A bitter pill as marriage of convenience ends in divorce (From Worcester News)

A bitter pill as marriage of convenience ends in divorce

12:12pm Wednesday 3rd March 2010 in

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THE rocky marriage of convenience between the private and public sectors took another painful knock when controversial company Take Care Now (TCN) decided to pull out of a contract to provide out-of-hours care in Worcestershire.

It seemed like the ink on the dotted line was barely dry when TCN decided last month to withdraw from a five-year deal to run the county’s out-of-hours service, just 16 months after the contract was signed in October 2008.

Dr Richard Taylor, the Wyre Forest MP, has already asked why TCN decided to sell the remaining part of its £4.3 million-a-year contract with NHS Worcestershire – before a report by national health watchdog the Care Quality Commission (CQC) is published.

The CQC report, expected to be published before the summer, follows the death of 70-year-old David Gray in Cambridgeshire. He was given a fatal dose of the painkiller diamorphine by an exhausted and grossly negligent EU doctor, Dr Daniel Ubani.

The episode blew a large hole in the reputation of TCN and has damaged the faith of patients in the quality of the service.

TCN still offers an out-of-hours service in Worcestershire from 6.30pm to 8am, Monday to Friday and 24 hours a day at weekends and bank holidays so people have medical cover outside normal working hours when their regular GP surgery is closed.

TCN bosses want Harmoni, a larger private company, to take over the out-of-hours service but bosses at NHS Worcestershire insist they will call the shots when it comes to a local decision.

There are primary care centres at Worcestershire Royal Hospital, Malvern Community Hospital, Kidderminster Hospital, the Alexandra Hospital in Redditch and Tenbury Community Hospital in Tenbury Wells.

Bosses at NHS Worcestershire, which launched its own investigation into TCN and first awarded the contract, have been forced to defend the company after it came under increasing attack at public board meetings, notably from representatives of Independent Community and Health Concern, including Wyre Forest district councillor Howard Eeles who attends such gatherings religiously, usually armed with some searching questions.

Last November, NHS Worcestershire chairman Dr Bryan Smith said TCN was not “some nasty, cheap, back-of-the-wall organisation”. He said that, during the tendering process, they went for the best service, not the cheapest.

Paul Bates, the chief executive of NHS Worcestershire, has also praised TCN for coping well with the pressures of the swine flu pandemic and with pressures on the health service in the winter of 2008/09.

He also said TCN ran the service far better than NHS Worcestershire when it used to provide out-ofhours care itself and said his organisation’s investigation had nothing to do with the national investigation prompted by the death of Mr Gray.

Coun Eeles said: “I think what happened to Mr Gray has been extremely damaging for them. I think that’s why they are trying to get out of it because they know there’s this damaging report coming out on them and they wanted to wash their hands of it.

“The thing that’s concerning us is that TCN seems to have the control over who they hand the contract on to. Our views are that if you have a contract and terminate it, you lose that power.”

Dr Simon Parkinson, secretary of the Worcestershire local medical committee, said: “The biggest problem that TCN had is that nobody could understand why they seemed to go out of their way to alienate and not work with people locally.

“They came in as the big experts and they didn’t look after the hardcore of hard-working staff they had, including receptionists, doctors and nurses, people who had been part of the out-of-hours service when it was run by the primary care trust and, before that, by GPs. They should have kept hold of these people who were their rock and grown on that.

“They dropped rates of pay for doctors. We said, ‘It’s not enough.

People won’t do it for that’.

“We were right – large numbers of local doctors said, ‘I’m not going to do it for that’. People didn’t enjoy working in that situation and it wasn’t just the money.”

Dr Parkinson called for a focus on training and on streamlining the existing service, making sure it was of the highest quality, which had been achieved in other areas.

He also wants to see more local involvement from GPs but said there was a will in Worcestershire to improve things.

Dr Parkinson, like Coun Eeles, is also adamant that two doctors is insufficient to manage the service and is not convinced the service was better run by TCN than NHS Worcestershire.