Okay I've been holding off on some of this stuff but there is a load going on in the world that I just need to let off my steam about. So a bunch of posts to follow...
So hang on - the government have hardly warmed up their newly acquire leather seats and are no doubt still cleaning out the 4000 paper clips at the back of the drawer left by the last encombant and they come up with this load of nonsense! Firstly - where the hell was this in the manifesto? Really bugs me we elect people on a set of "promises" and then they either don't do that or come up with some totally new. If this was in the plan why wasn't it debated in the election campaign? If they've only dreamt it up since being in power that is even more worrying - you can't take something like the NHS and dream up a reform of this magnitude over night.
My issues with it? In principle the putting the money closer to the patient sounds sensible but... how will you make big funding decisions about where in an area you will have centers of excellence - whether the MRI scanner is a better investment than some other bunch of equipment. The government tell us GPs will be making these decisions - sorry? I thought we wanted them face to face with patients - I'm sure that is what most of them think their job is not endless budget planning meetings and co-ordination across practices and hospitals. I just see the risk of this as reduced investment in the latest technology, confusion, dilution and duplication of services in local areas, reduction of some lesser used services and an explosion in third party management companies coming in to "take the management burden" away from the GPs. Great for some companies but I really feel that not managing the money / investment at a regional level is a potential recipe for disaster.