<<2. The government has a majority of almost 200, and is still the most
popular government in history! Its PR machine will ALWAYS be bigger and
better than ours...and it will ALWAYS win.>>
No it won't. It can win PR wars but how real are those?  Do those mean one
damn thing in the chaos of the average Monday morning surgery? 
Remember----no-one can control my inner feelings unless I let them and
no-one can make me feel bad unless I let them. YOu can spend years in
chains (literally or figuratively) and still be free in your mind.  Mein
gedanken sind frei --or something like that---"my thoughts are free" which
was the name of a company in a Joan Vinge science fiction story.    Once we
stop worrying about being popular all the time then we are free to do
whatever we like.    Has the government won with those of us who say sod it
to NHS GP and go our own ways?  Don't think so....

<<. The nurses will willingly take those seats....and then THEY will be in
control of our GMS, our reimbursements and our incomes.>>
And responsible for rationing and hiring and firing and accountable and all
those things that nurses traditionally do very badly if at all.  I can just
hear the refrain from the PCG boardrooms now---"But I'm not covered to do
that...."

<<7. We have fought for the right to be in the majority and in control.
Even
if the system is shite, it is better to influence from pissing within, than
from pissing outside.>>
I would be warned by the number of people who have thought that and ended
up being corrupted by the system they sought to change. Besides we don't
need influence, we need total and radical change. Even concepts like PCGs
(or PCGs as they could be with a majority of intelligent and competent
professionals backing them to the hilt and cut loose from the shrimp nets
of bureaucracy) are still fiddling around the edges of a massively
complicated and self-destructive system.  The NHS is a socialist experiment
and it is still in progress---but so many in power forget the latter clause
of that sentence and seek to fix it , like one would fix a software package
at a given stage of development, call it v1.1 or whatever and release that
version, support that version and keep on selling it while work continues
on the next version which will likewise be fixed and released at a given
time.   Basically what I am saying is that the NHS should be treated as any
heuristic experiment, we should be learning all the time from what works
and what doesn't and we should be changing it.   What experimental evidence
do we have that a massive change like PCGs will be worth trying?  None!  
I can see this argument might take a few thousand more words to explain
properly but I shall leave it there for now.


<<and a
few brave chaps going private in a market which only the few wish to join -
why pay for a rolls royce when you get a Merc for free?>>

Let me rephrase that---why pay for an old Skoda when you can get a Corolla
for just a little more?  Think about Joe Public actually does with his
money.   He spends enough of it,   enough cash, on non-NHS health stuff to
finance a massive OTC market, he supports a  population of alternative
practitioners which is at last count bigger than the NHS GP population, he
supports an unknown number of NHS-type people like state-registered
chiropodists who do some private practice,  ditto physiotherapists.  BTW I
have a business friend who is a kinaesthesiologist and she has a two-month
waiting list. Two months!  And then there is Viagra, Oilistat and all the
rest of that stuff which is supposedly coming our way and will certainly
not be available under the NHS to all those who want them. 

I rest my case.  For now.
Declan


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