Mike
I mainly lurk on GP-UK. I'm a senior adviser for the NZ Ministry of Health
(and a GP) and have kept well briefed on NHS changes over the last five
years. The reaction to the most recent White Paper is going to be
fascinating - I thought your comments were pretty apposite.
We have developed a very limited form of budget-holding here (mostly only
for pharmaceutical and laboratory usage) but are looking to expand that
(driven not by the centre but more by GPs and communities). Our GPs have
amalgamated into large Independent Practitioner Associations (IPAs) that
may well form the future integrated care groups. Some are developing
relationships with our Trusts, their communities and specialist clinicians
- much like you said was the early focus of your TPP.
I'd be interetsed in any info you have to share about your experiences
(where are you - ?Bromsgrove). I may be in UK later this year and would be
interested to find out more.
John Marwick
[log in to unmask] on 08/03/98 07:07:09
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To: [log in to unmask]
cc: (bcc: John Marwick/MOH)
Subject: Re: Shotgun marriage
I am not so anti these PCGs, after all the Labour party in opposition said
it would get rid of Fundholding and it has - by making us all Total
Purchasers! I hope we all enjoy the irony. Having been part of a TPP for
several years now I can see advantages in the PCGs and our TPP is planning
to dissolve into two PCGs rolling out the commissioning experience that we
have gained. Though alot of the focus in the early years of the project was
on process and structure and building up trust between the members (HA,
Trusts, GPs) latterly, the drive has been service oreintated with a strong
emphasis on the clinical and particulary Primary care. Having the ability
to engage the hospitals in a meaningful dialogue and putting our point of
view has led to changes. Our project has been indpendently evaluated from
the the beginning with the evaluators feeding back their reports into the
project. We are a very different creature from the original form.
However, the move to PCGs must be GP led, bottom up and be owned by the
members or it will all end in tears. It seems clear that alot of you out
there are vey suspicious of the govt and HAs and you may have good reason
but the message from the top seems to be pro GP and I would encourage you
to consider co-operating, 'cos if you don't manage yourselves then someone
else will and not to your liking!
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