Friday, January 19, 2007

Sauce-Box Commissar

Health experts shred another £40bn

Whatever else she lacks, the Commissar's got more sauce than Lea & Perrins:

"If we anticipated this business of GPs taking a higher share of income in profits, we would have wanted to do something to try to ensure that the ratio of profits to the total income stayed the same and therefore more money was invested in even better services for patients. Neither the Government or BMA anticipated how much GPs would do in response to performance-related pay."

Translation- if we'd actually understood how those new GP contracts were going to work, we'd have capped their pay.

Right. But what the rest of us want to know is wtf you ever imagined you were capable of managing such a huge upheaval in the first place? As your "esteemed" colleague My Lord Warner whinged just before Xmas, those grasping GPs "kept their eye on the ball" while the Department of Health... er... ummm...

And wtf don't you draw the clear conclusion- from IT systems to pay, you lot are totally incapable of ever getting taxpayers a good deal. We can all wring our hands, and wallow in the pain of regret, but what we actually need is action to stop this stuff happening all the time. As we've said many times, we'd all be a lot better off if you just got out of the way.

And railing against doctors- doing your very best to make them the villains of the piece, launching a guided Gerry Robinson, and generally slagging them off (see the Doc on this)- simply doesn't do it. In fact, it's highly likely to backfire, not just in terms of their general morale, but also in terms of driving them piecemeal into the private sector (cf the large swathes of Britain that are now NHS dentistry-free zones).

Yet somehow the Commissar still reckons things are cool:

"GPs in England are doing more for their patients in terms of prevention and giving support for long-term conditions than almost any country in the developed world."


On Monday I went for my annual medication review (don't ask) with my GP. She is the same GP who twenty years ago saved one of the young Tylers from an early exit- I would literally trust her with my life.

In the past, the review has always been pretty straightforward, taking about 6 or 7 minutes. This time it took closer to 15.

Why? Was it perhaps because she was was giving me a far more thorough inspection than ever before?



It took 15 minutes because she had a whole new load of boxes she had to tick. Well, not just tick. She had to fill in various new sections on her computer screen. Eg:

"Has your cancer made you depressed?"

"No. The increase in taxes to pay for NHS cost inflation- that's made me depressed. But not the cancer, which got sorted. On BUPA. Why are you asking?"

"Well, because I have to fill in this information for our PCT or we don't get paid. The only problem is I can't find the right bit on your form..."

Phones practice manager. "Right... right.... OK, so I tab across to the second screen... and then what?"

Etc etc.

It would be grossly unfair to say she was following a call-centre style computer script, but I certainly caught a whiff of my experience with NHS Re-Direct.

As she said when I commented on how ludicrous the new system was, "yes, the Department of Health simply had no idea what a great deal they had with GPs".

They certainly didn't.

We can all argue about what GPs are "worth", and as we've said before, only the market can really decide that. But what we know for absolute double-definite, is that we taxpaying consumers are getting a much worse deal now than we were before the Commissars' latest brainstorm.

As even Hewitt admits, they've unambiguously moved us in the wrong direction.

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