Letters Calls & Emails: DoH has to stop reinventing the wheel

Dear Editor 

So more change is on the way: PCT numbers are to be halved in a bid to save £250,000,000 and, lo and behold, many PCTs will revert to the old health authority boundaries.

We are told that the intention is to create economies of scale by sharing workload and allying PCTs more closely with local authorities.

These are the arguments we ourselves made several years ago when primary care groups (PCGs) were introduced.

To a man, the GPs of Rotherham wanted to stay as one conglomerate.

So, dignitaries from the business world, the political world and the world of the health service and local authorities were brought out to argue that having three PCGS would give greater flexibility for patient care and we would be able to fit our care more closely to local need.

It was pointed out to these dignitaries that patients in different practices in different PCGs might live next door to each other and what was right for one was probably right for the other, and that their needs didn't differ a lot.

Anyway we were given three PCGs. All the administrators had laptops, assistants, and secretaries, and rooms were found for them.

Then, a few years later, they were duly converted into one PCT. Why?

Because of the economies of scale and sharing workload.

Now, lo and behold, PCTs across the country need to look at economies of scale and sharing workload, and it is better to make them bigger and that will make them more efficient.

On the other hand, practice-based commissioning has been wafted in. Instead of having one body of professional negotiators commissioning and negotiating for prices and administrating a system of commissioning from the provider, we are to have lots of little systems.

We have to amalgamate into little groups and do the bidding ourselves.

Most of us don't wish to be businessmen; we wish to be GPs. But no, this is the way to go and will give greater flexibility to patients - deja vu.

How long will it be before the government and local health authorities again realise that, because of economies of scale and sharing workload, it would be better to commission on a larger scale?

Little practice-based commissioning units will be disbanded, computers thrown away, administrative systems broken up and a bigger system put in place.

When will this continuous change cease? Lessons must be learnt from history if we are to maintain an efficient, happy and effective NHS and workforce.

But I fear there will be plenty more opportunity for wasting taxpayers' money and for the demoralisation of health service employees, while new management systems raise yet another empire to be admired the world over.

Dr Martin C Clark, Rotherham.

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