The Fortune Practice10: Frank’s guide to NHS REFORMS

Dear Alex,

Thanks for your email, sorry to hear you are so busy with all the CCG work, but it sounds like you are doing a good job.

Here is the leaflet I gave my patients. I don’t know if it will work for you, but you can use what you want. I wrote it from the diary I kept

I called it “ A Frank guide to the NHS Reforms”

See what you think:


1948: The NHS is born following the National Health Service  Act in 1946


I thought when I qualified from medical school, they would make me sign the Hippocratic oath. I’ve never really asked anyone if they thought the same…but anyway we didn’t. We all knew about it though.. Looking back to the 90s..maybe they knew already that at some point in time, they would be asking me to ration health care


Jan 2010: Conservative Manifesto re NHS published:

We want to free NHS staff from micro management, increase democratic accountability and give patients the power to choose treatments that are best for them

We are cutting the cost of admin by 5 billion

Every Patient will have the power to choose any health care provider, independent, voluntary or community

We are stopping the top down reconfiguration of the NHS


I thought this was dodgy, my colleagues thought this was dodgy. It didn’t make any sense. How could the patients suddenly come in control of health care? By this time I was a pretty experienced doctor, been qualified for 15 years, which in NHS years is more than dog years, with all the hours you worked.

I would have said something like, the NHS is only here because of all the slave labour immigrants, devoted Christians, rugby players, socialists and enlightened nice people  they’ve have put in. But it’s not bloody perfect. It would be great if it was a bit more patient centered and managers and clinicians actually understood each other



May 2010

General Election

That was a pretty miserable night, do you remember it: not many people voted did they…


Coalition Government elected

June 2010

The commonwealth fund reports that the NHS is second to Netherlands only on the parameters of quality , efficiency , access to health care , equity and healthy living


I remember reading that report and the tweets and comments in the medical press. I have to read stuff like that for things like my appraisal. They published it in the BMJ. In between and after surgery, when I’ve done my referral letters and looked at all your results and decided how I have to contact you, after I’ve been to a maternity or child health care meeting..I have to read journals and have to prove that I understand and reflect on the current most  effective care for patients. And when a patient comes along that it doesn’t suit, I need to fight their corner. Often I do that via a significant event form and discussion with my colleagues. I guess NICE was a good thing in the end once it really got itself going providing  evidence based medicine for us all. They want to get rid of NICE


July 2010

Liberating the NHS:

White Paper Published

My memory gets a bit blurred here…what I remember was confusion and fighting. It wasn’t rioting on the streets…the patients had no idea what was going on. It was the GPS : everyone was arguing. The government said we had to form commissioning groups and become responsible for the NHS. But we had to do it for £9 per head rather than £30. They said that if we didn’t do it, then they would get “any qualified provider” to do it. They said they would ease us in and we could become “pathfinders” in waves. They are good at that aren’t they , the Tories…rhetoric and all that…

Well loads of GPs just said no. They knew that the government were trying to destroy the NHS and they didn’t agree with it. They didn’t agree with it because they knew that it was the only way to look after patients properly. Well it was very difficult working every day when we were arguing, divide and rule they call that don’t they?

At the end of they day, the truth was we had no choice but to become pathfinders.

Doctors , on the whole are pretty clever and talented I would say, but I am a bit biased. Anyway, there’s loads of good leaders. I can be a good leader, if I really try and it’s something I believe in. Well the way I see it , there were lots of good leaders came out of all this, some autocratic and some democratic. Some who served their best interests and some who thought it was all set up to fail but thought they should do their best , in the interest of their patients


October 2010

Claire Raynor dies ( long time activist for patients) and ex nurse: Her last words were reported on the Radio 4 programme “ tell Lansley that if he destroys my beloved NHS, I’ll come back to haunt him”


Jan 2011

Health Care and social Services Care Bill Published

Things were hard for me at this time. I disagreed with the bill, but thought I should engage with what was going on, seeing as we had no choice and all that. So what I did was became an activist again. I had to. I tried to tell as many people as I could what  was going on, I organized postcards and talks. Anyway, despite what we did, nothing was changing. So I thought if I can’t beat them. I’d join them.  Fight from the inside. I was a member of the BMA anyway,our main union so what I did was reactivate the local division. Than was  a job, between surgery and my family and all that, anyway got that done and people turned up…, so that was good. Lots of doctors from different aspects of health care, just from living in the area ..pathology consultants, secondary care…


11 March 2011

Tsunami hits Japan



12 march 2011

Riots at Liberal Party conference : Shirley Williams speaks about universal access to health care from cradle to grave


15th march 2011


First time an extraordinary meeting has been held since 1992

I had never been to a meeting like that before, it was mostly men and there were hardly any black people. It was a bit like being at medical school again. Working where I do where it’s very poor you forget that the profession is mostly Conservative.

There was one speaker who I thought was brilliant so I wrote down her speech:


Dr. Jackie Davis:

The NHS belongs to the people who work in it and the people who depend on it, our patients. This bill will destroy the NHS. Today we have the opportunity to reject what is being undemocratically imposed on us against the advice of the profession and to the everlasting detriment of our patients. This opportunity will not come again, we have the power , we have the mandate to oppose this bill. Please support us


Sadly even after her speech Andrew Lansley survived a vote of no confidence and the

room did not vote to vote against the health care and social services bill in it’s entire by a narrow margin. I realized then that the BMA wasn’t the union for me, so I switched to UNISON



TUC march


Many of us marched on that day, I really thought it would help.

The battle that went on the next year was exhausting. Protest , twitter, everyone fighting whilst at the same time trying to do the huge amount of work that the government were inflicting on us. The Royal College of GPs were adamantly opposed to the Bill, so Cameron refused to even have them at the negotiating table.

The press didn’t cover the story very much, except the guardian and the FT. The BBC wasn’t even  interested


12 March 2012

Health Care and Social Services Bill Passed

RIP NHS 5/748 -20/3/12


Sept/October 2012

CCGs required to go through Authorisation


Well Alex, I’ll leave you to talk about that since you are part of a CCG!

Anyway, we must catch up and relive some med school days!

Take Care






About dralex007

I'm a female Salaried GP at the Fortune Practice. Helen Gould and Prakash Mehrotra are the partners. Abi Dark is my salaried GP colleague. I am into fitness, travel and film.I live with my boyfriend Andrew who is from the states.
Gallery | This entry was posted in Uncategorized and tagged , , , , , . Bookmark the permalink.

2 Responses to The Fortune Practice10: Frank’s guide to NHS REFORMS

  1. Finally a person that puts some real work into a blog. I do like what you have done with the blog.

  2. dralex007 says:

    Ta mm, these blogs a bit slow, but like anything.. Worth it ..dr alex

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s