>Particularly intrigued by your musing that it might enable DOH to
circumvent / >undermine GP in the case of industrial action etc.


>To be honest none of what I have seen from the DOH to date would make me
think >they have the wit to think about even some of the simple implications
of NHS Direct let >alone have the devious "master of the universe" foresight
to be able to think up the >scams you describe.

I may be paranoid but why setup a telephone answering service with triage
when Co-ops are doing it, ambulance trusts are thinking (doing) it.
Casualties are doing it. As someone said "Why reinvent the wheel?" The NHS
admindroids are not capable of such foresight but those bright boys in
Whitehall are more than capable. They are playing chess with us it would
seem. Which way to jump?

>Interestingly however in my experience to date a lot of GPs can recognize
potential >uses of NHS Direct much faster than our HA colleagues......maybe
we are just more >insightful   or devious

Oh yes insightful and devious? Isn't it quick and easy, why pay for Co-op or
Health Call when 888 will deal with 50-60% of all your calls for "free" and
refer on the rest. Rather a tempting and easy thing to foresee, no?

If GPs were goaded (What really would do that?) and finally stopped on their
treadmill NHS Direct could form a dyke to soak up the acute healthcare
dross. Enough for that and an expanded AEU service to just cope. How long do
you think GPs would go on for, as long as the miners? I doubt it!

>I bet you suspect there was a second gunman on the grassy knoll and watch
the X->Files ;-)


Nah JFK committed suicide ;-) and the X files is just a "I fancy Skully
zone!"

>Your comments however should spur us GPs  / Co-ops to get involved in
NHS-Direct >and get influence in the project rather than surrender it to our
ambulance colleagues

The ambulance guys see the writing on the wall. If NHS direct really gets
going it will run all the OOH including the ambulances. Co-ops and Ambulance
Trusts go to the wall!

>Not least as one of the first questions the DOH are already asking is "if
NHS Direct >takes over some of the GP OOH workload then some of the GP OOH
funding should >be rerouted to NHS-Direct" (direct quote from a HA Chief
Exec)

So the downward spiral starts. GPs end up being salaried docs on NHS Direct
for OOH. Mind you they would have to pay big time! Blowed if I would do any
OOH!

Indeed why stop there? Why not in hours and they take the calls and make the
appointments to SS, GP, AEU, DSS whatever?

>If your not sitting at the management table you lose most of your influence


Join this or not? Management or medicine? Tell the lot to FOAD?


Paul Attwood
GP Thanet



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