Thursday, November 30, 2006

GP Contracts

The good Doctor Crippen is up in arms about the government accusing GPs of dishonesty.
My pay has gone up approximately 25% over the last two years. That extra money has been earned by hitting government targets. The targets were set by the government, not by us, and mostly have little to do with health care, but a lot to do with “process” and bogus but quantifiable “healthcare achievements”.

We told the government at the outset that it was a waste of money, that the money could be better spent but, to them, “control” was everything.

They removed our professional autonomy. They told us what to do, and promised us piece-rate financial rewards for doing it. So we have done it, and done it more efficiently than they thought possible.

This was always a lose-lose PR exercise for doctors. If we had not hit the targets, we would have been lazy. If we hit them, we are greedy.

Well, up to a point, Lord Copper. I don't know how GP practices are run, but whether they are run on a company or partnership basis, the GPs could elect to pay themselves less. But, then, why should they do that?

The government is effectively complaining that the money should not go to GPs' salaries but, as Health Minister Lord Warner puts it, to "further improvements in services for patients, such as longer opening hours or widening the range of services." The trouble is that, if you have longer opening hours, then you would rather expect the doctors to pay themselves more for those extra hours, wouldn't you? After all, that's how it generally works in business: you work longer hours, you get paid more.

Lord Warner, as Wat Tyler points out, is the kind of lame-arse fuckwit who has never actually worked in the private sector.
Who is Lord Norman Warner? He's someone who has spent his entire career moving between the "public and voluntary sectors – as a civil servant, local authority executive, political adviser and quangocrat" (see this profile). "High spots" include a spell as Red Babs Castle's Principal Private Secretary in the 70s. He would not be my choice of shopper.

Quite. And what is it that Lord Warner was actually shopping for?
He said: "We invested extra funding in GP services in good faith both to improve services and reward GPs. The money was not intended just to boost GPs' profits.

"We expect a higher level of these profits to be invested back into their businesses, to bring about further improvements in services for patients, such as longer opening hours or widening the range of services.

"We want to see this year and next a higher proportion of practice income going on service improvement for patients, and greater efficiency rather than windfall profits."

Well, my Lord Warner, might I suggest that if that is what you wanted that you actually write it into the fucking contracts, you stupid cunt? Have you absolutely no idea how business works?

No, no, of course you haven't. And, of course, you seem to think that doctors should be above all that grubby money, don't you? That they should altruistically work for as little as possible and even throw their own money back into patient care.

Tell me, Lord Warner, how much are you paid for utterly cocking up the GP contracts and pissing away millions—or, more likely, billions—of pounds of taxpayers' money? Will you be giving some of it back because you have completely fucked it up?

We have to make these bastards personally, financially liable for fuck ups: it is the only way that we will ever get a half-decent level of value-for-money from these idiot, arsehole government nutjobs.

In the meantime, Lord Warner, could I respectfully ask you to fuck off?

8 comments:

Mr Eugenides said...

The BMA told the government that doctors worked harder, and performed more functions, than the government was claiming; oh yeah? said the government - well prove it!

So they did. And the cost of the GP's contract has ballooned way over the estimates as a result.

It's not the doctors' fault the government are morons. Their attitude is that they are being made to jump through evermore demeaning hoops to satisfy Whitehall's mania for targets, performance indicators and the like - hoops which government pays handsomely for negotiating - so why on earth shouldn't they watch the money roll in?

And why not, indeed?

JuliaM said...

"...might I suggest that if that is what you wanted that you actually write it into the fucking contracts, you stupid cunt? Have you absolutely no idea how business works?"

Drawing up of contracts isn't the only stumbling block & reason so many public sector projects fall down, but it certainly is the first one. Public servants simply don't know how to 'do' contract negotiation...

As a result, the govt (i.e taxpayer) finds that they aren't worth the paper they are written on when the shit hits the fan......

Rottweiler Puppy said...

"It's not the doctors' fault the government are morons."

'Morons'? Well, much as I hate 'em, I'd say the proper descriptor in this context is 'naive'.

After all, what's the betting that if you invite a welfare state parasite like Crippin to suck harder at the public teat, he will? Huh?

Now, over in hard-realityland, the smarter move might have been for Labour to say something like this:

"Wakey-wakey, NHS leeches. Since the shitload of cash we bribed you with a few years ago didn't succeed in motivating you to do the jobs you're paid to do, we've decided to forgo the carrot in favour of the stick. Accordingly, in six months time, we're going to sack the bottom-performing 1% of your 'profession'."

If they'd done something sensible like that, what's the betting we'd be looking at hospital floors you could eat your dinner off, well-fed care-home inmates and waiting lists slashed to six seconds?

... But, of course, taking that kind of stand would mean you guys couldn't throw Crippin-shaped stones at Nu Labour. Well, then, the enemy of my enemy really is my friend. And if he's a whiny, blood-sucking, big-state parasite ... Whatever.

Anonymous said...

Accordingly, in six months time, we're going to sack the bottom-performing 1% of your 'profession'."

If they'd done something sensible like that, what's the betting we'd be looking at hospital floors you could eat your dinner off, well-fed care-home inmates and waiting lists slashed to six seconds?
this would only work if this were applied to the managers,sack them and keep them out of the NHS in future instead of moving failures sideways to another area hospital

Dr John Crippen said...

Hi DK

It was a monstrous cock-up by the government. They (aka you the taxpayer) have not had value for money. They set up the hoops. They offered the cash. We jumped through the hoops and collected it. As would anyone. This money was NOT earmarked for anything other than a personal financial reward to be paid to GPs who hit the targets.

I don't mind at all if you say we are overpaid, that it is bad value for money, that the government could have done it better....... but for God's sake done scapegoat the GPs by suggesting we have been dishonest.

We have not.


John

towcestarian said...

I'm not defending the government at all, but (as someone who has not had the benefit of a 25% pay increase) I'm gettin a bit fucking sick of people like Crippen taking my tax money then whinging that the NHS is underfunded.

Be one thing or another for fuck sake; either be a greedy rapacious capitalist who doesn't give a shit about his customers/patients or be a kind-hearted humanitarian who realises that the more he takes out of the pot the less there is left the people he is serving.

Overpaid fucking whingers.

Umbongo said...

If an idiot offers me more money to do what I'm already doing (and, more or less, like doing) why should I stop him? It's not as if Dr C's monetary sacrifice would actually end up where it could do some good (it would probably end up in some scum's bonus because the scum in question could demonstrate that s/he's "saved" money on doctors' pay). I'd rather the money went to doctors who are, at least, doing a job which taxpayers want done and not to the incompetent pieces of dung who claim to be providing services to the NHS.

RP's suggestion (as modified by anonymous) about applying a little stick is OK as far as it goes but who is going to decide who is the bottom 1% in provision of services? Ms Hewitt or a nice little (expensive) quango of Nu and BluLabour parasites?

Anonymous said...

It's pretty rich listening to whingers going on about GPs getting loads of cash instead of NHS care. What do you think NHS care is? Is it visiting a brand new hospital that is all shiney to see a state of the art machine? Is it visiting a really plush administrator's office? No! It is about seeing people who can help. Those people are what the NHS is. If you pay them less than the administrator who is taking a survey how many of them do you think will stay? How many will join in the future? It is the doctors who will determine whether you live or die. Don't you think it a good idea to keep them sweet? Think about it the next time you need a medical opinion.