November 18 2010 (Thursday) - CPA, NICE and Politics...


When I started this diary I resolved that it would *not* be a vehicle for my ranting, but I feel I need to get something off my chest…

In my thirty years in the NHS I’ve seen some changes. The way the NHS is run changes all the time. The latest plan is to re-organise so that the entire NHS is commanded by the GPs. But this isn’t a new idea - am I the only one who can remember that this has already been tried. Does the phrase “GP Fundholders” ring any bells?
Did it work when it was introduced in 1991?
I don’t know. It’s been shown that there was absolutely no evidence as to whether it might have worked or not. Instead the decisions to implement the scheme and the decision (under a different government seven years later) to abolish it were taken purely on political and ideological grounds.

It’s rather strange that if I want to make the slightest change to how I perform my professional duties I have to fulfil a myriad of regulations to prove beyond any doubt that the proposed change is for the better. If researchers have ideas for new treatments, these must be radically tested to destruction before they can even reach the clinical trials stage. But the entire structure of the NHS can be reformed on the whim of current political opinion with no evidence whatsoever as to whether or not the idea is good, bad or just plain stupid…

How many other decisions in government are made this way? How are the police, the armed forces, schools, the nation’s transport infrastructure organised? Are they subject to sensible management? Are they run on sound financial principals? Or are they run at the whim of political ideology too…?

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