You get what you pay for

Time was, not everything was counted, catalogued and ticked. In the era before management consultancy and targets professionals were left to run their profession with minimal meddling. After all, they did know the most about it. And it worked well. A few bad apples made the headlines and the stifling, corporate, faceless culture moved in to transform a once beautiful vocation into a parcel of 'Programmed Activities'. And there is unlikely to be a way back.
Seven years ago the New Contract was introduced/imposed (delete as per personal view) on the hospital consultant body. Initially representing a basic pay rise along with the threat of no pay advancement for those that did not sign up, it was embraced by the majority. But now those carefully monitored and counted chickens are coming to roost. The working week was painstakingly divided into fractions with each Programmed Activity representing fours hours a week of work. There was initial managerial surprise at the amount of previously unpaid work that went on but after the usual acrimonious 'smoke and mirror' accounting (see below) the answer was usually 'ten'. Some managed eleven or twelve but the allocating depended more on negotiating capabilities than real work done.
Now, with the recession in full swing, there is a desire to cut these 'PAs'. But the expectation is that the previously done work will remain. In days gone by the consultant body would have tightened their belts and weighed in with a collective effort in the interests of professionalism but now, the goodwill having been long since eroded, there is the liklihood that it will take the attitude that - as with any other paid job - if one pays less one gets less work back from the employee. And services will suffer.
That's what comes from having one's cake and eating it. Ultimately they will regret destroying what had been and some lessons are hard to learn but necessary.
Oh woe, my beautiful profession.