Or is it more like just oiling the wheels? Money, it seems, comes into it, with more than a suspicion that it might be funny money: the now-you-see-it-now-you-don't kind that appeared when fundholding began, then vanished, mirage-like, as later applicants were punished for their tardiness.
So, glue, spark, string (all analogies were on offer), or just money? Even after a three hour session with an enthusiastic team from Edinburgh, few of us here in Auchendreich were much the wiser about the Scottish Executive's latest nostrum for the transformation of our NHS: the managed clinical consortium (MCC).
Certainly the MCC presentation was impressive, not just for its virtuoso PowerPoint. Drawing on all the latest management theory, MCCs will, we were told, offer low friction, high gain, information rich, user friendly virtual networks that cross boundaries, transcend distance, and maximise added value over entire clinical journeys through complex healthcare systems.
“Eh, does that mean we're all going to be told what to do?” a urologist asked. The lead presenter smiled. “That's a question that comes up quite often. No, not at all. Clinically led, fully automated quality control systems are fundamentally supportive, with compliance and significant aberrance handled alike in strict confidence, through anonymised datasets, coded feedback, and lockdown password control.”
The urologist nodded thoughtfully. There was no stopping the lead presenter: “If anything, most clinicians feel liberated by what MCCs can do. And while they're not a panacea... ” To our surprise she went on to cite more than a dozen problems they might address, including waiting lists, consultant understaffing, and—intriguingly—the European working time directive.
Any worries? Well, the pilot consortium had met difficulties arising from the 59 different IT systems in use; and burnout was a significant issue for both IT people and clinical leadership. But such minor matters were essentially front loaded and transitional, with no real bearing on the national rollout of a brand new initiative of limitless potential.
As evening sunlight flooded the chairman's hospitality suite in our otherwise cramped new PFI, the meeting drew to its close. Evangelical fervour had won no converts. Discussion had elicited the kind of scepticism to be expected in Auchendreich. So, as with all NHS fads, Auchendreich will simply wait and see.