Analysis And Comment

The magic roundabout

BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7532.43 (Published 05 January 2006) Cite this as: BMJ 2006;332:43
  1. Peter Lapsley, chief executive, Skin Care Campaign (peter.lapsley@btopenworld.com)1
  1. 1 London W3 9AN

    It is 2015, and what goes around has come around several times in the past 10 years. Back in 2005, Zebedee, or whoever it was who spun the magic roundabout from the Department of Health, seemed confused about the difference between change and progress. Change produced instant good-news stories but constant disruption within the health service. Progress was boring.

    Circle of change

    So, Dougal the doctor, Florence the nurse, and Ermintrude the practice manager scuttled around reorganising everything. They went from general practice fundholding, through primary care trust commissioning, to practice based commissioning. Primary care trusts merged to become what had been known previously as strategic health authorities. Then, in 2008, Zebedee, convinced that giving most of the health budget to primary care was a recipe for inequity, pulled much of it back to be controlled centrally.

    The target set by Zebedee in 2005, that anyone who wanted to see a doctor should be able to do so within two days, proved hopeless, making it more difficult for working patients to get appointments rather than easier. So it was scrapped and the status quo restored. In 2009, after several years of huffing and puffing …

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