Don't confuse rationing with rationalisation. The latter is about asking "what
is good?" eg rational prescribing; the former about restriction of a 'good'
service eg only doing a set number of CABGs per year purely becos of lack of
money. Of course the two are interlinked.
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From: [log in to unmask] on behalf of allan harris
Sent: 13 May 1998 21:07
To: [log in to unmask]
Subject: PGC's
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.
--
Allan Harris, GP, Haxby, York YO3 3PH
tel 01904-768666
work 01904-760125, fax 750168
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