Since the New Zealand Medical Association has no opinion about the proposals about to be thrust upon the doctors with a "general" registration by the Medical Council, I crave space in order to take a closer look at them. We can feel certain that the proposals are unnecessary, and very expensive in terms of both time and money. Who, then, is behind them? Well, a thing called bpacnz, for one."Welcome to bpacnz. We provide evidence-based, educational material for primary healthcare professionals in New Zealand."The bpacnz site reveals that this "not-for-profit" organisation, already distributing materials to doctors, has five shareholders, who, one charitably presumes, have no interest in making money, but who may indeed be spending it. It is all a bit strange. The shareholders are: Procare Health South Link Health General Practice NZ (GPNZ) Pegasus Health Limited. (the word "limited" stands for "limited liability," and is used by all bodies anxious to protect themselves if they go broke.) University of Otago. The University of Otago is in Dunedin. Dunedin is a small town, but there is plenty of room there for academics, and we quickly find that the University has a Department of General Practice and Rural Health. This Department has a Head of Department; it has academic and research staff numbering twenty, and they include two Professors, and two Associate Professors. There are nine other people described as Support Staff, and four Research Postgraduate students. The website provides no financial information, but it offers spadefuls of higher education.Turning to Wellington, we can uncover "Our People in the Department of Primary Health Care and General Practice." Listed are 29 people with miscellaneous tasks. Auckland is, naturally, bigger still. It boasts a PhD student studying sleep.The involvement in bpacnz of a body entitled General Practice NZ led me to another body with a cluttered website. It seems to have rounded up all the GPs, but the funding of General Practice NZ is not divulged. That visit led on to the Royal New Zealand College of General Practitioners, which is loosely affiliated to it. From its inception, the College has wanted to get all the GPs on board. It now claims to have 95%, but that figure cannot possibly include all doctors who work as locums. It has grown into a big business, rumoured to be insolvent. Right from the start, it fished for privileges for its members, and, when these were denied, it cast a wider net. Years ago, the Professors of General Practice did not have a particularly easy time, but now it is harder for dissenters to argue with the numbers that their publicly-funded departments control, (shown above), and with the links that the academics are shrewdly forging with the issuers of the licenses.My research left me in no doubt on one thing. It is time for an audit. We have to be told just how much it now costs to become a GP, and just how much of that sum the government puts up one way or another, and who collects what once you've arrived. What are the ongoing, endless, and increasing costs of being a general practitioner? Once you have spent the day surfing the net, as I have, and caught a glimpse of the people who are fleecing the doctors, the patients, and the taxpayers in one way or another, you begin to feel like a cow that has wandered into a swamp in the middle of an information blackout, and who fears that it will never get out.Milton Friedman pointed out in 1979 that, "as government has come to play a larger role in medicine, and to finance a larger share of medical costs, the power of the American Medical Association has declined." It has happened here, too, and we can now begin to understand what happens when the power to license the doctors shifts, unopposed, to several expanding bureaucracies. They never see the poorer patients scuttling past the medical centres on their way to the Casualty Departments. Roger M Ridley-Smith Retired GP Wellington

Since the New Zealand Medical Association has no opinion about the proposals about to be thrust upon the doctors with a "general" registration by the Medical Council, I crave space in order to take a closer look at them. We can feel certain that the proposals are unnecessary, and very expensive in terms of both time and money. Who, then, is behind them? Well, a thing called bpacnz, for one."Welcome to bpacnz. We provide evidence-based, educational material for primary healthcare professionals in New Zealand."The bpacnz site reveals that this "not-for-profit" organisation, already distributing materials to doctors, has five shareholders, who, one charitably presumes, have no interest in making money, but who may indeed be spending it. It is all a bit strange. The shareholders are: Procare Health South Link Health General Practice NZ (GPNZ) Pegasus Health Limited. (the word "limited" stands for "limited liability," and is used by all bodies anxious to protect themselves if they go broke.) University of Otago. The University of Otago is in Dunedin. Dunedin is a small town, but there is plenty of room there for academics, and we quickly find that the University has a Department of General Practice and Rural Health. This Department has a Head of Department; it has academic and research staff numbering twenty, and they include two Professors, and two Associate Professors. There are nine other people described as Support Staff, and four Research Postgraduate students. The website provides no financial information, but it offers spadefuls of higher education.Turning to Wellington, we can uncover "Our People in the Department of Primary Health Care and General Practice." Listed are 29 people with miscellaneous tasks. Auckland is, naturally, bigger still. It boasts a PhD student studying sleep.The involvement in bpacnz of a body entitled General Practice NZ led me to another body with a cluttered website. It seems to have rounded up all the GPs, but the funding of General Practice NZ is not divulged. That visit led on to the Royal New Zealand College of General Practitioners, which is loosely affiliated to it. From its inception, the College has wanted to get all the GPs on board. It now claims to have 95%, but that figure cannot possibly include all doctors who work as locums. It has grown into a big business, rumoured to be insolvent. Right from the start, it fished for privileges for its members, and, when these were denied, it cast a wider net. Years ago, the Professors of General Practice did not have a particularly easy time, but now it is harder for dissenters to argue with the numbers that their publicly-funded departments control, (shown above), and with the links that the academics are shrewdly forging with the issuers of the licenses.My research left me in no doubt on one thing. It is time for an audit. We have to be told just how much it now costs to become a GP, and just how much of that sum the government puts up one way or another, and who collects what once you've arrived. What are the ongoing, endless, and increasing costs of being a general practitioner? Once you have spent the day surfing the net, as I have, and caught a glimpse of the people who are fleecing the doctors, the patients, and the taxpayers in one way or another, you begin to feel like a cow that has wandered into a swamp in the middle of an information blackout, and who fears that it will never get out.Milton Friedman pointed out in 1979 that, "as government has come to play a larger role in medicine, and to finance a larger share of medical costs, the power of the American Medical Association has declined." It has happened here, too, and we can now begin to understand what happens when the power to license the doctors shifts, unopposed, to several expanding bureaucracies. They never see the poorer patients scuttling past the medical centres on their way to the Casualty Departments. Roger M Ridley-Smith Retired GP Wellington