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PT and the Greater Good

Power to the People

Published August 3, 2010 9:45 AM by Dean Metz

I wrote a few weeks back about how the NHS was changing. We've got a slightly better picture of what is planned. Currently, primary care trusts are in charge of commissioning services for each of the regions they cover. The central government has determined that this set-up is far too management-heavy and inefficient. Their new plan is to eliminate the PCTs entirely and hand over control to the general practitioners. They feel that GPs have a better handle on the needs of local populations. There will be consortiums of up to 500 GPs who purchase and commission services for their patients.

Initially this sounded like a good idea, but then I reflected on how UK general practitioners differ from US primary care providers. The biggest difference is that US doctors have much greater business savvy. UK doctors are skilled at being doctors, not businessmen. They will have control over billions of dollars. They are also plenty busy treating patients without managing the finances behind what the region needs for health.

So what will they most likely do? Commission financial management from the very people just thrown out, the primary care trust staff. All in all, it appears the dramatic change will be nothing more than an exercise in pushing paper.


It is often intersting to me to see practical outcome of the mandate to cut "management costs".  Seems that is when people get most creative.  I'll be interested to read your updates to see how the reality pans out.

Janey Goude August 5, 2010 5:04 PM

Here is an editorial in today's NY Times talking about exactly what I describe above:

Dean Metz August 5, 2010 5:01 PM

Great question Janey! Actually the funds will come from the same central government source. The actual loss of funds will come from the additional bureaucratic work necessary to affect this "change".

The details still aren't fully clear. We get weekly updates from our Chief Executive which are about the same as reading tea leaves.

The one thing that is very clear is that management costs across the board must be cut by 30%.

Dean Metz August 5, 2010 2:03 PM

I understand how it is reasonable to expect the same responsibilities will get done by the same people, but just in a round about way.  But what about the impact on finances?

In the old system that is being disbanned, where does the money to pay the PCTs come from?  If they are paid out of the funds they are dispersing for patient care, then I can see where it might be a wash.  The doctors can assign monies to pay those same people to administrate funds.  They'll just be getting paid by the doctors instead of the government, but the money will be coming from the same place.

But, if the government was paying the PCTs from another money pool, under the new system will doctors need to pay a business person from the patient care funds, making less available for actual patient care?

Janey Goude August 4, 2010 11:37 PM

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About this Blog

    Dean Metz
    Occupation: Staff Development Specialist
    Setting: New York, NY – Newcastle Upon Tyne, Great Britain
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