About 20 years ago I suggested to a very senior NHS clinician involved in the R&D programme that short-term grants should be made available to give NHS GPs protected time to prepare research grant applications. ‘If you think I’m going to pay GPs to write grants you must be joking’ he replied. When I tried to explain that GPs needed funding to enable them to pay for locum cover he said ‘Oh yes, I know. My wife is a GP and I get this every morning at breakfast’. Last weekend a London consultant told me how open warfare had broken out between the local CCG and his hospital directorate over referral criteria for outpatient appointments, against a background of a toxic hospital administrative culture and a not entirely consensual approach from some of his GP colleagues.
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