Oh no, Hamish. No, no, noooooooo.

This is a bit silly.

I know there is a view that the BMA is at its best when it’s battling a Conservative government, as when opposing the introduction of the internal market.

Even Justice Secretary, chubby tobacconist and then-Health Secretary Kenneth Clarke admitted that the BMA won the PR war for public opinion over the internal market.

But Hamish's concept that GP commissioners are going to conspire to defeat competition in the NHS not only ignores the emerging evidence Nick Timmins points out in his FT article today, it assumes that the GPs who will try to lead clinical commissioning oppose competition.

Which is not universally true.

It also ignores the emerging evidence (which we wrote about here and here, and more is published here by Carol Propper and colleagues) that competition has broadly positive effects – with due caveats about the timescale studies being mostly pre-or early-recession.

It also assumes that services everywhere are equally good (or even equally adequate) and should be preserved as they are. Which is highly questionable.

It also assumes that the economic regulator (into which Monitor and the Co-operation and Competition Panel will regenerate, like a composite Doctor Who), would not notice such a cartel. I think they just might.

It also ignores Lansley’s revelation at the NHS Confederation conference in response to audience questions that the independent commissiong board will negotiate all 8,000 contracts for primary care provision.

Nor does this really leave BMA negotiators with the element of surprise over the revised GP contract.

The Bagpuss effect
I’m assuming that Hamish is a lover of the classics, and will therefore be familiar with the episode of Bagpuss about ’The Hamish’.

No, it’s not the yawn I'm on about here.

Bagpuss tells his friends that this Hamish is “a Highland beast that keeps its distance because it makes a terrible noise, like bagpipes being played”.

But eventually Bagpuss and chums realise that the Hamish is actually a procupine pin cushion.

And they stick him full of pins.