In our rapid descent into the Darkside it has become increasingly clear that GPs are being set up for a fall. The buzz words we have heard most frequently are "we want more clinical involvement" which sounds nice but it becomes increasingly clear that this means you rubber stamp what they say.
For years NHS managers have got away with this for politicians think doctors are thick and that they know better. And the managers agree with them for they too are thick and always know better.
So consider how you get to be an NHS manager outside of Shiteton PCT where we are blessed by Harvard and Yale MBA's from the most junior level upwards. The rest of the country gets this:
The first dan is the comprehensive school failure who is not bright enough to get into the private sector but reads the back of the local free ads section and sees a salary (for doing nothing useful) when they realize that in order to get money you have to work something they never did at school. They do this for several years and as others go off with stress or pregnancy they are promoted because they are still there.
Eventually they become senior in a local Soviet and at the next reorganization "someone" suggests they move up and elsewhere. There is only one place that these otherwise unemployables can go. And that is always "upwards" for failure in NHS management is always rewarded with promotion.
Anyone reading their CVs sees things like "I put toilet rolls into the toilets and it were epic" and immediately sees someone they can work as they are clearly gifted for they never thought of that and so they achieve Strategic Health Authority dan (Shadan) status for having done nothing ever for patient care.
The same process continues year on year until they reach the Department of Health dan the elite Dohdan. This is rarely awarded on merit but usually as a result of acquiring several third world polytechnic "masters" degree(s) in non-subjects.
At this level they usually have more initials than your average teaching hospital professor of medicine after their name and the complete inability to do anything useful like count.
At this level the only level is up as the next dan is the Nicholson level dan the Cockupdan.
To reach this you have to have done everything your political masters have wanted regardless of costs and with no interest in healthcare whatsoever. You are now an NHS Zen Master in delivering bugger all quality healthcare and you do not even need any knowledge of maffs or statistiks to get there. You only need to be an enforcer like Hitler's SA and SS.
So our as yet brief sortie into the Dark Lord's realm has seen how this same process has evolved over the last few weeks in the following way:
There is a problem.
We (managers) want "clinical" involvement.
We (then) ignore the clinical involvement (we asked for).
We have got a promotion and as a result will bugger off and leave the issue we are supervising unresolved.
A few months down the line we will be supervising this particular issue. So who will be criticizing the new boys and girls?
Those who did the whoopsies.
Miss a Staffordshire and who can sort it out?
Those who did the whoopsies in the first place.
Praise be to the Party for realizing that no-one is too thick for NHS management and for promoting everyone well and truly above their own level of incompetence. If this is happening at a local level we are sure that it won't happen any higher will it?