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16th June 2012 

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The end of the line 

News and Comment from Roy Lilley
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Beer, burgers and bunting. Rain and reign. Thank goodness we are still good at something! We've even invented a new geriatric therapy. Forget the quiet comfy of the day centre. Make the eighty and 90 year olds stand in a freezing down-pour for hours. If it's good enough for 'them' it's good enough for the rest of us!

What a weekend! A wag on Twitter pointed out that there were fewer doctors on duty over the bank holiday weekend than there will be on the 21st June, the BMA's day of action, inaction, strike or lunacy - depending on your point of view.

I don't think I'll bother rehearsing the doctor's claims. They have been badly treated in the negotiations, badly led in the process and will end up better-off than most of us. Enough said.

The British Medical Association has reversed into a cul-de-sac. They cannot strike and their call for imitation industrial action will be badly observed and badly received. Escalation is out of the question. They have no place to go. Humiliation beckons. The BMA once the British Machiavellian Army has stopped thinking and been outwitted. They are now seen as the British Moaners Association.

If they'd thought about it they would have walked away from any meeting involved in commissioning, CCGs and budgets. That would have damaged LaLa's desperate efforts to have the reforms in place by 2015 and the election. Instead they are taking a meaningless industrial action that demeans them.

So, what next for the BMA?

Over the years the BMA has got most things wrong. It misjudged the inception of the NHS. In 1948 it warned that doctors would become little more than 'common servants'. Wrong; they became the barons of the NHS. In the 60's and 70's they made a mess of running the NHS and were rescued by the Griffith's Report who installed some sanity and managers. In the late eighties they made another bad call and opposed Fundholding.

Unscrupulous GPs used NHS money to install a garden Jacuzzi and called it a hydrotherapy facility, but apart from that it 'worked' and might have been the beginning of something really good. The politicians sensed the BMA represented a divided profession and pulled the plug.

Last year the BMA could have played a pivotal role in the passage of the Health and Social Care Bill but made a mess of it. Again, chances slipped through the divide between members' opinions and a hesitant leadership.

Now we have a very different NHS and the same old BMA. Is it fit for purpose? There will doctors who will be commissioning services and doctors providing services. Buyers and sellers. Should they belong to the same organisation?

Isn't it time for the Buying Medicine Association and the other lot to start something new? The Bestowing Medical Association? Two organisations reflecting an NHS that has been forced to look in two, different, directions.

The National Association of Primary Care and NHS Alliance have been divisive forces during the passage of the Bill. They are likely to merge and attempt to recover an inclusiveness that is desperately needed. A new organisation will emerge.

Hospital doctors, their senior ranks set to benefit from any relaxation of private income streams, have grown out of the BMA.

Unlike the Monarchy, looking set for another 60 years, the British Meddling Amateurs are looking like the end of the line.  
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Medicine for Managers
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Dr Paul Lambden
Lymph Nodes
More in the series - 'why do I need them?'  You should know you have 600.  
I wonder who counted them?
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News and Stuff
News boy
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secret 
Gossip
This is what I'm hearing.  
Unless you know better.
  Tell me
>>  I'm hearing concerns in the DH at the loss of so many senior nurses in PCTs and worries about quality.  CCGs don't seem set-up to replace the roles.  They are thinking about the coming Francis Report and the hint in his first report that the 2006 reorganisation was partly to blame for the Trust's failures going unchecked.
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>>  NAPC boss in trouble - over de-registering patients.  Story here.  We reported on the original news back in August.  Apparently, the tail goes, the PCT stop paying so they stopped providing.  I still don't really know the truth - Charles, if you want to write 500 words on your side of the story, be my guest.  I think there are important issues for the future here.