What were they thinking? Cameron hasn’t been too bad so far, some really good stuff, but he’s gone off the rails with this one, and everyone I talk to seems to agree. Did he not ask anyone?
The GPs just aren’t suitable for the commission role – they are too busy, don’t want to do it (most of them don’t really even want to manage their own practices let alone manage a load of NHS bureaucracy), don’t know how to do it (haven’t been trained, have no experience) and will just be wasting all their hard-earned and valuable clinical knowledge to do a management job instead. They’ll be much more expensive than the equivalent (current PCT or new alternative) manager, and not as motivated.
Of course there are some who want to do it, and some who will be great at it. Others will find ways to make money out of it. Most will move across all the existing people, paying expensive redundancy on the way and then re-employing them, and all will be the same except for an expensive period of crazy upheaval (yes, another step towards change fatigue and collapse of the whole thing) and then a finished situation with an extra link in the chain – an expensive and weak extra link.
But what annoys me most about this is that it’s another failure of management. “Can’t run a local council’s IT department?” Give it to a private company. “One or two PCTs not very efficient?” Give the whole lot, even the great ones, to someone else to have a go. Surely it would have been better to analyse which are the good and bad ones, and then just fix the bad ones, by putting in some better managers. It’s what normal organisations do.
How I hate to watch a slow motion car crash, that’s wasting money and possibly costing lives too…
Thanks for letting me rant.
PS – and of course, the Tories have no mandate from the electorate, having promised us that the NHS would be ring fenced. A bare faced lie!