As we wrestle with uncertain futures, financial stringencies, and retaining a focus on ensuring services continue to get delivered, there is a creeping realisation that something is missing.

There is a bill before Parliament which details, in jargon that defeats me, the changes to the structures for commissioning. It lays out the way the system will be regulated and steered towards the new dawn. At its heart, at the core of this radical change, is the premise GPs will be willing and eager to pick up the challenge being laid at their feet. Why will they?

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There are a number of variants on the cartoon about an alien asking someone or something to “take me to your leader.” Of course we all laugh because we can see the alien doesn’t realise they are approaching the wrong person or thing. Now, there is a new version being played out between PCTs and consortia and it is no laughing matter. Who is the leader in a newly formed consortium? What mandate and authority do they have? more…

This is about the 13th reorganisation I’ve seen in my 3 decades as a GP. Up until now I’ve put it all down to the fact that politicians can’t resist “fiddling,” and if we called all managers administrators instead, they’d administer rather than think they too have to introduce change for change’s sake or to prop up their egos. However, this “reorganisation” is far more sinister as the label “NHS” will not be in any way applicable afterwards. more…