-----Original Message-----
From: Ruth Livingstone <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 07 June 1998 20:42
Subject: RE: Meeting the GMSC
. Pulling back to county level would seem to
>me to be the only realistic way to avoid a massive increase in NHS
>management costs/ management personnel, and will dilute the problems of
>rationing by postcode. Let's reinvent the FPC. How many of you would go
>along with that? It would be useful to have your thoughts
>
>In our area, South Lincolnshire, we would be strongly opposed to a county
wide
>PCG. One of the problems *we* face is being constantly overlooked when it
>comes to doling out resources, due to our geographical distance from the
>headquarters of our FHSA, and due to the fact that our main providers are
out
>of county.
>The key to success for PCG is GP control on the management boards. We need
a commitment from the government that true
>power will reside with the GPs and Nurses within PCGs. >--
>Ruth Livingstone
>http://www.stamford.co.uk/littlesurgery/
Thanks Ruth. Interesting point about being on the periphery. The key is ,
however, that the Board of the County -wide group would be profession led,
as proposed for PCGs. All practices would have to have some democratic means
of input. Don't forget the FPC pre 1990 was 50% professional,50% lay, with a
lay chairman. It's a very different scene to that of the HA now, where many
HAs have no GP input at all to their Boards. The figures suggested in GMSC
documents last month as reflecting DoH intent, outlining plans for PCG
Boards of 10 to 12 with one or two GP members, horrified me.
Glos HA has been working on costing exercises. Our own common sense also
indicates that reinventing the wheel five times over in Gloucestershire will
be very time consuming, compared with a single county-wide base. Each of 5
(or 6 if local politicians have their way)PCGs will require staffing,
buildings, IT infrastructure, etc. Enormous chunks of work will be
duplicated. A central county wide (or larger) unit (HA) will still be
essential. We already see the need for that for many things which will be
difficult for PCGs to handle efficiently eg cost rent, payment of GPs,
superannuation etc. I don't know about your area but staff cuts at the HA
have already made it difficult for us to get good advice on many aspects of
payment/terms of service because there are insufficient experienced people
left at the HA, especially compared with skills available at the old FHSA.
With smaller units of administrators specialist knowledge will become more
difficult to access.
Regards,
Peter Fellows.
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