I ask you - if you were to design a new national health service from scratch, would you really design it with nobody to think ahead and make decisions on resources?
So why are the main political parties in UK engaging in their favourite sport of manager bashing?
Perhaps because there's an election coming up. We've had 10 years of Doctor bashing (they are paid too much, an nurse can do the same job, they aren't safe on 60 hour shifts etc etc) and the main result has been the poor quality of Out of Hours services since it was taken from the GPs and put with the PCTs (Primary Care Trusts) in April 2004 - deaths and doctors who don't speak English, anyone? How about software not fit for purpose?
So who's the next scapegoat, to distract attention from the politicians who make these decisions? Well, as Mike O'Brien put it last month "you will receive less budget, less resources. But any manager who cuts services because of a lack of funds will be named and shamed, and drummed out of the health service". Talk about passing the buck!
Conservative and Lib Dem are fighting to get onto the bandwagon - "we can put everything right with a magic wand - more of what Labour's doing, only faster!"
So what are the differences between the parties? as I argue on Technorati.
Labour wants GPs to do more for patients, so NHS can save money on hospital appointments. GPs are also being encouraged to take part in Integrated Care Organisations (ICOs) which provide pathways of care.
Conservatives want GPs to own the budget for patients - a return to GP fundholding. Certainly some GPs are keen on this idea, but others don't want the responsibility.
Lib Dem (who can say what they like because they won't have to implement it) say GPs should have to do everything: see more patients, at all hours, with longer appointment times. I think someone has forgotten that there are 168 hours in a week, and most human beings need time to sleep.
The game goes on!