Monday, 18 January 2010

Snow, snowploughs, improving services and why Practice Based Commissioning will never work.



One of our number spoke to a journalist friend who knows our frustration with some of the items in the title. They suggested that we look at a link on a local BBC News website. Unfortunately the link will have expired by the time this is published but some of the more technical of our crew may try and get the video up as a link a bit later but we make no promises.

It was the story of a farmer with a tractor. A tractor that can be fitted with a snowplough who offered to clear roads in a village called Kilburn in North Yorkshire for free, gratis, nothing (you will notice our use of literature from the Carry On films no less).

He approached the council who sent him a contract with 16 terms and conditions. It said he had to have £5 million of insurance, a particular type of fluorescent jacket, a certain type of flashing light and could only use agricultural diesel if the plough was fitted at the front of the tractor.

The more “enlightened” press so beloved of medical bloggers here in the UK have run a similar story here.

The story reminded us of why Practice Based Commissioning will never work. If a GP comes up with a good and simple idea like using a snowplough to clear roads of snow the local Poliburos (council) will swamp it with bureaucracy rather than have it succeed.

The news item ended with a picture of the tractor and snowplough going nowhere and being wrapped in computer generated red tape sitting idle in snow.

We think the news story is a modern parable about PBC. Here endeth the lesson.

Praise be to the Party for why, when you can make things better for people via something simple, do you make things more bureaucratic?