Kung Fu And The Mysteries of the Purchaser Provider Spilt

(Let's start the week with a bit of humor - or even humour -  with thanks and apologies to the writers of Kung-Fu…)

Good morning, little grasshopper. What is the matter? You look troubled.

- Master, I do not understand.

Ah, you have been reading the Public Accounts Committee minutes again, have you not?

- Yes Master. I fear I made that error again.

Well, what is it you do not understand?

- It is Accountable Care Organisations in the NHS, Master.

Ah! few are privileged to understand these mysteries, as old and dark as the caves of the fabled Elephant’s Castle.

- But Master, Simon Stevens must understand. He is the boss. He told the Public Accounts Committee that 10 pilot ACOs will be introduced soon. And he said that he will “effectively end the purchaser-provider split, bringing about integrated funding and delivery for a given geographical population”.

Indeed he did, grasshopper. He is a man of great purpose.

- Master, but if he moves to what the wise ones at the palace of LSE and the elders of the MahKin Sea call a "planned, localised health economy", how will that fit with currently competitive situations where private sector providers carry out considerable elements of the current health delivery in an area? Even the mighty Stevens cannot just remove their contracts?

No grasshopper, I do not believe he can.

- And when those contracts come to an end, what will be the process for deciding who will then do the work? Surely there must still be some competitive process? And what if two public sector Trusts both want to carry out some particular work, who will decide … ?

Grasshopper, grasshopper, too many questions. You will note what I said – Mr Stevens is a man of purpose. But, grasshopper, have I not taught you that purpose is what we seek - but wisdom is what seeks us. Is Stevens a man of wisdom?

- I do not know, Master.

No, neither do I grasshopper. Perhaps he does not know himself. The road is long, with many a winding turn, that leads us to who knows where …

- Yes, yes, you’ve told me that before. But can you answer my question? How does competition and private sector provision fit with the ACO model?

Grasshopper, let me tell you the truth. I have no f****g clue. And I hope the Emperors’ Court of Disputed Healthcare Contracts are mianfued* up and ready to go, because I fear their work may be needed soon …

(To be continued, after a slow motion fight during which Simon Stevens beheads then ritually disembowels Andrew Lansley while screaming “death to the purchaser/provider split and clinical commissioning groups, death to the idiots who created the Health and Social Care Act of 2012"!)

*You need to google mianfu ...


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