Sunday, 20 March 2011

Retreating armies and sleepwalking GPs.

One of the advantages in being involved in the training of the next generation of doctors is the opportunity it gives us here at ND Central to meet other similar minded doctors from other areas on a fairly regular basis. These are not just fellow GPs we also get to meet our consultant colleagues.

What we find is that both GPs and consultants are both the same in terms of what the intended reform of the NHS involves and surprisingly are just as confused. It is clear that some areas like ours with our Harvard and Yale MBA rich PCT are streaking ahead of the field in terms of GP led commissioning while other areas are going nowhere fast.

Historically retreating and defeated armies have usually employed a slash and burn strategy to leave as little as is possible to the incoming occupying army. In areas where co-operation between PCT and GPs such as ours is good then the damage will be minimal.

However from talking to our colleagues in other areas of Northernshire it is apparent that certain Soviets are being very obstructive and refusing to relinquish any power to their local GP consortia and are indeed dictating the terms on which any form of GP led commissioning can take place.

From a military point of view this is an excellent tactic. For although the PCTs have taken casualties in terms of staff lost, by refusing to release power and information to local GP consortia, and, we have heard of some that are trying to force local GP consortia to merge against the wishes of the consortia involved before they will engage, they are clearing playing a long game.

By doing nothing, and if local GP consortia don’t get Pathfinder status, they can’t be forced to do anything with local GPs they are engaged in a bunker mentality that ultimately will see the same idiots at the local Soviets remaining in power and continuing to run the local Soviets until they finally are torn down as the GPs finally storm the Reichstag.

But when the GPs finally get into these little Soviet empires what will they have? No knowledge of what is going on for they have been shut out. The GPs will have the power but no infrastructure. So what will happen then?

The self-serving PCT will be the only viable player in town and so this tactic preserves the status quo. What is worse is that some GPs we have spoken to realize this is happening and see that they are sleepwalking into this unless you get Pathfinder status. How one gets Pathfinder status is a mystery but there are rumors that PCT approval via way of the SHAs may be part of the process.

So in areas where the PCT has been run as a Soviet top down dictatorial authority it appears that it will be business as usual. Fortunately in our part of Northernshire this is not the case but we know that some of our colleagues are sleepwalking into this scenario and what is worse the Ceausescu’s currently in charge preside over some of the areas of worst health inequalities as a result of their benevolent years in power.

We hope that Mr Lansley is aware of this gaming activity especially if you listen to his last few seconds of this propaganda clip regarding GP Pathfinder consortia at a Downing Street reception. It can’t possibly be that the Emperor Ming does not know what is going on in some of the least healthy but far flung parts of his empire?

Praise be to the Party for once again ensuring that all pigs are still equal as always. We wish our less fortunate colleagues well in these uncertain times and thank them for sharing their positive experiences of NHS Reform.

Education is after all is the sharing and transmitting of information and if you are reading this then thank a teacher. Both health and education are to become increasingly rationed and costly to those that need and use them despite of reform of both for the better.

That is not good for it deprives both talent and need of improvement.

1 comment:

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