The cause of the crisis in A&E

The root cause is the misguided Blair commisioned Wanless report which massively increased GP incomes and drastically reduced their workload in particular relieving them of their previous obligation to provide out of hours cover for their patients. In effect they now work 9 to 5 for 5 days a week. If a patient becomes ill out of these hours they have two choices. Either go through the tortuous and convoluted NHS direct with its numerous delays or pitch up at their local A&E. Even if they fall ill Mon to Fri 9 to 5 there is no guarantee their GP will see them and they can still be referred to the useless NHS direct. Small wonder patients vote with their feet and go to A&E.

Wanless, knighted by Tony and  now deceased managed to cock up everything he touched. I quote from the Independent,

" Although as the youngest chief executive in NatWest's history he had presided over a wave of changes, including a more professional approach to management, his had was on the tiller when losses of £90m were unearthed, and proposed mergers with Abbey National and Legal & General came to naught. This forced the share price down and allowed Fred Goodwin's RBS to table a hostile takeover bid, which eventually prevailed. All this contributed to Wanless's removal in 1999.

A year later he was a non-executive director of Northern Rock, the building society-turned-bank, and head of the audit and risk committee at the time of its collapse, leaving it owing the Bank of England £24 billion after misjudgments in the derivatives market. Following an investigation by the Commons Treasury Select Committee Wanless, as one of the most experienced bankers on the Northern Rock board, was singled out for heavy criticism, accused of failing to ensure that the bank "remained liquid as well as solvent, to provide against the risks that it was taking and to act as an effective restraining force on the strategy of the executive members".

So if he had not been the worst CEO ever of Nat West, Fred Goodwin's RBS would never have been able to take it over given it was three times the size of RBS. So no Wanless there would have been no RBS bust which the UK taxpayer is still paying for and will probably never see their money back. 

The TSC document the starring part he played in another great British bank scandal , Northern Rock . That only leaves Lloyds TSB and HBOS which he did not contribute to!

His most damaging contribution to our country was his recommendation seized upon by Tony on GP's pay and hours. He in fact produced a system that paid the average, mediocre GP more than the average more highly qualified and certainly harder working hospital consultant. It is hospital consultants who deliver health care in the UK. They do the surgery, they do the invasive procedures, they handle the difiicult drug regimes in short they do the heavy lifting.

What really worries me is that it is GPs who are now to be put in charge of the NHS. It is a clear conflict of interest. For all the cries about privatising the NHS it has been privatised since its inception. GPs are private businessmen not NHS employees. Financial scandals are sure to follow this decision to put the contractors in charge of the contracts!