Divide and conquer

When it comes down to it this is the part about the way the NHS is run that irritates me the most. The idea that dividing primary (GP) from secondary (hospital) care is remotely useful. It created an 'us and them' mentality with the two factions warring over spending - and using up vital funds in the process. As if the poor patient wanting treatment gives a moment's thought to which particular link in the chain is paying for something. The internal market was and remains a disaster for patient care.
Worse, the energies (considerable) wasted in inventing methods of cost cutting with respect to the other party are enormous and could so much better be spent on actual work.
The latest incarnation of this crazy system is CQUIN- or Commissioning for Quality and Innovation - a Department of Health initiative (if that is the word) to force a certain standard out of hospitals before their services can be bought. That in itself seems all well and good but the realities of the process involve countless man-hours of paperwork collecting meaningless data that is then interpreted by those who cannot possibly understand it and on this the decisions are made.
During the last decade the number of NHS managers has doubled but the number of frontline staff has risen by only 30%. When you go to your local hospital you are more likely to bump into a manager than a clinician.
Is this 'rage against the machine'? Well, yes and no. It is rage at the fact that a system that is in many parts so utterly wonderful, an idea so envied but never reproduced around the world, so altruistic in its conception can be degraded into a political football.
About the number of Americans as there are people in Britain have no health insurance and they would kill for what we have. As it is they are more likely to die for what they have. And yet we treat our national treasure as a management consultancy training exercise.