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There's been threads about GPs going downhill since before the computer was a twinkle in Babbage's eye. They sit alongside the ones about the country going to the dogs and creme eggs getting smaller.


Hardly evidence that performance related remuneration doesn't work.


Incdientally, I don't believe it to be a solution in isolation - it needs to be linked to other elements that free clinicians and their administrative support from stifling and dehumanising bureaucratic controls, and give them more control over their own destiny.


More importantly, the fact that there are 'risks' is not sufficient reason not to implement the new structure. We take a risk just by getting out of bed in the morning.

  • 2 weeks later...

Interesting article by M.D. in the latest Private Eye talks briefly about the leaked risk register and the continues with


"[the risk register is] helpfully colour coded in red amber green, and the risks are largely red


The NHS top brass, led by chief executive and former communist David Nicholson, are petrified that such a massive unforseen change in structure and the predictable consequences will see them lose control over money, strategy and power.


The delay in the passage of the bill has simply allowed Nicholson time to claw back his power to the point that the NHS is now more centrist that it was under Labour, rendering Lansley's bill the most pointless and expensive reorganisation in NHS history.


Commissioning support services htat didn't even appear in the health bill are now sprouting up everywhere and their leaders will be appointed by Nicholson's board. They'll tell GP commissioners what they can and can't do.

Commissioning GPs clearly need to be accountable for the ?60 billion they spend, but many will give up faced with the 118 authorisation requirements, site visits and box ticking exercises they have to pass before they can be approved to take over from the PCTs in April.

Lansley promised to liberate the NHS instead it has been shackled to the centre for good"


So bottom line, the bill went ahead despite a register largely coloured red (ie risks not managed) and the botched bill has merely resulted in greater complexity serving the centralisation of power by the NHS grandees.


Even if the intentions were good it looks a right old balls up.

  • 4 months later...

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