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Independents' Day

The Jones Duffers Awards

After two years my column is coming to

an end. So I shall finish with my three 'Duffers Awards for Daft Policy'.

Here we go – in reverse order, of course.

(Drum roll, please.)

In third place... the reorganisation/ disorganisation of PCTs.

In a short space of time we have gone full circle from health authorities through PCGs to PCTs and now back to structures that look suspiciously like the ones we started with.

The clincher for this bronze medal must surely be Sir Liam Donaldson's claim that he knew nothing of the plans and was given two hours to include something on public health!

In second place... the Payment by Results catastrophe.

The tariff was infamously withdrawn

in March, weeks before the new financial year. The result confined months of planning by every financial director in the NHS to the bin.

Not a laughing matter.

And, in first place... the absolute calamity that operates under the name of Choose and Book.

Words almost fail me, but suffice to say it is costing billions, causing a gulf between us and our consultants and bemusing patients in equal measure.

It works infrequently, consumes most

of a consultation involving referral, and usually obstructs rather than aids accessing consultant subspecialties.

In addition, a discussion on choice is utterly meaningless in the absence of information.

Policy developments

During the period I have been writing this column, I have tried to follow policy development as it occurs. And boy, have we seen some policy.

A couple of weeks ago, on one Monday alone, we saw no fewer than four major reports totalling more than 150 pages of closely typed text.

They included next year's operating framework (the 'we're going to create a £250m surplus for 2007/08' plan) and the optimistically entitled Simplification Plan (presumably to reduce bureaucracy from the operating framework).

I certainly can't criticise reform for lack of paper!

My favourite moment came in October 2005, after our esteemed health secretary had accused GPs of squandering around a million flu jabs after flu vaccine ran out. But the reason it had run out was not GP extravagance – the reason it had run out was that grossly inadequate supplies had been ordered in the first place.

I recognise it's very easy to critique the best-laid plans, and rather more difficult to steer things in a more joined-up fashion. But then, 'fools wonder while the wise man asks'.

A very happy Christmas and New Year

to you all.

Dr Andy Jones is a GP in Stamford, Lincolnshire, and PBC director at UnitedHealth Europe.

He has been appointed health policy adviser to Stephen Dorrell, co-chair of the Conservative public service commission

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