I can't think of a better subject for this morning other than recommend this post on Dr Grumble's blog.
It's lengthy but thankfully free of jargon and should give us all food for thought.
Although it applies to England, I found it very informative as some of the ideas could drift north of the border. To be forewarned is to be forearmed.
Here are a couple of quotes but please do read the whole article.
'All hospitals, public and private, will be answerable only to the central regulator, Monitor, which is concerned only to ensure that they stay solvent and behave competitively.
They will be supervised for safety and quality by the Care Quality Commission, but the CQC is notoriously feeble: it gave mid-Staffordshire top marks when several hundred patients had been dying there from neglect.'
'The proposed change that has attracted most attention is the shift of commissioning from Primary Care Trusts (PCTs) to ‘local consortia of GP practices’. This is being done on the grounds that ‘primary care professionals’ are best placed to know what is best for patients, and will engage in ‘more effective dialogue and partnership with hospital specialists’. Who could object to that?
You do wonder why PCTs haven’t previously been told to organise such a dialogue between GPs and specialists; but the more important point is that GPs can’t in fact do commissioning.'