On Wed, 3 Jun 1998 15:33:22 GMT, Graham Ride wrote:

>As a potential patient, devil's advocate and Jo Public I need to know, in a
>nutshell, what the governments PCG proposal is so that I can assess why you
>say all these things will obtain.

Yesterday,  we discussed the first batch of 5 reasons why PCGs are Bad
for People,  Bad for Doctors and Bad for Britain.

Here is batch number 2:

6.  Loss of family doctors' independence

-  we learnt yesterday that family doctors are really independent
contractors who provide services to you on behalf of the NHS
-  that means that family doctors run their own business,  what you
might call a 'small business'
-  that also means that family doctors have invested their own money in
building up their business.  Things like employing staff,  finding and
furnishing Surgery buildings,  computers and all sorts of equipment. 
Everything in your doctor's surgery from the telephones,  toys and the
ECG machine to the loo brush would have been paid for by your doctor
-  that independence to run a small practice as best they can to
provide services to people they know allowed family doctors to tailor
their services to your needs and to adjust and adapt quickly to your
comments and suggestions
-  in return,  you grew fond of your doctor,  you trust him or her to
look after you and you rely on your own doctor to help you with lots of
things that are not strictly speaking of a medical nature
-  your family doctor knows you and your family and knows what worries
you.  You trust your family doctor to do you right
-  that fundamental relationship of trust and knowledge is under threat
because your doctor will become just a small part of a large
bureaucratic orgnaisation that will decide for him what he can and
cannot do


7.  Move towards USA style health care through HMOs,  managed care and
hyper-surgeries

-  family doctors set up shop in areas where their services are needed
-  their surgeries often become the focal point of the community
-  you know you can always go to your doctor's and that the door will
be open
-  this is because your family doctor is on your side and does not have
to worry too much about questions of profit and loss
-  your doctor just does what is best for you
-  lumping doctors together in large unwieldy organisations has many
benefits for the accountants and managers
-  this because the hyper surgery can be run more efficiently
-  how many times did you hear that before!
-  you will just have to go where that hyper surgery happens to be and
not only that you won't be able to see your own family doctor,  you may
not even get to see a doctor at all!
-  this is because some bureaucrat would have decided to put your case
to 'the team'!
-  that team will include doctors and nurses,  yes,  but it will also
include social workers and other people you have never dreamt of giving
information about your health to
-  this large bureaucratic organisation will have too many masters to
please
-  it will always be worried about expensive things and will look to
buy things on the cheap or it might even cut corners when it comes to
serving you!
-  the whole idea of lumping family doctors together whether they like
it or not is to be able to control and manage them
-  in America,  family doctors are always under pressure not to spend
too much.  They even get penalised if they do and rewarded when they
don't!
-  would you like your family doctor to be under the same pressure?


8.  No one to apply the real pressure on government to address the real
ills of the NHS

-  we all know that there is not enough money being spent on the NHS to
improve the health of the British people
-  we all know that there is so much waste on managers (who
incidentally,  got a pay rise this year several times that of nurses!)
-  we all know that we spent far too much on things like expensive
weapons and support for corrupt overseas regimes,  money that would be
better spent on the NHS
-  just look at the hospital waiting lists!  They have doubled in a
year!
-  who is there to stand up and shout about the real problems facing
the NHS other than the people who are at the coalface?
-  but the doctors and nurses who should be doing all that shouting
will be too busy attending meetings,  looking after multi-million
pounds budgets and sorting out endless disputes between themselves
because they never wanted all this in the first place

9.  Inefficient management by untrained and unsupported doctors who
currently barley have time for patients

-  we all know how busy our family doctors are,  you just try to get an
appointment to see your doctor on a Monday morning!
-  we are also told that Britain is short of 1000 family doctors today!
 That number is likely to increase over the coming years because many
overseas doctors working in the NHS are near retirement and there is
not enough young doctors to take their place
-  doctors spend long hours studying to get into medical school.  When
they do,  they spend many years in hard study and training.  When they
qualify,  they spend many more years working like slaves as junior
doctors.  You may have seen the documentaries on TV about the lives of
junior doctors
-  if they wanted to be managers and bureaucrats,  they wouldn't have
gone into all that trouble,  would they?
-  these large groups the government wants to impose on family doctors
will be run and managed by those very same doctors who are also
supposed to be in the Surgery looking after.  How do you square this
circle?
-  and because they were never trained to run such huge organisations, 
surely things must go wrong
-  and they will have no one to blame and the government will blame
them and you will be the loser nevertheless!
-  the government said that they are not prepared to spend money in
training and supporting those doctors running this big organisations
-  would you expect your family doctor to spend her own money to do the
government's work for them?


10. Increased say of social workers and social services in who gets
what

-  the Minister for Health said recently that there are 22 different
groups of professionals who will be involved in running these mega PCGs
-  22 different groups I ask you?!
-  will they ever agree on anything?
-  who will lose out when 22 different people with 22 different masters
and 22 different agendas can't agree?
-  YOU will lose out
-  do you really want social services to know everything about you?
-  do you really want the local Council to know everything about you?
-  do you really want the DSS to know everything about you?
-  think about it


We continue to expose why PCGs are Bad for People,  Bad for Doctors and
Bad for Britain with the third batch of explanations another day.  Stay
tuned :-)

The Major

________________________________________

Dr Ahmad Risk
http://mednetics.org
home: +44 1273 724866
work:  +44 1737 240022
fax:     +44 1737 244660








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