How to choose a GP?

In 2016 CQC thought that the “Days of single-handed GPs are over“.  Well, there seem to be plenty of them still around.  It just shows you that the NHS is very slow to change, and that’s not a good thing.  There is no clear advice on how to choose the best kind of practice, here is the NHS’s advice. It’s very clear on the how, but no information on the criteria for making a choice.  


So here are my criteria:

  • At least 7 GPs
  • Good range of nurse-based services
  • Good rating on GP Patient Survey
  • Additional non-NHS services included or close by
  • Digital services, like appointment booking and prescriptions

It’s as simple as that.   And just incase you want to know what the best looks like, here is an example https://www.bbbc.org.uk/


The secrets of productive people

I see that  FastCompany has one of their exec lists out.  I’m sure that these lists are rubbish, but they can be hilarious, imagine doing all of the things on the list in the belief that they will make your more productive. So here’s the latest list.   I particularly hate the idea only travelling with your sports gear on business trips and having your business attire posted by FedEx.   This one falls foul of my rule #2, never be separated from your kit.

What should humans eat?

I recently asked my Doctor what humans should eat?  She thought a little and then said, “You know, I have no idea.”  She could tell me all of the things I should not eat but had not thought of it as a species question. So, a little research later and apparently, humans are adapted to eat a palaeolithic diet. 

How hard can that be? Well if you know how to select food, prepare and cook it, then it’s not too hard. I was lucky my Mum was a home economics teacher, back in the day local education authorities in the UK thought that students should know how to cook and look after themselves. Luckily no one needs to know how to do that these days because it’s been outsourced to big business. My mum was not so sure, so she taught us how to cook and manage a home.

So, I now have my pointy stick plus a sack, and I hunt in the fresh food aisles of my local hunting ground. In my case it’s called Asda, I tried Waitrose, but didn’t like the other animals hunting there. However, that’s another story.

YouTube Part 2

There are some more channels on YouTube:

Leadership- being nice rarely works

No doubt you will have read with interest the difficulties Mr Corbyn finds himself in over the Labour Party failing to be clear on anti-semitism.

I can see why the Labour party would like to pick and choose elements of the definition.  But the best is nearly always the enemy of the good, but in some cases leaders just have to make the tough decision and choose the hard road.

In the case of Mr Corbyn he tried to have it all ways, adopt some of the elements but not others to allow the Party to continue to criticise Israel.   And in taking this middle ground, he ended up taking no ground at all.

Mr Corbyn in trying to be flexible, not upset one part of his Party managed to create a much larger issue.  Failing to lead always has consequences but being a partial leader, not taking to the moral high ground and mincing your words in the hope that things will turn out OK is never a good idea.

Good leaders aren’t nice, neither are they ruthless, good leaders understand the context of their leadership, they lead for the many, not the few, to quote the Labour Parties 2018 slogan.

Oh, and Max Joseph has something to say on leadership and being a dick.

What to watch on Youtube now v1.0

I’m a fan of YouTube.  Here are some of the shows I like:

  • Nerdwriter1 – The Nerdwriter is a weekly video essay series that puts ideas to work.
  • Vox – Vox helps you cut through the noise and understand what’s driving events in the headlines and in our lives, on everything from Taxes to Terrorism to Taylor Swift.
  • Max Joseph –  sometime filmmaker and part of Catfish .. just not the one you are thinking of.

More next week.

Is an NHS monopoly a good thing?

Public sector monopolies are a good thing right. They can’t affect private provision or innovation, and they are what they are. And in the case of the National Health Service in the UK, it’s a miracle. Thank goodness laws protect us from private companies taking over the NHS.

That’s the public service dialectic. Well, I have some worrying news for you.

Baxter’s law (also known as the Bell doctrine) is a law of economics that describes how a monopoly in a regulated industry can extend into, and dominate a non-regulated industry, named after law professor William Francis Baxter who was an antitrust law professor at Stanford University.

Here’s an example:

A new nurse-led social enterprise sets up on the South Coast of England to provide a wound dressing service. The local CCG likes the new service and signs a three-year contract. Costs go down as the service dresses wounds more innovatively, patients spend less time as an inpatient and pharmacy bills reduce.

At the end of the Contract, the CCG advertises a new Contract. The local NHS provider offers a lower price for the next tranche of the agreement. They undercut the local social enterprise by using funding and revenue from other areas of the local health monopoly. They win the new contract. Of course, they do this to protect their income in others areas of their business. Classic monopolistic and anti-competitive behaviour.

So what happened?

Did the cost of care on the South Coast go down? Did the quality go up? Or perhaps the NHS used it’s monopoly to reach into a Third Sector and kill innovation and alternative provision and protect its income. I would content that Baxter’s law applied and the NHS used its power to stifle innovation.

My concern is that many are unaware of the anti-competitive nature of this monopoly position.    Next time you attend a meeting looking at NHS Contracts or as a member of the public at a Health and Wellbeing Board you might think to ask;

  • What steps are we/you talking to limit the monopoly of NHS provision?
  • Are we/you aware of any examples of the NHS limiting innovation or new service provision through the use of economic muscle?

The NHS and the public it serves will be better for it.