Twas me. We've already had some good examples of it in this list. First of
all, there is inter-practice variation in service provision (outside GPFH),
then there is private medicine versus NHS, then there is GPFH v. non-GPFH
(shortly to be replaced by PCG v. non-PCG?), then there are the differing
levels of service between different HA contracting profiles (recently
popularised as 'service by post-code,' but in fact it has been around since
1948, often in much worse forms than now - for example the annoying and
rigid 'cachement areas' of the 80s.)
The disappearance of GPFH and the appearance of PCGs will only have marginal
impact on any of this. There have been six or seven reorganisations of the
NHS since the 60s, and none of them have had any particular impact on
patients. This is the reason why PCGs don't excite patients very much; they
are sophisticated enough to work out that health service management
reorganisation doesn't change health care delivery all that much.
Andrew
> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of Graham Ride
> Sent: 07 June 1998 14:53
> To: [log in to unmask]
> Subject: Re: PCGS are Bad for People - 2
SNIP
> Somebody referred the other day (my apologies, I have forgotten
> who and lost
> the email) that we already have a 3 or 4 tier system. I assume that other
> than private tier the other tiers are internal tiering within the
> NHS. If so
> how does that come about?
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