I should say that I am sure there are many great GP’s who are not driven by money…

On being disheartened.

I think there is cause for optimism.
While perhaps neo lib free market economics is appropriate to some areas of production, all the evidence points clearly to the fact that it is not appropriate for health.

Since the ‘internal market’ was established in 1991, the administration costs 1991-97 were already doubled, representing an increase in admin costs, from 6% to 12%. That is roughly a £6 billion increase, going not towards patient care but to company profits. Now the Admin costs I believe are 18%, and rising.

A great myth about free maket economics is its ‘efficiency’. Sprinkle the magic of market forces all over the world like gold dust and watch everything transform.

I think freemarket economics is a theology like… creationism

Are you based in England? –

I have done a few film interviews with a friend and plan to do more.
The NHS is a tangle of a subject. I started researching it a while ago. And I am still researching!
The NHS is a Jigsaw puzzle. I have (occassional)moments where I feel disheartened, to be honest.

On London Health Emergency website there is a good breakdown of the effects of so called ‘reforms’ contained in the Bill. It is a letter from Hackney based GP’s to Andrew Lansley.

A great book to read is Julian Tudor Harts book ‘the Political Economy of Healthcare’ (2010 2nd Ed). Absolutely brilliant.
In it he talked about different concepts of ‘ownership’.
GP’s tend to understand ownership in terms of ownership of property/capital. A narrow conception.
In contrast to this, ‘ownership’ in its wider and truer
sense, that of ownership of their profession. This means autonomy, power to research, understand and serve the needs of their populations.

Thank you for creating this website

The real problem is fragmentation and the complex phenomena that flow from it: the NHS is being transformed from a (more or less) integrated service into a nexus of commercial contracts. Care will not be integrated, costs will not be controlled, decision-makers will not be accountable, bureaucracy will not be reduced, quality will not be maintained. And yes, this will often manifest itself as private providers doing it cheaply and badly. These are enormous dangers. Boiling them down into one word is not adequate; even if it were, that word would not be ‘privatisation’.

On other specific points: it’s debatable whether the Bill’s duty on the Secretary of State is substantially changed, but the political reality is s/he will continue to be accountable, so don’t get side-tracked by that; public health staff were in local authorities until the mid-70s anyway.