Commissioning

The government’s proposals for commissioning health care have featured heavily in the media and in the blogosphere, and most opinions seem to be very negative. The overriding view seems to be that GP’s will have neither the time nor the inclination to do this directly and will therefore have to employ some private commissioning organisation to do it for them. Such a system will attract those who see the NHS as a business opportunity and these organisations will, like PFI, skim off the top of the NHS budget diverting yet more NHS funds into private hands.

As hospital consultants it seems that wherever this leads we will have to follow, although there is one interesting aspect which I will explore in a subsequent post.

So what can we do if we wish to oppose these proposals. Perhaps the BMA could organise something. In your dreams. The BMA are toothless, ineffectual, irrelevant and worthless. Not even their own members take much notice of their empty posturing. The idea that they might sway government is laughable. In the absence of any credible opposition it has to be accepted that these changes are probably going to happen, like it or not. The government have got the bit between their teeth on this one and it might be better to look at damage limitation rather than total opposition.

I am of the belief that any reasonable system can be made to work as long as those at the helm are people of integrity and intelligence. That we have systems now that increasingly are working badly is a reflection on those we have allowed to run things because the rest of us don’t want to, rather than weaknesses in the system which could have been overcome by better men.

But the best GPs and hospital doctors are primarily, if not exclusively interested in practising medicine, leaving managerial, & administrative roles to their less dedicated colleagues, many of whom have an agenda centred around personal advancement.

The last thing we want or need is to see, when the dust has settled, the same old parasites running the show that we have now, in co-operation with the private sector, simply rebadged and probably with an even bigger salary.

If our jobbing GPs and Consultants express their opposition by turning their back on the process and refusing to get involved the door will be open for the show to be run by those most interested and least suitable and the dire prophesies will become self fulfilling.

That is why those most opposed and disinclined to getting involved, should get involved. It is the only way we might salvage something worthwhile from a potential disaster. You never know, with the right people at the helm we may be able to keep the private sector at arms length and make it work.