Declan,
So you feel that we should stay with the present managerial system, and in
addition have clinical governance imposed by a mixture of management, the
post-Bristol GMC and the MDU?
Whether you like it or not clinical governance (or whatever you want to call
it) is going to get more and more prominence. Rightly. too I believe. There is
an incredible variation in management of illness with resulting variations in
outcome. Clinical freedom is the cry at the moment - but you raised the
subject of mirages, clinical freedom is the classical example. Are you for
instance free to treat tonsillitis by amputation of the great toe? No. Should
you be able to ignore guidance on best practice. No.
That does not mean that there has to be uniformity of style, just disease
management. We accept the BTS guidelines etc why not others? Is the mirage of
clinical freedom more important than the standard of treatment we provide?
Iain
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