Patsy talks bollocks

Who the fuck does this crazy woman think she is?

Has she ever run anything herself? If she has ever run anything has it ever run anywhere than into the ground? Do her ideas have any more flight than a block of concrete? Is she to business management what Saddam Hussein is to the Nobel peace prize? Is she to honest dealing what Enron was to accounting?

She surpassed herself on Friday, aided and abetted by Toynbee. Here we have two women neither of whom has any idea how to run anything. Now they think they can tell GPs how to run their businesses.

Patsy’s wrong to attempt this for several reasons:

Firstly, there’s no evidence she can run anything well.

Secondly, there’s fuck all evidence that anyone in her party can run anything well. John Reid “Oh fuck, not health” and now “oh it’s a fuck up at the home office”. They run fitness for purpose exercises but neglect to run it on themselves. Shame.

Thirdly, there’s no evidence that the expensive management consultant fuckers she employs can run anything at all. The fact that Patsy emerges from such a background shows just what poor value management consultants really are. They know everything, until it comes to implementation. Then they try the King Charles 2nd exculpation:

Rochester "We have a pretty, witty King, Whose word no man relies on. Who never said a foolish thing, Nor ever did a wise one"

King Charles II: Be just, Rochester. The wise words are my own, the deeds are my ministers'

Sadly Hewitt has never even got as far as saying any wise thing.

Fourthly, she has no knowledge of how to run general practice

Fifthly, GPs are mostly actually very good at running general practices. We’ve been doing it for a long time and we have worked out some of the pitfalls.

Sixthly GPs are independent contractors. This means we are tasked to do a job, not told how we should go about a job. We are not employees, and if we were we would be appalling employees as we like to think for ourselves, not simply obey orders. So if we want to employ extra staff we can. If we want to keep our costs down we can. If we make good profits we keep them. If we employ too many staff we have to pay them.

The new GP contract was meant to be an adult deal. As GPs we have over delivered on the new contract (ministers believed all the stories about GPs being on the golf course, and not being very good at medicine spread by researchers and specialists who should know better). Ministers should be celebrating our achievements and saying thank you to us. Instead they are berating us for the consequences of us running our practices well to achieve those outcomes they wanted us to achieve. This is incompetence and base ingratitude.

If you asked for your front room to be decorated would you say to the decorator, “Well we agreed that price but we’re disappointed you didn’t do the bedroom as well”, or “Well you can do the job but you cannot hire any one else in to help you”. You just wouldn’t do this. You’d specify the job and the price and trust the decorator to get on and deliver the job, by whatever fair means he wanted to use.

The practice receives the income and uses it sensibly to achieve a good service for patients and a good profit for the partners. The government has a duty to see the money is well spent, and services delivered, but has no right to meddle in the internal management of practices.

Seventhly, [Is that a real word, Frank? - Ed.] this government is actually in deep doodoo over health. They have poured billions in with bugger all idea about what they were buying. They have got next to nothing for their efforts although the taxpayer is picking up a huge bill. They thought doctors were lazy, idle shysters, when in fact it was their researchers who relied on false, lazy, flawed assumptions.

Patsy is trying to deflect blame for the state of NHS onto GPs. Apparently she’s going to try and blame us for the failure of out of hours (OOH) services as well on Monday. Yet it was the DH that thought it could run OOH better than GPs despite the successes of the GP OOH co-operatives.

Patsy suffers from the delusion of all new Labour and management consultants that they know better than the people who do the work how it should be done. It’s bollocks. We need to stop accepting external wisdom as being better than internal wisdom. It usually isn’t for reasons that David Craig and Jim Collins explain.

The NHS is suffering from Medicine for Idiots at the DH.

The NHS is suffering a financial haemorrhage as money disappears into the pockets of:

• Management consultants (More than is spent on medical consultants: so we pay those who tell us how to do the work, more than we pay those who actually do the work. This is lunacy.)
• Perfected financial idiocy
• Choose and Book (aka Booze and chuck, Chaos and Bullshit)
• The NHS computer system
• Measuring everything that everyone who sees patients does
• Payment by results
• Outsourcing of support staff
  
• ISTC
• NHS Direct and NHS 24
• [Don't forget GPWSIs - Ed.]

At least the GP service in UK works. If the rest of NHS was as well run as general practices it would be far better.

To Patsy Hewitt: Fuck. Off. Let us run our practices. We do it far better than you can.

And please do not be as daft as to try to dictate our income vs expenses ratios.. They are OUR business, not YOURS. You don’t try this game with any other NHS contractors do you? You’re quite happy for private companies to make as much profit as they want aren’t you? Whilst hospitals go bankrupt and cut services.

But suddenly it’s new when GPs earn well. Anyone can make money out of the NHS, but not GPs. You bloody hypocrite.

We’ll get our income/expense ratios right according to the contract in place at the time. And we’ll look after the patients well.