The new boss of NHS England

Custodes has never heard The Who live, mind you I don’t think many of The Who can hear The Who live these days. However, thanks to the producer of the CSI franchise having an obsession with their music, loads of people are vaguely familiar with their oeuvre.

I was reminded of their music this week when I decided to open the bonnet and peep under the  hood of Herr Cut of the SS who will shortly be taking the frayed pieces of string that pass for reins in the NHS from Old Nick.

Now please note that I’m not referring to Simon Stephens who, according to Wikipedia, is a successful northern playwright (although I’ve never heard of him). I’m talking about somebody different.

Searching Wikipedia reveals an interesting past, advisor to Number 10, Head of a big American HMO, not bad for a Comp educated brummie and former labour councillor.

Now, before you start to cheer at the prospect of change, think about this:

This bloke advised the previous administration on how to set up foundation trusts, authored the NHS Plan 2000 (yes just like Death race 2000) and has spent 10 years at the helm of an organisation which prides itself on value based contracting. Do you think things will be changing?

The line that started to rattle in my brain was ‘meet the new boss, same as the old boss’.

Of course The Who fans will name that tune as Won’t Get Fooled Again.

Let’s hope as a profession we’re prepared to live up to the lyrics or the NHS will be gone by the end of My Generation.

The magic of

I love a good magic show. Derren Brown – he’s good. I wouldn’t want to be his GP – would he know which antibiotic I’d chosen before I did?

That Dynamo guy, he’s another good one, I’ve seen him walking on water, but I’m clueless as to how he did it.

My problem is that there is nothing as bad as a bad magician.

The whole art of magic is to be able to do something which looks clearly unbelievable but to demonstrate that it can be done.

Now, modern magic has always involved some technology, sawing a woman in half, hiding a rabbit in the box, there’s always a gadget.
Arthur C Clarkes third law is that ‘any sufficiently advanced technology is indistinguishable from magic’ and so we move on to and Mr Magic.

Mr Magic has told his audience that he will seamlessly connect the several strings of NHS data and Voila! A fully connected rope appears.
This rope is also magic, it will fix the NHS, bind tighter links between hospitals and GPs, turn lead into gold and mean that patients will live longer and be healthier.

Usually with a good magician you end up looking where they want you to look, you miss the léger de main which accomplished the trick. Mr Magic is used to this, he used to be a journalist, you know – the people who are appalled it takes two visits to a GP to get diagnosed with cancer, the people who tell us that mad dogs, immigrants and aliens ate my dog.

Unfortunately the British public has spotted the sleight of hand, the rabbit in the hat, the purse being cut. Mr Magic is a bad magician.
And bad magicians don’t last very long, especially when your soon to be ex-Boss extracts the data on youtube… at least according to the Mirror!

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How GPs can enjoy a pay rise when there is no new money

Custodes has always been a seeker after wisdom. It turns up in all sorts of odd places.

This last week I flicked through a book by the creator of Dilbert cartoons. In one cartoon Dilbert is not successful in obtaining a pay rise, so he decide to extract a rise by doing less work for the same money – voila! A Dilbert pay rise.

Right now many GPs will be looking at their annual accounts, reading the runes of next year’s contract, realising that their financial position will be less good.

There is no new money, so no pay rise.

Many of us may be thinking about how we can extract a Dilbert pay rise.

Unfortunately if we do a Dilbert then others will pay the price, patients hospitals, self respect will all suffer.

However against that cost the balance sheet records other debts, other charges.

The absence of a safety net for GPs means that when we slip off our financial tightropes there is no one to bail us out. In the great Wall Street crash the stories of bankers and financiers jumping out of windows to escape financial failure echoed across the world.

I only hope we won’t have a non-fatal exodus of GPs from  primary care, or, god forbid, a fatal one

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