On Fri, 10 Jul 98 23:04:49 UT, Paul Caldwell wrote:

>Much enjoyed your talk on IT at manchester. So what if the 10 'incompatibles' 
>are right?!

It is not  a case if they are right.  It is more the case if you wish
to live with them!

I do believe that the proper and good working of PCGs (ie,  maximum
benefit for the patients) relies very much on getting rid of those
incompatibilities.

otherwise,  you wouldn't be doing anything new.  The HA will still be
in charge,  appointing whomsoever they like,   but you take the blame
and you end up by being a HA but with all the crap and none of the
benefits.

If you take PCGs to their natural cycle to PCTs to HMOs,  why on eartgh
would you want to stifle innovation and enterprise just to protect some
old HAs?

I do believe that very soon we are in the lanbd of PCTs (3-5 years), 
there will be a wave of mergers.  500 whittled down to about 200.  Go a
step further and give those Trusts freedom and autonomy and we should
end up with perhaps half a dozen very large and very powerful 'Firms'
contrlloing health care delivery in the UK.

Contrary to popular belief,  big is beautiful.  Otherwise Price
Waterhouse wouldn't have merged with Coopers Lybrand or BA with
American Airlines or Glaxo wouldn't have got so close to SKB.  Look
around you.  All the major corporations are getting bigger.  Why?

Why do you think NHS trusts are merging right now?

The tictonic (?sp0 plates are on the move again.  The landscape is
shifting.  This is *not* another simple reorganisation of the NHS.

The whole world is amalgmating and consolidating power.  It is now
ruled by the USA,  Japan and eventually the EU block when they get
their act together.  Little PCGs will be like little England,  confined
to the dust of 'other'.

I say to government:  if you want me,  my energies and strengths and my
visionary qualities,  have the balls and allow me to flourish not
encumbered by the incompatibilities I describe ;-)

I say to budding PCGs,  if you want to prosper and serve the patients
well,  you need someone like me at the helm but with a free hand to do
the necessary culling and breaking of eggs ;-)

For example:  I am involved in a project worth 10 million pounds.  I am
looking for a project manager who will be paid 80,000 a year.

What is your budget and how much do you propose to pay your fulltime
executive team?  Peanuts and monkeys spring to mind.

Stop nancying around and appreciate that a Primary Care Firm is
potentially a very big enterprise.  Your organisational structures must
reflect that.  Plan it so.

Ahmad


Ahmad

________________________________________

Dr Ahmad Risk
http://mednetics.org
home: +44 1273 748198
work: +44 1737 240022
fax:  +44 1737 244660




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