Health Matters | Paul Corrigan's blog

A. When they might chose to do something with which the BMA disagrees.

Over the years the BMA, like any effective trade union, has always stood up for its member’s right to make their own choices. All trades unions do this and the BMA is assisted in this role by the professional autonomy training that all doctors receive.

Whilst this is true of all doctors, it is even truer for GPs because GPs have also traditionally run their own businesses. Therefore, as small business people, it has been up to them where they get their accountancy or legal advice from. Similarly it has been up to GPs to decide whom they might employ as receptionists or nurses. Read the rest of this entry »

Last Wednesday I ran a session with about 60 people in London, all of whom were involved in the governance of NHS commissioning over the next 16 months. As you can imagine, given the confusion around who is commissioning what, there was a broad range of different organisations represented. Most of them were non-executive directors of PCTs, PCT sub-clusters and PCT clusters. This led to much jesting about whether their title would have changed at the end of the meeting from the one they had at the beginning – a whole 2 hours later. (Yes I know – what a sad world I live in where this passes for jest!) Read the rest of this entry »

On Monday I spent the afternoon working with representatives of all of the local Public Health and Health and Well-being boards in North West London.

Two interesting issues arose from this experience.

The first was that local authorities across the sub-region are dedicating developmental time and effort to the process of taking on health improvement. They all recognise that to achieve this they will need to develop their Health and Well-being boards as the forum for discussion with clinical commissioning groups. Read the rest of this entry »

I spent last Thursday at the NHS Alliance Conference and heard from GP’s own mouths where they felt they were in terms of taking on NHS commissioning. This is not a random sample of GPs but represents a part of their leadership who want to take up commissioning.

The first thing it’s important to say is how keen nearly all of them are to take on the challenge of commissioning for their patients. Most of the GPs I met understood what this will entail, recognised that it’s going to be difficult and were generally realistic about the task. But they really want to do it. Read the rest of this entry »

On Tuesday I suggested that sooner or later GP organisations would recognise that they have a great deal of power over the way in which the Government could carry out its policy of GP led commissioning.

It is clear that the leadership of organisations such as the NHS Alliance and NAPC really want to make GP led commissioning work. But if they were to decide that the conditions that the National Commissioning Board are now constructing for that commissioning to take place would reduce the possibility of it working they could suggest that, unless those conditions change, they would walk away. Read the rest of this entry »

Back in April someone who was just about to start working for the Government on NHS reform asked me what the biggest risk was to their success. I said I thought it was clear. The biggest risk would be what would happen if the vast majority of those GPs that had once been enthusiastic about commissioning lost interest and walked away? Read the rest of this entry »

(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 »

As I mentioned yesterday I spoke last week at the National Association of Primary Care Conference. What was really interesting was listening to the Secretary of State speak just before my panel session began. Read the rest of this entry »

Last week I spoke at the National Association of Primary Care Conference and was interested to hear the Secretary of State. As I shall explain tomorrow it was good to hear him articulate a narrative explaining why his reforms were important to an audience of future leaders of Clinical Commissioning Groups. (Even if that narrative failed to encompass the real life experiences of creating CCGs that those in the room expressed to him). Read the rest of this entry »

(One of the great experiences of writing this blog is that it is read by doctors. Recently I discovered that one of the great things about doctors is that they know Latin. At the beginning of this week in developing this argument about centrifugal and centripetal forces I got my ‘fugal’ and my ‘petal’ mixed up. A number of doctors very kindly responded saying that ‘petal’ related in Latin to ‘the centre’ and therefore centripetal forces were dragging things to the centre and conversely centrifugal forces dragged thing to the periphery.

So thanks for letting me know! And my apologies to those who have been confused in trying to understand not only NHS reform, but also the creation of the universe – which as all of you will know came after the big bang and involves some large centrifugal forces that are pushing matter every million years or so further and further away (centrifugally) from where the bang took place).

[I am of the generation that thrilled to Peter Cook (and Dudley Moore). In “Beyond the Fringe” there was a great sketch where Pete was convinced that the only reason he did not become a High Court judge is because he never had ‘the Latin’. I feel it must be the same for me and becoming a doctor] Read the rest of this entry »