>I was at a meeting last night where Professor Alan Maynard
>who is both chairman of our Trust and of course head of the
>university Dept of Health Economics was talking about the future.
>About 70 GP's turned out. All anxious about the situation and
>certainly no happier after the meeting. It cast a little illumination
>on the darkness but the fundamental truth is that no-one really
>knows how this is going to pan out.
>There is no evidence base for much that is being created. There
>is overt rationing, although they don't like the 'r' word. We are
>on another magical mystery tour like 1990, only this time it
>is compulsory and there are only sanctions and no carrots.
>He forecast that this is the end of the independent contractor status,
>that we are to be managed, quite rigorously, that resources will have
>to be reallocated, either on an equity basis or using an economists
>jargon on an efficiency basis.
>It was rather depressing as it really crystallised some of the threads
>that have been running on this forum. There is no good news in the short
>term, it will mean massive change; the public will have to accept
>rationing in other forms than the waiting list. We will have to say that
>for instance, there is no indication for treatment of symptomless varicose
>veins so we won't even bother to refer as they won't be seen. Our clinical
>freedom is going to be curtailed by guidelines from above, (NICE, NICELET,
>CHIMPS etc.) and you won't be able to stray.
>Do I sound a trifle depressed? Just a smidgeon.
Is the Observer correspondant still on the list, is the BBC listening? When
will this feature for more than 5 minutes on the lunchtime news?
Today we have had a fax asking us to rank four choices. This is because the
definative, make a decision meeting to vote on what we are going to do in
our part of Sheffield turned into a shambles, three choices turned into
four, without a decision. Out of the 7 partners we have several different
views. Some taking into account the needs of practices 5 miles away, others
not caring what happens next door. My partners who attended commented about
the difficulty of getting 30 GP's to agree. One of the possible solutions to
the problem will result in a PCG with over 150,000 patients, and about 70
doctors in over 30 practices. When will the government call a halt? The
difference between this and implementing fundholding is that we are putting
in the work without any recompense. Fundholders had new computers and
eventually new buildings etc.
I am more depressed than he is.
Trefor Roscoe
Trefor Roscoe
GP, Beighton Health Centre
Queens Road, Sheffield S20 1BJ
GP Tutor Informatics - N Trent
http://www.medical-legal.co.uk
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