<<. If GPs withdraw co-operation then the
spin doctors will be set to work, destroying our public reputation, and the
PCG board will be redefined in our absence.>>
Why are we so terrified of public reputation etc? We are the most trusted
and respected group in society and where has it got us? What good has it
done us?
<< Financial penalties for budgetary non-compliance.
- The heavy hand of Clinical Governance run by non-medics.>>
Bugger all money for computers for years now, even for fundholders.
As for clinical governance, forget it, it's shite, it's all about manager
things writing reports and thinking they can gain more power over docs by
invoking this thing which they have great difficulty defining.
<<- Hoards of politically correct "graduate" nurses telling us what we have
been doing wrong all this time>>
Hordes or hoards? Ain't no hordes coming into nursing in this universe
for a while. As for hoards, well yes there are lots of trained nurses who
have found better things to do with their lives than work in crap
conditions for crap pay but I don't think HMG has quite got it together as
to how to tempt them all back to the coalface.
<<- Unilateral amendment of GMS reimbursement (e.g. midwives succeed in
taking
our maternity services fees as argued at the last RCM conference).>>
Stickin out! Let them have it all. Oh and charge rent for use of rooms,
call taking, coffee etc etc. And do something else with the time to make
money. Maternity is not a big earner now is it?
<<- Cost/notional rent messed with by people who have no personal stake in
the
capital we provide for the NHS.
- Compulsory this - imposed that - every perceived injustice and unfairness
at the hands of GPs - REVENGED!>>
Sure I agree that there are plenty of incompetent apparatchiks in the NHS
and some who would love to get at us but what you fear is a situation where
GPs will be near enough employed. And there is a massive body of
employment law for protection of employees, some of which could be readily
invoked if those higher play dirty.
<<Now is definitely the wrong time to throw away such influence as we
have>>
Mark, you are being suckered with the attraction of power. Good power I
mean, the power to influence for the better what happens to your patients.
BUt it is a mirage. We thought we would get that with fundholding but it
didn't happen despite contracts people and senior clinicians coming
crawling to us. I won't start on what is wrong with the NHS purchasing
system but it needs to be seriously overhauled by someone with intelligence
and ability-----even the smart managers have that massive hole in their
capabilities which comes from having no clinical experience, most of them.
We have had this mirage waved in front of us for years now and it remains
that, a mirage. There is no way that groups of GPs can exert significant
power to force long-lasting change in the present system. Whether it can
happen in any health service is debatable given some of the American
evidence which suggests that big providers *still* largely call the tune
despite competition which is totally unbridled relative to here.
We can fiddle around at the edges and maybe even do some real good for
individual patients by getting them better services but overall the service
available is a function of money. And that's all she wrote.
Declan
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