‘Terrible consequences’ from NHS managers meddling with CCGs

"Oppress"??!!

Sorry Dr Dixon I don't know if you have heard but the aim is to reduce management costs. If it costs 4 times as much to have a GP at a meeting than a manager due to locum cover costs, then you can only afford a quarter as many meetings, or a quarter as many management organisations.
Add in 40% cut in management costs and that takes you down to a tenth.

No amount of your drip drip publicity strategy promoting clinical commissioning will change those numbers!!!

I can understand their concern for privatisation and competition as it might upset their private non competitive status that they enjoy at the moment

Dr Dixon is looking around desperately for a raison d'etre for his organisation. There has been of proper testing of pathfinder CCGs yet and therefore no evidence to say what might happen either way. I wish re would be a bit more rational...

In my experience CCGs are being given assistance to help GPs understand what it takes to run large organisations. PCT staff aren't perfect and obviously have not been through anything like this before.

PCT Finance Manager

Dear Anonymous Manager,

Why divert the attention on costs. The real issue has been effectiveness. From what I have seen in PCT and FT management is that we have more managers attending meetings - 50% are not needed and are total waste of time. There are more meetings created in the name of good governance - waste of money, resources and have no measured outcomes except for producing tick box paper work. At least GPs and Clinicians at meetings can make better and more effective decisions and support the managers into reducing ineffective systems. Time to change and have a look at more clinical-management integrated approach for improving the way we deliver our clinical and care services. There should also be no need for people to hide behind 'anonymous' - if they really believe in what they have to say.

Dr Peter Patel, CEO - South Birmingham Independent Commissioner and not a GP or a clinician - just a manager.

Oh FFS!

I feel like saying "I told you so" but I know that is never very popular , but I'll say it anyway because I just have to , in fact I'll say it in capitals just because I feel like it "I TOLD YOU SO" There I feel better now.

Why do I have to say that? because it shows that anyone (me and thousands of other GPs and doctors who were not enthusiastic about the "reforms") with any ability to analyse what is really going on would have been able to predict that this would happen. GPs have been used - used and abused - the more naive of them actually thinking that the government meant it when they said they wanted GPs to be "in the driving seat" and the the GP commissioning enthusiasts fondly believing that they could be the knights in shining armour, the bulwark against the onslaught of the private sector - that they could protect the NHS against privatisation. I've heard it from the CCG leaders in my borough "better that we lead the CCGs and help prevent privatisation than we let the likes of KPMG, United Health and McKinsey do it ". "How will you prevent privatisation?" I asked innocently. "Oh, we will co-operate and collaborate with our local hospital and ensure that the contracts go to them". I replied "but you won't be allowed to do that as it will be challengeable as anti-competitive". The response to that is that I was just too cynical , too negative and was underestimating how much the clever GP commissioning leads would nimbly and deftly work their way round the system to ensure that they did not have to support privatization. This sounds very like Dr Dixon's delusions. But now we know that not only will the actual commissioning be done by KPMG et al but also that the rules on competition will be enforced. The idea that the role of Monitor had changed significantly as a result of future forum lobbying was a deliberate deception - it has not changed at all. So Dr Dixon - GPs will not be able to stem the tide of privatization. Where do you stand now? What are you going to do about it? Stop pretending this whole thing is not a total disaster and start thinking of alternatives.


"Dr Dixon said he shared GPs' concerns about competition and privatisation in the NHS.‘But these concerns are poor reasons to turn your back on clinical commissioning,' he concluded. ‘They are every reason to embrace it. It enables us to make sure that our patients really do come first. Not the ideology of markets, nor of competition nor the private sector.' "

I can't read this without wanting to vomit. It has so much wrong with it I don't know where to begin. This is the argument that has been made from the beginning and that led to the BMA taking its useless "critical engagement " position - that somehow the health and social care bill is creating "clinical commissioning " that can exist in some kind of pure and imaginary form , on a different plane separate from politics, the market, the private sector, the real world - where we GPs can have an imaginary existence planning a perfect health service for our patients. But its patently untrue - actually existing commissioning in the actually existing world was always about using GPs as instruments in the marketisation of the NHS and anyone who thought otherwise was deluded or venal. Oh God, I'm tired - can I hand over to someone else - anyone else - to continue this line of argument.........?

Marie-Louise Irvine you have hit the nail right on the head. i think you are wonderful. Can I exercise my right to choice and register with you please?

Dr Irvine,

Excellent, intelligent, strategic, well thought out, well constructed comments as ususal.

Peter Patel - comments as usual - based on a tiny area of the country.


PCT Finance Manager