I listened this morning to a discussion on the radio about the plan to give doctors power over budgets in the NHS. During the discussion, someone in favour of the idea mentioned that this would be an end to top-down management. I future, decisions would be made ‘bottom up’. I disagree. GPs are ont at the bottom of the pile. That space is occupied by the patient. Indeed, in the British system, the GP already has the power of gatekeeper to NHS services. In my view, that is too much power. It is already very difficult for patients to be referred to specialists. That situation will worsen as GPs weigh the cost of a referal to their budget.
Interviewed a little later, David Cameron admitted that the UK health service performs worse than many other European countries, despite having about the same spend. Yet, in the same interview he expressed his devotion to the NHS, apparently unaware that this financial behemoth is the cause of Britain’s weakness on health.