'Stalinist Whitehall controls will be needed'

After all, it’s been another turbulent week all over the NHS, though not all the news was bad. Last week also saw the NHS Atlas of Variation in Healthcare deliver what MPs and health analysts like Dr Foster want from the service - a clear guide to unacceptable variations in performance.

It was also the week its chief executive Sir David Nicholson did not disagree with Tory GP-MP Sarah Wollaston that many PCTs are “effectively in meltdown” and admitted “Stalinist” Whitehall controls will be needed (at least temporarily) to see the Lansley commissioning consortia into being. Now there’s a familiar surprise, ho ho.

At Sir David’s side during the session with the Commons health committee, was Andrew Lansley who leapt in to repudiate the M-for-meltdown word. The health secretary also pre-briefed MPs about this week’s ambitious public healthwhite paper.

Plain cigarette packets, higher booze prices, breastfeeding at work, the secretary of state shows a commendable grip on detail.

But he can sound like a one man show and is certainly trying to juggle a lot of balls, like Hull’s Mr Morley, only more so.

Newly appointed Mr Morley (his trust’s website had not responded to Dr Foster’s charges by noon on Monday) insists that his improving mortality rates are now “just above national average”.

He also has 40 per cent smokers (double the average) and only 12 hospice beds among his 600,000 flock. That pushes up his hospital death rate.

Yes, but raw data often deals out rough justice. What struck me about Hull is what also crossed my mind when I heard that Circle, the self-declared “John Lewis-style mutual” firm, had won the contract to take over ailing Hinchingbrooke Hospital in Huntingdon, the first such complete takeover of an NHS facility by a private firm.

Both trusts suffer from comparative geographical isolation as communities, a problem we often find with underperforming trusts.

Hinchingbrooke has been under pressure for years. Unison - alarmed this week by the Circle decision - published a paper as long ago as 2007 complaining that this 1983-built 360-bed hospital is a victim of NHS funding policies more than bad practice.

Whitehall believes suspicious locals are grateful that Circle’s win means they don’t lose their hospital altogether. We’ll see. Officials stress that this is not backdoor privatisation - as the unions fear - because it and its staff remain on NHS books. But it strikes me as a significant moment in the drive to diversify NHS provision - one which was under-reported in the media and not picked up by MPs too interested in the design of fag packets and breastfeeding.

Labour’s health spokesman John Healey is paid to be suspicious. He doesn’t condemn the Hinchingbrooke experiment - “in situations like this where there is no alternative” - but says it needs to be transparent and accountable to ensure there is “no sweetheart deal” which gives City entrepreneur Ali Parsa’s Circle unfair advantages over other trusts.

That seems fair enough. Private firms have never run, for instance, hospital A&E units in Britain, and have sometimes screwed up medically and financially - just like everyone else.

But, if they play by the rules and are seen to, who knows, we may all learn something.

Michael White writes

about politics for

The Guardian.

See opinion, page 14