<Ahmad's PCG snip>

Trims replied

>PCGs are not HMOs. HMOs are "vertically integrated" i.e. they include
>the "purchaser" and "provider" functions. Both primary and secondary
>care clinicians are heavily managed. PCGs will probably be more like
>PPOs (Preferred Provider Organisations) which arrange contracts with a
>range of clinicians / hospitals. The point is that these organisations
>appear to work best when there is clinician involvement at management
>level.
>
>A further point is that our own contractual arrangements are quite
>different to our American colleagues': the Part II GMS contract
>remains the default option, even at Level 4, providing a national
>contract and no increased direct financial risk.


Not the way I understood it Trims. Thought that GMS funds would be directly
at risk if poor management or poor budget or for whatever reason the money
runs out?

>While it is compulsory to belong to a PCG, there is no compulsion to
>actively participate. You are free to delegate responsibility to your
>colleagues and you should expect them to listen to your opinions. You
>will not have a budget and you will not be required to record every
>referral you make. But you may also expect a more detailed examination
>of your clinical behaviour, rather than just prescribing, as at
>present.

Will spend 30 mins looking at my Prescribing PACT data, out of curiousity,
but if PCG management want me to do any work, meetings, provision of data,
comments on data, then this cookie charges BMA rates. I did a lot of work
for free in FH and my goodwill went with that. PCG no payee me no workie and
that goes for GMS as well.

>Every PCG will be headed by an "Accountable Officer" - this is the
>person who will be accountable for the "rationing" decisions and the
>clinical and financial performance of the PCG. There will also be a
>person responsible for "Clinical Governance".

As long as Accountable Officer has a phone number which will be given to
irate patients and MPs then no probs. Clinical Governance wot no Big Brother
officer? :-((

>The choice you have is whether you are happy for these people to be
>appointed managers or whether you would prefer democratically elected
>colleagues who are willing to participate and represent your views.

Coercion equals no voluntary participation. May even equal guerilla warfare
but we'll see.

>I would rather have Doug Black than one of our HA colleagues.

I agree! I would rather trust another clinician than *any* short term health
authority employee who looks no further than his Profit Related Pay or own
advancement up the slippery NHS pole. Saying that I was watching a colleague
the other day who spends a lot of time on Committees etc and to be honest I
looked at him then at the HA bods and I couldn't tell the difference (Animal
Farm).

Gengis Khan
aka Paul Attwood
GP Thanet




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