Here’s a great counterblast from Kevin Ball in response to the know-nothings who keep banging on about how the NHS doesn’t need management. As he says, the government is about to ask a group of people, many of whom have little enthusiasm for management, to….erm….manage £80bn of health spending.
I particularly liked this bit:
Safe from the evolutionary effects of market freedom, some Doctors have retained the view of management as an unnecessary impediment to their work and it is easy to see why. GP Practices are private organisations contracting to an NHS which nannies, nags, and shouts at them ineffectually in almost equal measure. Management in the Practice is usually delegated to a senior administrator who is cheerfully overruled by the owners of the business in a Lancelot Spratt kind of way. Partners meet for a cup of coffee every now and then rather than anything that might resemble a Board meeting. After eight years of medical training who can blame any GP for not wanting to learn how to read a balance sheet, analyse their work flows for improvements or consider developing their leadership skills?
There are some very capable GPs who are really up for this and who will make a very good job of commissioning healthcare. But I suspect that an equal number of them are dreading it and wish the whole thing would just go away.
Update: Paul Corrigan continues his dissection of the NHS white paper. He has a bit to say on this subject too:
GPs have had 60 years of working as small businesses and for all of that time they have worked alongside, and not for, statutory organisations. Over that period generally GPs have not had a high opinion of the way in which statutory organisations have worked. They have looked at the public sector governance that hedges around the leadership of all of these statutory structures. GPs recognise how the room for manoeuvre that leaders need is restricted at every turn. They recognise that it’s not the individual people who run PCTs that cannot make better commissioning decisions. It is the duties and governance laid upon them by the state as statutory organisations.
The strange thing about this policy is that the Government agrees with GPs. They agree that state organisations are not the way to commission – and yet they now appear determined to force GPs into them.
PCTs are being recreated before our eyes.
Well even Dougal could see that one coming.