egafd.com

errrr did dave ask the GPs before the election he wanted them to do this? the first steps to the end of the NHS as we know it,engineered by cameron and his fag clegg

"did dave ask the GPs before the election he wanted them to do this?"

Not sure, but I certainly dont recall it. What I do recall is the Tories stating that there would be "no more great structural change" in the NHS. Well if giving 80 billion to GP consortiums for purchasing services is not a great structural change, I dont know what is.

This smacks as more of a worrying trend for this government to go off half cocked without any pilots to test out their ideology.

I note Ed Balls the shadow education secretary, asked Gove whether he had at any point received advice from departmental officials which recommended or suggested consulting with local authorities before publishing the list of schools due for the termination of their building projects. He also asked Gove whether official advice was given on potential compensation claims from local authorities, contractors and suppliers from cancelling capital projects.

Gove has so far refused to answer these questions surrounding the complete pig's ear he made of announcing the list of schools whose building projects would/would not go ahead.

As we know Gove is very fond of his free schools idea where schools are setup by groups of individuals, private companies etc and get government funding.

Simon Hughes, the Deputy Lib Dem said "It would be a nonsense to take money that could be used for improving existing schools to create new schools" Apparently Clegg put him in detention for that and he's been there ever since.

You couldnt make it up

CHeers
D

This restructuring means that GPs need to become business managers as well as clinical professionals. When will the need for a practice to make profit overtake the primary duty of providing the best available health care to the patient? With no extra money for the NHS (apart from increases to keep up with inflation) there will come a time when the funds are short, the needs of the patient great and the practice needing to make a profit. Where will the priorities lie then? And what happens to those GPs who are unskilled in financial management or simply don't want to be involved in such matters?

This is the first step toward the privatisation of the NHS

"This restructuring means that GPs need to become business managers as well as clinical professionals"

I think the obvious comment about the above is that this is not possible. At least on the sort of big bang scale, Lansley is planning. What is likely to happen is either GPs will move from concentrating on patients to working as treatment commissioners or private companies will do the work on behalf of GP consortiums.

My understanding is that currently, I go to GP, GP refers me to local NHS hospital or the nearest NHS hospital if the local one cannot provide me with the necessary skills.

Under Lawnsley's plans, I go to GP, my requirement is referred to possibly a private outsourcing company who pass on my referral to different service providers such as an NHS hospital, a private company e.g BUPA or a charity with special knowledge such as Marie Curie. Given these companies offering commissioning services to assist GP consortiums could be the very same organisations that provide healthcare solutions, then there is an obvious conflict of interest here.

Is it best for the company or best for the patient? Now we know what big business typically decides.

The British Medical Association has yet to comment on the basis that "they are yet to see the full detail of the plans!"

I see trouble ahead given unless GPs are allowed to make substantial profits from their consortium, what is in it for them to take responsibility for this stuff i.e. commissioning services via third parties?

Cheers
D

Bob,

What will also happen is that many of what critics call the "useless/bureaucratic/parasite/insert insult here" managers currently in the NHS will move to the GP practices (thereby proving that they are required in the private sector model, too....but that's ok "cos they're in the private sector, innit?".... even though they are still effectively being funded by taxpayers).

Said managers will team up with the half-GP/half-entrepreneurs hybrids who thrived under GP fundholding and will then work the system like a dream (perhaps even in collaboration with a US-style multi-national health company). Outcome: a multi-tiered system akin to the GP fundholder shambles in the 90s. (And to think that people believe the current postcode is abhorrent....)

As you say, everyone takes their cut and the patient is left hoping they:
1) get a financially-rewarding disease (something simple and easily treatable) and not a tricky, long-term profit-averse disease (dementia/mental health or other long term pisser of a condition)
2) live near/luckily register with one of the more astute entrepreneurial GPs, who gets a semi at the site of profit charts and spreadsheets (who cares if he's not as good a clinician - what's that got to do with it now!?)
3) hope that the "cut" going to profits doesn't outweight the "efficiencies" of the new system, otherwise that is to all intents and purposes a real terms decrease in health funding.

Then it all becomes, in a sense quite literally, survival of the fittest. I'm so glad I live in Scotland; the weather's shite, but at least we don't have all this nonsense.

alicia_fan_uk

No in Scotland we just have nonsense like your 18 month daughter falling in the bath and hitting her head and when you dial 999 you get put through to a fucking indian with a flowchart. ( Have you tried rebooting the child?)

Or lazy assed doctors who tell you that "Its not their job to make call outs, even if it is an 80 year old woman who`s slipped on ice outside in the middle of winter and seems to be in shock.

Here`s a radical idea. Lets get GP`s actually working and earning their money

Good GPs work very hard for their money.

And neither of the incidents you cite, disappointing as they seem, are (i) flaws unique to the Scottish system, nor (ii) in any way going to be addressed by these new proposals (ie even if they were introduced in Scotland).

alicia_fan_uk

"Then it all becomes, in a sense quite literally, survival of the fittest. I'm so glad I live in Scotland; the weather's shite, but at least we don't have all this nonsense."

I may be wrong but I think Lansley's plans only apply to England. Health Services are devolved to the other parts of the UK including Scotland.

Looking at his plans, I can only agree with you, thank Christ for small mercies.

Cheers
D

Yes, health is a devolved matter hence my "glad I live in Scotland" comment.

Yeah, I wanted to check that the situation you described for Scotland also applied to Wales and NI. Levels of devolution, in general, seem to vary between Scotland and Wales for example.

Cheers
D