It was 2001, the government was still being referred to as new labour, the NHS plan was in its infancy and money floated around the new PCTs like it was going out of fashion. We were new organisations, we needed infrastructure, we needed to set up our systems and to be honest no one really appeared to know what they were doing. Money for education was allocated in pots - one for setting things up, one for our clinical staff, one for our non qualified staff, the list went on. If you could dream up a project and show a few outcomes the money was yours. It was wasteful, but a lot of people went off and learned lots of stuff that would give them a theoretical grounding in something and we did plenty of training on-site too. Some of the pots of money could be used to employ staff, and in some PCTs whole departments were set up on the back of such funding. GPs too benefited, there was funding to introduce appraisal for GPs, there was money for primary care medical tutors and money to pay GPs to employ locums so they could attend educational meetings and events (I kid you not).

The trouble was this pack of cards was built on a kind of never never type approach to healthcare investment. The more money the trusts were given the more they spent. We always kept within our budgets but along the way we paid for all number of conferences, away days and general jolliness. The good times had to end, and when they did the house of cards came with them. The departments built on project money allocated for education began to collapse as cash strapped organisations were unwilling or unable to pick up the costs. Course costs could no longer be met, and as the belt was tightened there was money for little more than mandatory training. Then one day the good times ended, there was a realisation that there would be no more central funding for education for NHS staff, employers would (shock horror) have to pay to educate their own staff like everyone else does. But there was no money and suddenly even fire training seemed to be a luxury.

This seems to be a good point to dip out, but is also a time for reflection. What could have been done differently? Were we corrupt? Well perhaps in some ways, this is public money and rich tea biscuits are as good as chocolate digestives, though less tasty. Training taking place in a hotel is more pleasant than the local post graduate centre, and the parking is better. But money is only ever allocated for a year at a time, and perhaps if there was more long term planning then there would have been less waste. The trouble is the way in which decisions are made, the long winded nature of the process of deciding whether to do this or to do that and then the time it takes to actually get things done. Before you know where you are it is January and you need to off load the money by march.

So the bottom line is that much money was spent wisely, some was wasted but that would have much less of a problem if the NHS didn’t function on an annual budget setting process. The good times are gone and now you can’t get a biscuit at your training session unless the person running it buys some out of her own money and she is off to be a commissioner!