole affair has been seriously mismanaged. The awarding of the contract to UnitedHealth should be put on hold and the matter referred to the secretary of state.
BERRY BERMINGHAM, NW1
It’s about time, too
• I HAVE been reading the articles and letters concerning the takeover of GP practices and I must say, it’s not a moment too soon.
I have been a patient at Adelaide Medical Centre for years and have seen the services deteriorate alarmingly over time.
The building itself is very ugly and never seems to be renovated.
Getting an appointment is very difficult.
A letter from the partners (We shall continue to operate as a local NHS surgery, March 20) says that it is “always improving”.
My question is: when is it going to improve?
I once got through to ask for an appointment and was told they were only doing emergencies that day, whatever that may mean.
I thought A & E departments did the emergencies. I didn’t get an appointment.
The waiting room is like an unsupervised kindergarten with multi-coloured plastic chairs (very hard on ageing bottoms) and a large Wendy house.
This just encourages children to be noisy, whooping in and out of it. It also has a large pink pair of paper breasts on the wall! Horrible.
If this particular practice is going to be replaced by something more suitable, all I can say is – bring it on.
J COOPER
England’s Lane, NW3
Top-class NHS care
• AS a recent and very ‘senior’ patient at Parliament Hill Surgery, I particularly appreciate the high level of personal care and friendly consideration shown to me by all members of Dr Graham’s team.
The realisation that small practices in Camden are in danger of being sold out to a huge American company with no knowledge of local people, their needs or their wishes, appals me.
I am old enough to remember the inception of the NHS and the high hopes we held for a first-class, not a cut-price, service for all.
JUNE ROSE
Holly Lodge Mansions, N6
Cost the only issue?
• AT the demonstration outside the Department of Health on Whitehall on Monday, it struck me that the “invisible man” in the debate around the primary care trust’s decision to appoint UnitedHealth has been the executive member for health, Councillor Martin Davies.
While public meetings are called by concerned residents, it is now fair to ask what his stance has been. He has said nothing about what the council’s position actually is on the PCT’s decision.
Councillor David Abrahams, chair of the health scrutiny panel, obviously deserves support at this late stage. But while I welcome his commitment to hold a meeting on this, to do so after the consultation has ended and after the service contract has been signed is not likely to be as effective as holding one last year.
There does seem to be an accountability problem at the Town Hall, which is sending out mixed messages.
While some seem to recognise the genuine public concern that the PCT’s backing of a US private firm will result in more generic and less locally-focused services, leading councillors have sought no assurances in this matter.
For example, they have not asked how the PCT’s decision will fit in with plans to tackle our health inequalities or the needs of our diverse communities.
Indeed, while all of this was going on, Camden leader Councillor Keith Moffitt backed PCT chief executive Rob Larkman as vice-chair of the Camden Local Strategic Partnership – the body that co-ordinates how public services are delivered across the borough! Is it because councillors in the Tory/ Lib Dem partnership administration have difficulty challenging each other?
Or is it because there is an underlying pro-privatisation bias, as evidenced by what is happening with caretaking, care homes and Careline?
It is only for the unimaginative that “diversity of provision” would necessarily mean a US multi-national, rather than mutuals, community-led organisations or other types of bodies.
A GP-led co-op or social enterprises could come to the table with “added value” for patients and the community. It might have been good to see that sort of diversity in our local health services tested.
Cllr Davies should give people a full account of his views and discussions on this matter with the PCT and tell us where he stands – is cost the only issue?
CLLR THEO BLACKWELL
Deputy leader, Labour Group
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