For God's sake Lansley, what the hell are you doing

It really does go from bad to worse. I'd have been back on here earlier, but my life is now spent producing piles and piles of reports telling my fledgling Commissioning Group the same stuff I told them last quarter, and the four quarters before that. Now I'm quite busy enough looking after my flock, without stating the bleeding obvious about the care they need and receive.
A few observations, just for a change. I thought I'd share them with a wider audience, because they don't seem to a) understand what I'm saying or b) want to do anything with the information, they keep asking for.

1) Hospitals now exist to make profit. This is a bad thing because it incentivises them to do unnecessary things to my patients, and also to make up scandalous codes to earn more money
2) If all my budget is spent making Trusts profitable and building more glass buildings on Hospital sites, (so they can make more profit), less money stays in Primary Care and so my surgery falls down for lack of maintenance budgets
3) How do I influence Nursing and community provision when some f**kwit at the DOH made us hand all our Community staff over to the Hospital Trust
4) When GPs were involved in antenatal care, our patients saw us first, and we decided if they needed assessment. Now they ring a duty midwife who admits every single one to the Hospital for assessment ."Ching" goes the Trust cash register
5) Competition is a good thing, but not if the competition is entirely over the easy, most profitable sectors leaving the difficult non-profitable stuff done by small "failing" hospitals or shunted out to over-stretched Primary Care. That is what will happen, there is nothing in this half baked bill that recognises or allows for it, because these jokers don't know what they're doing.
6) Every GP I know above the age of 55 is going to leave the profession. My generation will certainly not stick around beyond 60. The new Doctors will be stuck with working to 65+ or their pension will be worth bugger all.
7) GP recruitment and training is falling, experienced GPs (The ones they want to run all this Commissioning) are leaving in droves, leaving what in their place. A disillusioned workforce that will be forced to become salaried. When some bozo at the DOH then works out that you need 3 salaried GPs to cover the basic work of two Principals, and then have to pay someone to manage them, they'll discover the service costs more, and it will be crap. (See Out of hours provision since 2004)
8) No-one actually has a clue who is supposed to take over ownership of the estates in Primary Care, so I work in a building that will have to be sold once the PCT is dissolved in 2013.
9) Computing..not historically a strength of NHS procurement. The whole of primary Care IM+T is currently owned and maintained by PCT's. Again, no-one quite knows who's going to pick that up. The local branch of PC World perhaps !!
So there you are, buildings and computers. The two absolutely essential components of providing GP services, and no-one has a bleeding clue (with 18 months to go) who will run and maintain it all.

Surely only a total moron could get us into this sort of a mess


Don't get old in the UK boys and girls