Well the change in the UK Government and its great White Paper of NHS liberation has locally led to the very loud sound of the scurrying of claws being heard on the wooden deck of the super liner that is NHS management.
In our local shires loads of rats are apparently leaving, nay, high jumping and triple jumping away from their ships and looking for pastures new. They continue to deposit their droppings for as they scurry away their underlings are being promoted above and beyond their limited incompetence. Lots of their junior offspring are struggling to function for NHS management is a rigid Soviet style dictatorship and no-one dare make a decision without the say so of the local Great Leader(s).
New junior rats, in the same way as in war field promotions are rapid, are crawling up the stairways of the sinking ships of local PCTs. While grandiose titles are being bestowed upon them and may sound good they are merely the equivalent of being promoted to being the executive officer on the RMS Titanic.
The captain of the Titanic at least had the grace to go down with the ship he had mismanaged. The rats however are climbing the greasy pole in the hope that if they sh*te hard enough on their colleagues they may just reach the heady heights of the as yet undefined new super carrier of NHS management called the NHS Commissioning Board.
The rats that are jumping the sinking PCT/SHA ship may yet live another day and unfortunately populate the new SS NHS Commissioning Board when it is finally launched. This means that however good GP consortia may become those who have mismanaged the local Soviets for years may scupper any improvements that might come out of GP consortia when they are finally allowed to do something.
We thought, after talking to some colleagues from other Northern shires, that this process was just peculiar to the local and neighbouring Soviets but it would appear that the rats are now more like lemmings if this article is to be believed.
Praise be to the Party who will ensure that the new NHS Commissioning Board will be full of great captains like Admiral Nelson. Or will it be more like the Caine mutiny?
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1 comment:
Plus ca change...
Haven't we seen all this before in the early 90s with GP Fundholding? We had all the same spin as now - about how doctors would be in charge of the money and all the bureaucracy would disappear. It soon became evident that the complexities of shifting around millions of pounds, and setting up contracts to ensure stability of hospital services was too much for clinicians so a whole tier of managers sprang up in jobs that used to be in the DHA. Then they decided to merge funderholders into bigger Trusts, and a controlling overview in the shape of SHAs was needed, and before you know what, we had even more bureaucrats pushing paper about because the system was so damn complicted, and the GPs (or hospital clinicians) had very little say in anything.
And here we are again. Before long, GP 'Consortia' will be employing all the same bureacrats from the last tranche of change. They'll merge to form Supra-Consortia which will end up composed entirely of managers and admin staff with a couple of token doctors, and we'll be back to something like the old DHA again. In the meantime, billions of pounds will be lost in the reorganisation process as services are closed to fund all the shiny new PFI- funded buildings.
Lansley is a naive idiot.
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