It's often tempting to think that it's the big changes, the grand gestures, that do the most damage to a profession, but it's really the small acts of violence that really do the damage. The daily drip, drip, drip, that slowly erodes the foundations until, one day, the house falls down. 'Threats to democracy come one dollar at a time', goes the old American political aphorism, and so it is with professions like physiotherapy, which can suffer death from a thousand cuts if they are too distracted to notice. Foucault would say that the most powerful and dangerous ideas are those that arrive under the cover of common sense, where it seems almost impossible to dispute the reason and logic … [Read more...] about The large print giveth, and the small print taketh away
New: Money
A lot of really interesting attempts to change the way health care is being delivered are foundering because people can't work out how to fund them. There are certain pockets of money available: seed grants and step-change funds that get projects started, but often these are term-limited and there is rarely any chance of ongoing funding. One of the unspoken principles underpinning a lot of new models of health care (including primary care, health promotion, inter professional practice, patient-centred care), is that they will cost less, (or at least they will shift the responsibility for payment onto the individual and away from the state.) But few people have yet worked out ways to … [Read more...] about New: Money