Soldiers to work 8-8, seven days a week

“Soldiers to work 8-8, seven days a week in government directive” “Armed forces guarantee response to attack within 48 hours” “All wars must start within 18 weeks of a referral from parliament” Faintly ridiculous?  It’s ironic that the arm of the state occasionally tasked with shooting at things is less subject to targets than the […]

It’s time to ban competition in the NHS

The campaign has officially started and with the NHS a key battleground Labour fires the first shot, capping the profit that private providers can make at 5%. What were they thinking of?  It’s a small enough margin to keep out innovative private competition, who simply won’t be bothered.  That may be enough to ensure mediocrity […]

A manifesto for primary care - the three R’s

I don’t know about you, but in the unfolding election campaign I see an unhealthy lack of debate and challenge on how the NHS should work.  The parties argue about money, and that only at the margins, but the opportunity for improvement lies in function, not form, and no party has understood. Now see this week’s […]

GP telephone consulting is not safe after all

Well I remember meeting Dr Phil Dommett four years ago and his emphatic assertion to me “This is safer medicine”.  One of the pioneers of the GP telephone led model, you can read his note here how at his practice they are honing each others’ skills. It became clear to me as a non-clinician that […]

The best laid plans ‘o mice and men gang aft agley

I was at Roy Lilley’s Health Chat, King’s Fund last Monday evening, 100 very well informed primary care folk, very few of them sticking to Dry January, all having fun. Airy predictions are doing the rounds of “a minimum 50,000 patients in primary care units” of the future.  It’s all new models, MSCPs and PACs. […]

Spraying cash at the walls or feeding the seals?

If like us you have been burning the midnight oil to get your Prime Minister’s Challenge Fund bid perfected for the deadline yesterday, you’ll have enjoyed a night out and a lie in. But lamps will soon need to be refilled for the next deadline, 2nd February to express your interest in the £200m New […]

Missing from Stevens’ Five Year Forward View

Much has been made of Simon Stevens’ Five Year Forward View #5YFV and it seems to have achieved an obedient following across much of the party political and NHS political spectrum. I can’t comment from knowledge on much of it which is outside my area. So why run the risk of criticising Tarzan? “General practice, with […]

A manifesto for primary care

The season of manifestos and mellow thoughtfulness is upon us. We are not party political but we care about primary care and the policies which shape it.  Here is what the evidence is telling us: 1.  Stick to the principles of the NHS, universal, comprehensive and free at the point of use, because they work. […]

Form follows function, or fails the purpose

Dr Mike Bewick, Deputy Medical Director of NHS England, calls for primary care organisations covering 300,000 patients staffed by salaried GPs, as reported in Pulse.  He claims, “in 10 years’ time the term independent contractor will be anachronistic and probably it will be gone.”  Now Andy Burnham has joined in calling for predominantly salaried GPs working in […]

Around Europe, primary care wants to be more NHS

I’ve just spent two days at the European Forum for Primary Care conference in Barcelona, and presented a poster, a paper and a video.  Partly I go out of insatiable curiosity: what are people doing, what might we learn?  Partly out of a sense of community, joining with others addressing the issues of primary care.  250 […]