Home Page    David Zigmond Home Page  



Letter to the Secretary of State for Health


Dear Andrew Lansley

Commodification, commissioning and commercialisation: the growing threats to personal healthcare

I have been an inner city Principal GP since the 1970s and have witnessed and implemented the successive changes. All have been well intentioned, and all have had adverse unintended consequences. Changes towards commodification, commissioning and commercialisation of healthcare are particularly destructive where ‘soft skills’ and personal investment are crucial.

We are at the edge of another tranche of accelerated changes. In the near future I fear for the integrity of my work and the personal care of my patients. Beyond that, almost certainly, I shall become a patient: I have a dread of care by agencies and teams with no personal experience or knowledge of me, and little skills or interest to invest in these.

I enclose an analytical summary of my last few years’ observation and thoughts about these very difficult and important healthcare issues. ‘Five Executive Follies’ pursues lines of enquiry that may be unfamiliar for you, but may be rewarding. It has been written very carefully and requires similar attention to best assimilate and understand. Despite your enormous volume of written communication and other work, I hope you will find time for this.

I write to stimulate thought and creative discussion. I welcome any further contact from either you, or one of your deputies.

Thank you for your attention and interest.

With best wishes

David Zigmond



Copyright © David Zigmond 1986, 2011

Interested? Many articles exploring similar themes are available via David Zigmond’s home page on www.marco-learningsystems.com

David Zigmond would be pleased to receive your FEEDBACK


Version: 2nd May 2012



Home Page    David Zigmond Home Page