As the latest news tells us of the full magnificent of Lord Darzi's latest reforms, I am not surprised that some 'GP-led centres' will have no doctor on site at all, amazingly really:
"Some GP-led health centres could be run without a GP on site at all times, GP newspaper can reveal. "
So much of this government's reforms involve paying monkeys peanuts to do a job that was previously done by a more skilled monkey for pretty much the same peanuts, no wonder the quality of the service is falling all the time.
Another interesting aspect of the NHS is the fact that monkeys are frequently being hired by monkeys, who are being hired by monkeys ad infinitum. With more and more layers of bureaucracy year by year, the layer of useless monkeys proliferates, while those who actually do work on the front line find their funds cut as the monkeys want it all for themselves. If this continues we shall be left with just bureaucrats. The biggest monkeys of them all are the PCTs:
"PCTs lack analytical and planning skills and the quality of their management is very variable, the inquiry found. The report states: "We consider this to be striking and depressing."
"However, we remain very concerned that PCTs are not yet up to the task of putting these reforms into practice....We heard a lot of evidence about weaknesses in PCT commissioning "
The HSJ has taken this from the Health Select Committee report which can be found here, in fact the original document is even more damning as regards the complete inability of PCTs to do the job asked of them:
"Indeed, PCTs have attracted a good deal of criticism over a long period, often focusing on their inability to evaluate data and identify cost-effective interventions based on evidence."
"Witnesses were critical of the Department's initial attempts at Practice Based Commissioning (PBC) and doubted whether the situation would improve."
"Previous criticisms of PCT commissioning have centred on their inability to evaluate data and identify cost effective interventions based on evidence. Neither the Department nor Mr Farrar elaborated on the criteria which should be used to evaluate PCT commissioning. Neither did they tell us how they would identify the actions that would be taken to address poor performance. "
"Witnesses were critical of the Department's initial attempts at Practice Based Commissioning (PBC) and doubted whether the situation would improve."
"Previous criticisms of PCT commissioning have centred on their inability to evaluate data and identify cost effective interventions based on evidence. Neither the Department nor Mr Farrar elaborated on the criteria which should be used to evaluate PCT commissioning. Neither did they tell us how they would identify the actions that would be taken to address poor performance. "
I suspect that even if PCTs were staffed with intelligent capable staff (which they most evidently are not) then they would struggle to turn Darzi's and the government's reforms into winners, as the reforms are fundamentally flawed down to their very ideological foundations. PCTs are currently in the process of wrecking all the good services left in the NHS, as they are deliberately starving hospitals and front line services of cash, while they throw money at daft scheme after daft scheme. The PCT layer of bureaucracy has always struck me as a waste of space at best, now they are not only wasting space, but they are doing immense harm to any good that remains. It is time that PCTs were blown away.
