[log in to unmask],Net writes:
>On Tue, 5 May 1998 18:05:17 -0000, Adrian Midgley wrote:
>>>If you still call that trivia, then God may have mercy on our souls!
>>œ60 average per GP per year which is not extra money, just
>>distribution of the pool is trivial, considered against the backdrop
>>of reorganising the NHS.
>Missed the point. I was not referring at all to TRs. That particular
>issue has no relevance to me whatsoever.
The point was that _I_ was referring to TRs, which we agree is a
trivial matter.
Although irritating.
To the extent that we are small to moderate sized businesses (a
Treasury definition which seems to run from a single-handed practice up
to a PCG-sized partnership, just) we must accept the reality of the
market.
To the extent that we are citizens, with admittedly certain privileges
and obligations not universally enjoyed, we must be aware of the wishes
of our felow citizens (beer, sex, football, and PCGs)
and even if we would prefer to offer something for sale other than what
the market will buy, even if we might wish to educate our fellow
citizens into preferring other ways of being served, if the effort has
not been made (and it had not) then it is too late to start bemoaning
mistakes.
Good grief, can you not detect a lost battle, or an indefensible
position?
Withdraw, regroup, outflank, remain in being, and stand by for an
armoured cunterstroke, if you want a conflict-oriented view;
or write a tender, list the requirements, suck in your breath sharply
and say "difficult to find the parts, guv, it'll cost you" if you want
a commercial oriented approach.
As far as assuming the high moral ground goes, no chance.
It has been occupied for several years, by a thoughtful band building a
response to the idioces perpetrated by a previous administration.
The Mid-Devon Commissioning Group --> Pilot project --> PCG which is
currently in the middle of those stages, and fertile soil for a whole
barrowload of OBEs and such trinkets is testing the water, having
advised the architects of the incoming government from some time before
the election campaign started.
They are lions, lead by heroes, and their moral stance is unimpeachable.
THey wrote a good book as well, givng lots of detail on how to do it.
If you havn't read it, do. It is full of appeals to democracy, to
benevolence and other motherhood and applepie, but you and I are the
people to ensure these ideals are built into the orgs in which we will
work for the next few years (until another bunch of time-expired
bureacrats look at the mess they have made of their jobs and decide
only a full reorganisation can conceal it - or until we take effective
control)
Nobody has to run their PCG. They may think that their colleagues are
cleverer than they, or that the fees negotiated are so unappealing that
it is not for them, or that it is repugnant. But knowing GPs, it seems
unlikely that many will decline to be involved because they believe it
will serve the public and the NHS better if they stay out.
One of the sharpest cusps of decision i whether we allow another
papershuffling mediocrity of administration to hide its defficiencies
in chaos, or whether we grasp modemocracy and openness and make evident
what is being done, by whom, and why. PCGs represent our best chance
to do the latter, and it is a pity to waste it.
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