The first thing that happened was that a whole army of managers was employed to supervise. It was now necessary to cost every procedure and bill whoever was responsible for payment.
This still didn't seem to work terribly well and so PCTs, as they had now become, were encouraged to set up services which undercut the tariff price.
In some areas it worked well but it meant that hospitals went into debt because they weren't being used as much as they had budgeted for. What now?
The PCTs hadn't spent their budget so it was decided that they could bail out the hospitals. Is the internal market such a good idea? Perhaps we could go back to just sending a patient to hospital to get better and the central NHS budget could pay.
This would make many managers redundant and the money saved could be used for patient care. Or am I just a dinosaur?
Dr Diana Lowry, Essex.