-----Original Message-----
From: Adrian Midgley <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 04 April 1998 14:48
Subject: Re: Primary Care Groups


>>From: Peter Wilson <[log in to unmask]>

Noted that you didn't respond directly to the previous posting - political
training or wot?  :-))

>I think you need to think out what your attitude to PCGs, indeed to
>the management of the health service is.

I know what my attitude to PCGs is and I also have some views about the
management of the health service as a whole but won't digress for now.

>On the one hand you complain that rationing occurs, and on the other
>hand you wish to disguise, conceal or ignore it.

I had to read through your first few paragraphs several times before
replying and was hoping that you would give a specific rationing example so
we could make sure we had the same issues in mind. I don't recall ever
wishing to disguise, conceal or ignore it - just not
willing to carry the can for it when it occurs because of inadequate
funding.

>On the one hand you complain that you are not represented, and on
>the other you insist that nobody who is elected can represent you,
>and insist on neither electing anyone to represent you, or having
>them contact you or be made responsible for contacting you to gather
>your opinion, you object to the workings of the PCG being exposed to
>the public or your peers

Agreed in part but there's the rub, eh? In a vote for any representative
body
one only to gets to choose from those who *want* to stand. But bear in mind
for further down!

>You complain about the organisation, the constitution of the PCGs,
>and yet you refuse to participate in setting up an organisation and
>constitution that will satisfy you -

Coercion or wot?

>You are in general denying the legitimacy of anyone elected or
>selected to run things for their peers - and yet, you sign yourself
>as medical manager of a co-op.  HTF do you square that particular
>circle?

I think one needs to look back nearly ten years now to when the first GP
co-ops were established in Kent. I became one of the Medical Managers of
EKDOC simply because I had spent a considerable amount of my own time and
effort to get the thing up and running. I was motivated purely by seeking to
find a local and dare I say, personal solution to the burgeoning OOH
problem - a sort of "something must be done but not by me" atmosphere was
all pervading until a colleague and I decided to do it.

> Are you an autocrat imposing your agenda upon GPs

No, we have a steering Committee upon which I sit in an advisory capacity
but
have no vote.

>or do you feel that you were selected by them for that job,

Originally, they joined me - by choice :-)

>and that you are open to their suggestions, that you try to give them
access to
>all information they might reasonably request or require?

Yep, I publish a monthly newsletter which keeps all members abreast of
developments and invites feedback on all issues. The day to day management
is carried out by a General Manager who cut his teeth in the *real* world
whilst myself and that other bloke from Fanet provide medical input where
necessary.

>Is there, somewhere in your area, some anarchist revanchist
>fundamentalist no-voter who is telling anyone who will listen that
>you are unrepresentative but that they will never allow anyone else
>to represent them in your stead?

Not AFAIK but ... goes off to find dictionary :-(

>Is your org run, representatively, without any committees.  If so I
>think I would like to join<g>

That's it - "would *like* to join" - EKDOC's members joined because they
wanted to. Having said that though and realising that I stand the risk of
weakening my argument, committees are necessary and I truly hope that ours
tries to represent the wishes of our members but it will never please all
the people all of the time and before you reply with "Game over then" I
would ask how you know without a ballot of all GPs whether or not the
profession actually wants to be involved in the process.

>I might add that I ssuspect you do a good job and enjoy the support
>of your colleagues, but why do you think the rest of us are greatly
>different.

I would resign my post tomorrow if I thought that I could be replaced by any
other member who felt the same degree of commitment to the Co-op as I do or
if the membership decided to replace me. I said in my original post that I
wasn't medico-politically motivated and I'm sure you could run rings around
me in any such forum, blimey, I even had to look up "revanchist" :-(  My
posting was in no way a personal attack on you as you command my greatest
respect in a whole variety of fields and this makes you, IMHO, far above
"average".

In my neck of the woods the composition of the various committees is more a
matter of "We need another member, any volunteers? Just get a proposer and
seconder and you're in"! (Remember from above?)

I just feel that the PCG is a bad thing and deserves a serious attempt to
ascertain the true feelings of that, so far, unheard "average" GP.

>Now if you came up with lists of things which should not be done at
>present, and are being, and called for these to be stopped, but
>offered ways of doing so short of the reorganisation planned...then
>I would applaud.

Happy to contribute to that but not if it means joining a PCG :-) Surely
that is the sort of procedure that should be carried out first? It must be
easier to stop something that hasn't happened yet than get rid of it once
implemented and empowered.

Cheers

Dr Peter Wilson
GP, Broadstairs, Kent. <http://www.albionrd.demon.co.uk>
Medical Manager - EKDOC <http://www.ekdoc.com>





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