About Tales from the Black Tower
Dr Custodes is a shadowy GP figure with a keen interest in what's going on at the Black Tower - previously the home of the decrepit PCT but now inhabited by something much more scary...
Tagsacute trusts Andrew Lansley Andy Burnham Black Tower CCG CCGs clinical commissioning groups Coalition commissioning consortia Finance foundationa trusts General Practice GP GP commissioning GP consortia health bill industrial action Lansley locums mental health NHS nhs reforms Olympics PBC PCT PCTs pension pensions primary care QIPP RCGP RCGP Conference reforms Responsible Officer revalidation secondary care Silver fox Steve Field strike Tales from the Black Tower The NHS Commissioning Board White Paper x factor zombies
The honeymoon is here. The engagement took a long time, and the ceremony was very public but we’re finally in bed together, really doing it, committed together forever.
Thing is, I remember her being a lot more attractive when we first stated going out. She was going to take my name, engage me in her plans, had lots of money, promised freedom, no strings attached.
In the cool light of morning she’s become a hard mistress, demanding, jealous of my other interests. In fact she’s making promises I’m going to find hard to keep. She’s telling people that we’re doing things differently, that although we’ve been going steady now there’s going to be a few changes now it’s official.
She’s not even taken my name either, it turns out lots of the money she promised is already tied up and committed. Turns out she has a parent who’s a bit of a control freak, wants to know our plans, is gong to say whether or not we can buy the new couch, afford the new build or really make changes.
Perhaps the worst bit is that everyone I know is saying it won’t last, they’re giving us three years max, saying we’ll run out of cash, that our budgeting is naive, that we’re not starting afresh and it’s just an impulse fling.
I know most couples have doubts, I know that the average UK marriage lasts 11 years, but right now I think the spectators are not even giving us that long.
I don’t see it getting any better.
Vital signs are poor, the antibodies are up, temperatures rising, the metabolism is definately catabolic.
Anti-inflammatories from politicians are not working. The NHS is definitely sick.
Fortunately it has completed a preferred place of care document, which clearly indicates that primary care should be the final resting place. Trouble is, all the folks who should be looking after the NHS in primary care are busy carving out a personally secure niche.
I was recently sent an agenda for a protected time event by a CCG that wants to create a ‘vision for 2020′ apart from the medical pun there is an amazing lack of insight into the NHS and our current situation.
The future of the NHS will be decided in the next two years, by the actions of a range of players from CCGs to DH, from commissioning support unit to DGH.
One afternoon for a bunch of keen, motivated CCG types, working alone, will not produce a vision, just a mirage.
Our local CCG is very quiet, key players sit in dark rooms, once occupied by the PCT, repeating the same mistakes the PCT made. Too few people see the chairman beyond his practice or a small bunch of committee mates.
I know he’s been busy, I know he has a lot of demands on his time, but aside from an occasional email and quarterly protected time event there’s nothing. I’m even starting to miss the old PCT medicines management missives.
The NHS needs a doctor, but they seem to be busy doing other stuff.