(These new forms of media can be very difficult. Blog readers will probably know that I tweet to let people know there is a new post on the blog. But I am not sure whether blog readers follow me on Twitter. I assume that some of you just read the post and are not in the Twittersphere.
Yesterday I posted about the very difficult relationship between the autonomy of GPs in CCGs to make commissioning decisions for their locality, and the National Commissioning Boards central control of those decisions. Following that there was a fascinating flurry of activity about the problem – or not – of GPs making referral decisions about their patients and how those decisions will relate to the financial decisions they will have to make as commissioners.)
This question is not only at the heart of the current Government reforms but is also at the heart of the debate about the vision of professional responsibility within the NHS. Read the rest of this entry »