At 10:22 AM 4/6/98 +0100, you wrote:
>Julian,
>
>1. Are GP's the shareholders or the workers?
>2. What about practice nurses, practice managers. They can be partners in a
>practice, should they be disenfranchised?
>3. Pharmacists - PCGs are likely to affect community pharmacy too.
>4. How about the patients, shouldn't they have a say in how their health
>service is run?
>
>
>Regards
>
>Jeff
>
Good questions Jeff.
1. Not my point - simply to ask whether it is legitimate for sub-groups of
an organisation (or a country) to have their own ballots. I do believe
that a government can tell us what it is prepared to pay for. (It can also
make laws to tell us what it thinks should be illegal.) I will then decide
whether to sell my services to the government.
2. No-one is being disenfranchised but we are (I hope) an independent
professional group who are entitled to consult with each other and decide
on the role of our profession. We would have to think very hard indeed
about declining to co-operate with something the people wanted, but might
take courage if we believed we reflected the fears and concerns of the
many. However like Ahmad I believe that we should (though not over PCGs)
be prepared to stand alone for our own professional values. These are our
(GPs) professional values, not those of practice managers, pharmacists or
others, however worthy those souls may be. Hospital consultants, nurses
and hospital managers often have quite different viewpoints represented by
their professional bodies - we are no different. At the core of
professionalism is a set of fundamental values that cannot in fact be
over-ruled by any external democracy, let alone the tenuous thread that the
government might use to claim it had a mandate for PCGs.
3. Then organise your own ballot. Incidentally if pharmacists were obliged
to involve GPs in ballots over their professional representation there
would be hundreds more rural dispensing practices. Your profession seems
well able to take an independent view, often one that does not reflect the
views of GPs OR PATIENTS.
4. Yes. But they can tell us what they want, I/we are still free to decide
what I/we will do. In fact I think if patients could see the reality of
the present mess they would be concerned. However a white paper is only a
proposal, there is still time for many of the worrying details to be sorted
out. The 1990 contract was a disaster. However within two or three years
most of the really crazy stuff had gone.
Regards,
Julian
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