We don't yet know what the structure of Primary Care Groups Boards will look like but I don't see an assumption (in the posting below) that they will be GP dominated is valid. The recent guidance which suggest that those currently setting up Primary Care Groups hold on for further guidance is at lease in part motivated by the fact that the NHS Executive know that many of the structures people are setting up will not be acceptable to the politicians.
Boards will certainly include a GP and a Nurse and there will be probably be representation from LA social service. There will also need to be lay members no doubt drawn from local councillor, CHCs, voluntary and community groups.
Look at the structure of existing Trust Boards they vary but typically:
4/5 Executive members CEO (sometimes a clinician of one sort or another but more usually a professional manager), A medical director, A nurse and an accountant if there is a fifth it's more likely to be another manager than a clinician
4/5 Non-executive members. Under the Tories mainly widget manufacturers with token community representation moving to be the other way round under Labour
The Trust chairman is always non-exec.
I think PC Trusts will look a little different, but not a lot, and a GP majority seem highly unlikely. Remember when FPCs used to have a majority of professional representatives
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Ewan Davis
AAH Meditel - Voice +44 (1) 527 579414 Fax +44(1)527 837287
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-----Original Message-----
From: Ahmad Risk [SMTP:[log in to unmask]]
Sent: 19 March 1998 12:09
To: [log in to unmask]
Subject: Re: Of Luddites and Martyrs
On 03/19/98 10:36:48, "abayomi.mcewen" <[log in to unmask]> wrote:
>WE are all talking as if only GPS will be voting. Surely all the other
>professions ( pharmacsists social workers etc)and patients will be
>represented on 'the management board' whatever that will be. It will be
>a very politacal lifestyle lobbying all those to think and vote like
>you against your 'big' colleagues. THere are many ways of skinnin a
>chicken and you are very crearive Ahmad have some fun with the new
>systyem! We're all talking as though it's all set in stone while we
>only have a statement of intent at the moment.
No, Yomi. We do not have just a 'statement of intent', we have a
fully blown 'intent with aforethought'. A statement of indecent would
read: "we intend to do this, what do you all think?"
What we have is a very advanced stage of formation. Some PCGS have even
elected their 'Executive'. Legislation will be before parliament soon.
The date of April 1999 is already in Health Service Circulars.
I do not call all that just a 'statement of intent'.
The other point I wish to make is this:
We would be seriously kidding ourselves if anybody thought that these
Groups and their 'Boards' were not dominated by the GPs. In my area,
*all* discussions have been with GPs only. I wonder what other areas
are doing? I know that there are groups who are talking with other
constituencies, however, history tells us that the bottom line is
this:
In the Surgery, the patient wants to see 'the doctor'. This may be
changing, nevertheless, it is still a very powerful embedded cultural
trait. Inevitably, much of the PCG work will be doctor driven. It's
just the way the cookie crumbles!
I am not debating here the merits or otherwise of that. It may even be
awfully politically incorrect to speak in those terms. I am merely
observing and describing.
The fact remains: for me, as solo GP, to influence the decision
making process, I shall *always* have to work much harder. I submit
that this is morally and ethically wrong.
Ahmad
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Dr Ahmad Risk
http://www.cybermedic.org
Chairman British Healthcare Internet Association <http://www.bhia.org>
Director Internet Healthcare Coalition - USA <http://www.ihc.net>
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