A new and very different type of NHS in England (BMJ 2011)

David Lock: A new and very different type of NHS in England

2 Apr, 13 by BMJ Group

April 1 2013 saw the launch of a very different type of NHS in England.  The current government has grappled with the same problems as all previous governments, but imposed radical surgery on an ageing patient.

The previous government struggled with the problem of getting improved productivity and common high standards out of a largely monopoly service.  The NHS has always delivered its services through a mixture of employed staff and contracted private sector operators.  GP practices have always been private sector businesses that are paid by the NHS for the services they deliver, but without GPs ever being NHS employees.  How they swung the right to get NHS pensions is another story but just shows the negotiating brilliance of the BMA.  But competition plays only a small part in GP services.  There is no active recruitment by one practice of the patients signed up to the practice down the road (although maybe we will see this now).

This entry was posted in Commissioning, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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