Tuesday, July 13, 2010

Balzac, Rabbit, Fig & The NHS Reform

Can one really get the bends from snorkeling? Balzac, rabbit and fig!!! 


In Pulse:

GPs like 'rabbits in the headlights' says next RCGP chair
13 Jul 10
By Gareth Iacobucci
The Government's radical commissioning reforms have left many GPs feeling like 'rabbits in the headlights', according to the chair elect of the RCGP.

Speaking at a King's Fund conference on commissioning today, Dr Clare Gerada spoke out against health secretary Andrew Lansley’s plans for all GPs to take on commissioning, warning that it could cause a backlash from patients if GPs were taken away from their day jobs as family doctors.

Dr Gerada, who officially takes over as chair of the College in November, also warned attendees from both the NHS and the private sector that the plans would be tested by GPs natural reluctance to 'go to the dark side' by teaming up with private firms to deliver the Government's agenda through risk-sharing partnerships.

She told NHS managers at the event: 'We need your help. For most GPs, it's like rabbits in the headlights. There is also a natural disinclination to working with external organisations, for fear of going to the dark side and being part of the privatisation agenda.'

Dr Gerada said it was important that GPs primary roles as doctors were not forgotten, and warned that gaps in clinical knowledge required to commission some complex secondary care would need to be addressed.

She said: 'It's important we don't think all GPs will commission. 1-2% of GPs will have leadership positions. Otherwise, there will be an enormous backlash, because we still have to see the patients.'

Listen up, Mr Lansley. Most GPs don't give a fig about commissioning
“What they understand by 'giving power' to GPs is not what we understand. For them it is actually about devolving responsibility, so the problem no longer sits on their desks. A problem with chiropody? That’s a commissioning issue, you need to talk to GPs about this. But the power? That stays with those who set the budget, and there is absolutely no way that any politician will divest themselves of that.

But what was it about Balzac?
Random House

Well it was a little book I was reading when not under water:

Two young men, one the son of two doctors and one, of a dentist were sent to a remote village to be re-educated: by farming.

There was no choice; their parents too were now farming: bare-foot doctors took over.

Yet people were resilient and creative, when they wanted a feast, they pretended that a buffalo had an accident. When food ran out, they sucked pebbles dipped in salt solution. But reading Balzac was their ultimate salvation!

Then they met the little seamstress........

Looks like our 35,000 GPs had no choice but to take up commissioning (well, not farming!!!) and 64,000 at PCTs and others might be gardening. But hang on, I suspect that 30,000 will be helping GPs with their farming commissioning, having collected good redundancy packages and a pensions.

When Jobbing Doctor next refuses to prescribe gluten free diet to a non-coeliac patient or plastic surgery for psychological boost and receives complaints, think of the Little Seamstress story: we had it good.



Cockroach Catcher said...

My comment to Dr Grumble on a similar topic:

I think the public needs to know we are in grave danger of losing hospital doctors as public employees and in a few years most will be in private practice. Medicine in the private sector is different with different “ethics” and in Psychiatry we have all seen what it was like in the private sector without having to mention names. I worry for the future of the hospital service. It is more important to make sure quality is good.
Can you imagine the nightmare of charges and funding and what if it was decided that GP consortium will not refer the psychotics as they would be long term and expensive and GPs can prescribe the same antipsychotics. In children, GPs may just prescribe Ritalin without referring to a Child Psychiatrist.

Then there is demographics: one of my clinics used to have three times the referral of another one. Yet we do not have the IT system to tell us.

If it is about history or recent usage, the ones that did not refer much to hospitals may now lose out. I could go on………….

I cannot see Mid Staffordshire becoming Royal Marsden and not even the once great Great Ormond Street.

The trouble is many of the bright young ones no longer want to be hospital consultants and those that did wanted to emigrate. Soon, British trained doctors will not be exportable though. Was there a conspiracy somewhere?

What can we do?

Cockroach Catcher said...

My comments to The Shrink:

Well put. Cannot agree more. In many parts of the country, some consultant services (such as knee and hip work) were provided entirely by Private Health care even before the new govt. came in.

Allyson Pollock reckoned that UnitedHealth is poised to buy up the hospitals.

There are two kinds of Hospital medicine, one that Insurers can make money and one shunned by them.

We all know who were employed by these private Health Insurers: Ex Health Secretaries and advisers.