NHS Reforms – The Latest

April 13, 2012
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The coalition government’s much vaunted Health and Social Care Bill has now received royal assent. The health secretary, Andrew Lansley will no doubt be much relieved to see that his party’s grand plan to re-design the NHS has finally borne fruit.

The crux of the changes is patient choice and competition. Hospitals, private healthcare provides and family doctors will compete for patients who will be able to choose treatment and care. GPs will have an important role to play and will form consortiums which will take control of 80% of the NHS budget, buying services from providers in the public, private and charity sectors. The reforms aim to (1) give clinicians (particularly GPs ) better control over treatment by improving integration between the NHS and local authority services and (2) abolish the layers of regional and local NHS bureaucracy (the much belied “middle management “) that has been accused of soaking up vast proportions of the NHS budget that could have been better spent on front line staff.

It remains to be seen whether the proposed changes will improve the overall patient experience or not. There are concerns that making such radical changes in the organisational structure of the NHS will lead to an increase in the number of incidents of unacceptable clinical treatment where patients are injured unnecessarily, particularly at a time when spending on public services is being squeezed to breaking point.

Opponents of the changes are concerned that competition will actually lead to the eradication of patient ‘choice’ as availability and expense rather than need start to form the basis of treatment plans. It is worrying that so far at least, the government has failed to win the support of most of the medical profession. Indeed, even support among GPs (who actually have the most to gain from the reforms ) has been flagging as the enormity of the changes begins to become apparent . A recent 2012 poll of GPs suggested that only 12% of them now agreed that putting GP-led groups in charge of the budget would mean patients saw a noticeable improvement in the standard of care they received. This compares less favourably with a figure of 23% of GPs when they were polled in September 2010.

Surely medical professionals are better qualified than politicians to comment on whether the proposed changes will help or hinder them to do their jobs better?

The proof, as they say is in the pudding…..

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