Bad, like Tesco?

I attended a presentation yesterday about "Practice-based Commissioning". If you don't understand the term, may I suggest you click the "Next Blog" link at the top of the page? It would take too long ...

Anyway, one of the speakers was a passionate GP who explained what he and his colleagues were doing to ensure that the big, bad, Tesco/Boots/Sainsburys axis of evil didn't invade primary care. Why is this so bad?

Well, conventional GP thinking runs alongs the lines: They will open early and late so they will deal with our least-troublesome patients: the young, working people who don't want to take time off work to sort out their minor ailments. Under the present system of funding, we receive annually an equal amount of money for each patient. It doesn't matter what age they are, or how often they use our services. Since children and the elderly use us most, the loss of our least demanding patients mean we will find it hard to fund the same levels of care for these more vulnerable groups. GPs throughout the country are busy defending the status quo. I help ours to do so.

But before signing up to the received wisdom of the evil of Tesco et al, I think we all need to ask ourselves a number of questions about these companies and the services they provide:

1. Would you like your local McDonalds to be as clean as your local hospital?
2. Would you like to wait as long at the checkout as you do at your local GP?
3. Where do you buy fuel for your car and why?
4. Who deals better with complaints; Sainsbury or the NHS?
5. How much does it cost to park at your local supermarket and at your local hospital?
   

If you think I am being unfair, you are probably reciting a long list of the fundamental differences between a retail operation and a hospital. I don't see that cleanliness, punctuality, effective demand management, customer service and smart procurement should form part of that list.

Just Who Is This "Public"?

I live in a small rural village. It's lovely. It has a post office but not for long. Following a "public consultation" our post office will close at the end of the month. A lot of our neighbours submitted their opinions to the Post Office. Every one of them said "please keep it open". The only person I know who wants it closed is the man who owns the shop and post office in the next village five miles away. His post office is closing too! I can't imagine any sane individual saying: "close my local convenient post office (even though I only use it on 'high days and holidays')". Can you?

At the moment, the NHS is spending millions of taxpayers' money on a public consultation of the "Darzi report" on the future of NHS services in London. The big change in primary care is the idea of "Polyclinics". The consultation is about to be completed but no findings have been published yet our PCT has now published its plans for the first two polyclinics. The tenders are going out soon. Six more are in the second stage of detailed planning.

I hope the consultation agrees with Lord Darzi but somehow I don't really think it matters. Do you?