0F MOUTH :
'Christ isn't a person. it's an energy
' force known as pure love and
; wisdom. and it resonates to the same frequency as the colour turquoise.‘ David lc‘ke. formerjootha/ler. sports - presenter and (ireen l’arty speaker. andself-proe/aimed ‘Son ofGod'. on a more eoloar-eoordinated second
coming.
bastard.‘
dolphin.‘
winnerV
‘There still appear to be unwritten rules. I asked the l'l'(‘ ifcreet penises were allowed and theysaid . . . there‘s no hard and fast rule.’
John Willis. deputy director-of
' programmes at ( 'hannel 4 hopes there will he no cock-ups on the channel's forthcoming ‘eensored ' series.
Ill be List 5
‘l have to come to terms with the fact that I'm not your handsome class male. . . I‘ve been on a diet sinccl was eight. I‘m potentially a big fat
This issue 's (‘over model Timothy Spall admits that Spa/l ain 't necessarily beautiful.
‘lfdolphins were human. I’d be a
Jason Donovan wishes he was a more intelligent lite/own.
‘The fact is. I love firing arrows. riding horses. swinging from trees and getting involved in fights.‘ Flavour ofthe month Kevin ( ‘ostner reveals how his private life makes hint ~ the Victoria in Glasgow and the Princess the perfect choice for his forthcoming role as Robin Hood.
‘Julian (‘lary says the new strip is a A street vendor outside llampden
passes comment on Scotland's new . purple and scarlet a way strip.
is April 1991
Prescription for health chaos
Government proposals allowing hospitals to achieve self-governing status have met with a lukewarm response in Scotland. Alan Morrison discovers why many people believe opting out is more likely to kill the health service than cure it. I
Sam Galbraith MP: opting out would be a ‘disaster'.
his week the National Health Service took a step closer to privatisation. In England. 56 hopitals began life as self-governing trusts and over 300 family practices began operating their own budgets. North of the border. however. only four practices have taken up the Government's offerofcontrolling theirown funds. while the Scottish hospitals plan is being operated a year behind its English cousin.
To date. only a handful ofhospitals in Scotland
;_ have shown an interest in opting out of local health authority control. Strong indications that a
formal application will be made soon have come
from Ayr and Aberdeen. while others. including
Margaret Rose in Edinburgh. are considering their position.
Opting out is only one part of a wider Government plan for the reconstruction ofthe health service. the fourth such upheaval since 1974. Based on a Thatcherite competitive market theory with an American model. the system will allow local health boards to become the ‘purchaser‘ ofservices. entering into contracts with groups from the public. private and voluntary sectors. The hospitals themselves will become ‘providers‘. bidding directly to the Scottish Health Department for funding.
Supporters ofthe system claim that the trusts will be able to win additional income from private patients. but others fear that this will mean that less beds will be available to non-paying Nl lS patients and that consequently patient care will come a poor second to profit. Labour's Scottish health spokesman. Sam Galbraith. is under no illusions as to the outcome.
'l think it is going to be a disaster for the NI IS. It reduces patient choice. is intensely bureaucratic and is a step on the road to privatising the health service. There will come a time when the hospitals are primedand set up for a management buy-out. The board of directors will own the land
' and own the building. and it‘s an easy step for
them to buy it out. And then it will be another
private hospital. ()pting out will also break up the negotiating boards for pay and conditions in order to reduce them.‘ I
It is certainly true that one ofthe roles ofthe board ofdirectors of a self-governing hospital will be to set the terms for staff. which could lead to doctors being paid more in different areas for the same work. Jim Devine. regional officer with CO} lSE explains the trade unions‘ fears over the situation.
‘We know that what happened with the competitive tendering of ancillary services was that jobs were lost. wages and conditions went down and the service to patients was substantially reduced. What we‘re into now is the competitive tendering of hospital services themselves.
l lospitals will effectively have to compete against one another. Now. if you have competition on a football field. you have losers as well as winners.‘
Figures released in England indicate that competition would encourage hospitals to undercut each other‘s prices. A hip replacement operation has been quoted at £1027 by a Blackburn hospital. but at £3804 by one in Doncaster. This would surely lead to the Doncaster hospital being underused and perhaps closed in the long-term. while there are fears that cheap operations could mean that hospitals are skirnping on the quality oftheir services in order to guarantee money coming in. By heightening the budgetary element. the Government has flipped a coin that will come down either on the i side ofextra income or cutting costs.
These changes in the health service have i coincided with the announcement that Lothian Health Board is facing a major crisis. despite 3 being forced to take drastic budgetary measures last year. This may encourage Princess Margaret Rose Hospital — which. like the Victoria in Glasgow. has considered opting out in the light of closure threats — to press on with a formal application. Sam Galbraith believes that such a move would be misguided.
‘lt specifically says in the White Paper that opting out is not to prevent hospitals from closing. The one certain way to be closed down is to opt out because a health board intent on your closure just won‘t give you any contracts. and that will be the matter finished.‘
The moves towards self-governing status have met with strong opposition from the consultants at the hospitals involved. Initially at the lr‘oresterhill site of Aberdeen Royal lnfirtnary only 2 of is") doctors favoured opting out. In Ayrshire 1-1 of the ()2 consultants sttpport the application. At both. the management seems intent to go ahead with or without the staff‘s consent. Bulldozing the Government’s proposals l through can only cause further dents in the morale of a workforce already depressed by chronic underfunding.
Further information on local groups opposed to the opting out ofSeottis/i hospitals is available from Graham Smith at the STU( '. I o Woodlands Terrace, Glasgow. J