>NOT FUNNY and quite inapropriate. The man has integrity, the peddlars of
viagra do not.
>
>Trefor


Instead of flaming each other can't we save our energies for those who
threaten to make such an appalling mess of the health service?  My own
small decision and action was to submit my resignation to our PCG steering
group just a few hours before reading Ahmad's letter.  

The drip drip of information from the centre has been a cynical attempt to
hide a rather incompetent revolution in the provision of primary health
care.  Weren't we promised evolution?

Ahmad is right about forced co-existence.  While PCGs formed by volunteers
could do something useful our profession will not be serving patients
interests (or our own) by acquiescing to the present proposals.

There is now widespread evidence that merger mania is frequently not in the
best interests of companies. Why should we be any different?  If they do
survive it's often by sacking a large part of the workforce - if they don't
the organisation fails, but if this happens in primary care who's left to
look after the patient. 

IMNSVHO Guidelines have value but if a task in primary care can be done
according to an auditable protocol it doesn't need a doctor to do it.
Clinical governance as currently envisaged is about the destruction of
General Practice.

Fixed budgets for everything in a health service that centrally still
claims a virtually open ended coverage is a hypocracy that should shame any
government.  If there isn't enough money for comprehensive health care the
government should decide what it can afford to pay for, should reward staff
fairly, and ensure adequate staff to carry out the selected tasks.

Finally there is absolutely no evidence that I see that the present
proposals will release money from bureaucracy into patient care.  Large
organisations breed bureaucracy.  Clinical governance is a huge
bureaucratic task in itself with totally unproven benefits in terms of
patient care.

Fund-holding was bad, but the present proposals are worse.  We have a
lesson learnt from the history of the last government.  The rates were a
bad tax, but the poll tax was worse.

There is (just) time for the government to wake up, find a solution which
saves face, and moves us forward.  Conflict always leaves casualties so
patience and tolerance are great virtues but they don't justify appeasement.

If we can stick together (PCG enthusiasts please, please take note) we may
just save a battle that could only harm everyone.

What else can we do?
JB


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