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The waiting game

The next few weeks are critical for the future of networks

Editor’s blog

It’s rare to see the profession so united, but these network service specifications in England seem to have managed it.

Pretty much everyone is against them. Clinical directors are resigning, LMCs are advising their members to not renew the DES, the vast majority of GPs are threatening to pull out and even the RCGP called for the whole process to be restarted.

I suspect that NHS England know they will have to change the proposals – they have already made noises around this, even before today’s deadline.

But the response has to be in tune with the profession. There was speculation that NHS England are looking to drop the ‘personalised care’ and ‘anticipatory care’ elements of the service specifications. But in comparison to the care home requirements, these are not particularly onerous.

Networks need to be allowed to sort out all the problems that already exist in general practice

What we need from NHS England now is an acknowledgement that, if networks are the future of general practice and are to be the bedrock of the NHS, then they need to be allowed to sort out all the problems that already exist in general practice – not those affecting the wider NHS.

This won’t be quick. But it can only be done if they are not having to worry about impossible impositions. ­­And if they don’t get this right, networks will be consigned to the scrapheap of failed initiatives for the profession.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at

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Readers' comments (7)

  • Spot on. Sitting here in Wales horrified by what I’m reading colleagues in England were being expected to do.

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  • When the government realised that they had botched up healthcare provision in the UK through their mismanagement and squandering of the healthcare budget (a lot of it went straight into their pockets) their immediate instincts were for more centralised control, more collectivism, more “community” (that’s where the word “communism” comes from incidentally).. What can be more collectivist than “networks” that can be more easily centrally micromanaged by government? This of course comes with a big trade off. A confiscation of personal liberty and the inevitable backlash we are now witnessing. Ditch government involvement from our profession folks. In its entirety. Failure to do so will mean prolongation of this agony with further backlashes and resentment in the future.

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  • I'm glad you're with me, Harry :) It seems Jaimie still has some faith that the state will come good... like a battered wife...

    But we all know nothing will change, because of 2 fundamental principles:

    1. It is always easier to spend someone else's money (i.e irresponsibly)

    2. Power corrupts, and absolute power corrupts absolutely. In other words, the state is human/subjective/corruptible.

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  • Christopher, you are of course right on both counts. For thousands of years the relationship between doctor and patient was a sacred one. A private encounter between 2 willing, consenting participants. Doctor and patient. Now we have the benevolent, omnipotent government in the way making ever more outlandish promises it can’t keep to the electorate on whom it depends for its very existence....I don’t know about everyone else but I smell a rat here....In this perverse “love triangle“ the only party who benefits is the government as they stuff their pockets full with taxpayers money. What do we get in return? A lousy health service, entitled, unhappy and embittered patients who were promised one thing and got another, and a fed-up medical workforce who feel let down by policy makers. A 10 year old could have predicted this outcome. It’s not rocket science.

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  • Lol yet we have a sizeable chunk of the population who are on the Left that advocate MORE state intervention and taxation... so they clearly don't get it, the reasons for which are multifactorial.

    I obviously have to point out that I'm no anarchist. But I'm just glad, as it appeared for some time that I was part of only a tiny minority of libertarians/free marketeers/"evil" capitalists who want LIMITED govt. However, it is still a shame that it has to come to this, as well as the restriction of free speech, to get more to wake to the truth.

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  • The electorate will always vote to get something for nothing. It’s human nature. They’ll vote for more not less free stuff any day of the week. Why wouldn’t they given the choice? Those who argue that Corbyn losing the election is a rejection of socialism are deluding themselves. The tories are rampant socialists too, they worked out long ago that a hefty dose of socialism wins you votes and power. Plus this particular election had a massive dose of brexit baked in so this skewed people’s traditional voting calculus. The real evil is to be found in government whose underlying motives are always self serving and its tactics of coercion are ultimately based on the implied use of force and, if necessary, violence.

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  • I agree up to the point that its human nature. Yes self-interest and greed is part of human nature but that can be transcended e.g. altruism and human solidarity. I'm a brexiteer, and I voted so even acknowledging the uncertainty that would have likely brought, or that my house value might drop due to less demand if the population does not keep increasing at the rate it is through mass immigration. I do so, at potential personal cost, as I believe that it would benefit Britain as a whole in the long run, and that there are some things more valuable than £, like individual liberties.

    Also, the fundamental economic likelihood is that the bigger the state, the smaller the economy. There may be cases where a big seemingly benevolent state like Singapore, with a good track record of making MANY decisions that end up benefiting its citizens, could be trusted to make more good decisions, but even there, the population have either knowingly or ignorantly sacrificed free speech and other liberties.

    The evidence of history lies on the side of the libertarians, and the culture war will be worn on the 'young'. It will be whether we encourage our young to embrace critical thinking, and valuing history and evidence, against the indoctrination of left-leaning state schooling (don't get me started on that). The good fight is there to be fought, and we can't give up, for the sake of the next generation.

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