Our GP commissioner at the coalface ponders customer service
At a recent conference I attended commissioning GPs were exhorted to be more like big supermarket management offering better service, more choice and the customer is always right ideology.
The White Paper catchphrase of 'no decision about me, without me' seems to feed into this thinking.
Hmmm- that's all very well but rationing and demand management is not part of peacetime supermarket vocabulary. I have yet to have a shop assistant involve me in my decision making process and then tell me I can't have it. Similarly, it's unlikely that a jeans salesman would stop me making a ill-advised middle-aged purchase of knee crotch, gluteus displaying pants .
At the risk of inflaming homeopsychopathic practitioners, with a finite and in real terms shrinking budget, commissioning homeoplacebo services means we can't afford to buy in something with controlled trial proven real efficacy.This is irrespective of whether the Royal, or any other family, likes them or not. Having said that perhap a placebo service could be cost effective, trouble is you can't call it that.
Needs and wants. Costs and benefits. Real or imagined.
Rationing needs an effective rationale.
Coalface commissioner, Dr Clive Henderson
