I was interested to read that health minster Mike O’Brien had defended the decision to hold talks on polysystems in secret – on the grounds that the clinicians involved might be reluctant to fully engage with the discussions if they knew they would be reported.
It would be interesting to know which clinicians are involved – and what their strategic qualifications are. After all, this latest round of health service reform in London was masterminded by a tertiary surgeon who qualified and trained outside the NHS.
In the previous major shake-up of general practice in 1990, Government advice came from a failed private GP and one addicted to heroin.
Exactly how do governments select their advisers? Is domain knowledge a disqualification?
Eighteen years after the creation of the NHS, 1966 saw the discovery that the model (pure capitation – no costs) was not fit for purpose. The internal model of 1990 was ideological and, in ending the ‘golden age’ of general practice, disrupted a fully functional service model, resulting in near meltdown in 2002.
More people live outside London than in it but it looks as though the problems of the secondary sector and London are yet again to be exported to other areas and models which are unlikely to work even in London will go on being imposed on the rest of the country.
Who are these enthusiastic clinicians? And why are they so reluctant to discuss anything with the rest of us?
From Dr Mary Hawking
Dr Mary Hawking Dr Mary Hawking