Within a state run system choice and multiple points of entry both detract from the planning and are a sop to middle and upper classes who barely use the service.The NHS is and should be principally for the poor ,the disadvantaged and under privileged . We have allowed private contractors to come in and expensively cock up out of hours and we have un-educated the population in how to use an emergency service .I'm not keen to take back out of hours at any price but it naturally sits within a primary care remit much as out of hours in secondary care should not be contracted by a non NHS provider
The only way to deal with the inexorable rise in demand is to be much more honest about what we can and should deliver and much more strategic in our thinking about how we contract this
i despair of the labour party who should be supporting us . It is akin the end of animal farm - and im not sure i can tell the difference between man and pig anymore either .
My father is in his mid 80s and he told me hes glad he so old so he will die before the tories destroy the NHS completely . The big society seems to be a simple return to roots for our victorian elite where charity is all the poor expect or get - this isnt the NHS i toiled doing 127 hr weeks for in my youth .
MPIGs role varies our practice is in a deprived area so this in part mitigates the disasterous Cahill formula that
favours the leafy suburbs . We are not high spending -we are low referers and efficient prescribers - we come top in 6 metrics across the PCT .
Funnily enough i've just re-read 1984 ....