Those whom the Gods wish to destroy, they first send to the King’s Fund. The current Chief Pongo at the Fund, an academic cove who was publishing papers when Dr No was still in cap and shorts, has spent a life-time studying health policy and management at a variety of red-brick institutions. The trouble with studying health policy and management is that it is so dull that it addles the brain. Over a period of years, a selective memory loss sets in, leaving victims unable to recall what happened last time the NHS was re-jigged. The condition, known as hamnesia after the eponymous Professor, is progressive, and has no known cure.
It appears that there has been something of a national outbreak of hamnesia following the coalition government’s announcement of it’s ‘radical’ ‘revolutionary’ ‘biggest-shake-up-of-the-NHS-since-its-inception’ plans to hand control of healthcare purchasing budgets to GPs. The Prof has naturally been hamming it up gloriously (and needless to say unintelligibly). So too have many in the media. But the fact of the matter is it has been tried before:
In the early nineties, the then Tory government foisted responsibility for purchasing healthcare onto GPs in the name of fundholding. It failed, mainly because some GPs were too greedy, while others were not greedy enough.
In the early noughties, the then Labour government foisted responsibility for purchasing healthcare onto GPs in the name of primary care groups. These failed, mainly because the groups were too small; merger mania followed, PCTs emerged and grew, and then failed, mainly because they were too large, remote, inefficient and unresponsive.
In 2010, the coalition government has started to foist responsibility for purchasing healthcare onto GPs in the name of GP Commissioning…
Just as before, GPs will have a go, and, just as before, GPs will fail. The danger this time round is not so much that GPs will jump in, and GPs will fail, but in what happens after GP commissioning fails. Who, Dr No wonders, will step in to fill the gap? And – even more importantly – what will they bring with them?