Prime Minister David Cameron, Deputy Prime Minister Nick Clegg, and Health Secretary Andrew Lansley today launched the Government’s listening exercise on NHS modernisation.
Setting out the Government’s desire to modernise the NHS with the support of patients, the public and health professionals, Andrew Lansley announced that engagement over the coming weeks will focus on:
- the role of choice and competition for improving quality
- how to ensure public accountability and patient involvement in the new system
- how new arrangements for education and training can support the modernisation process
- how advice from across a range of healthcare professions can improve patient care
The Prime Minister said:
“I believe passionately in the NHS. It is our most precious national asset. And it is precisely for this reason that we want to safeguard the NHS for future generations. But we also recognise that there are some big questions about what we’re doing.
“This listening exercise is a genuine chance to make a difference. Where there are good suggestions to improve the legislation, those changes will be made. But let me be clear, it is only through modernisation that can we protect the NHS and ensure the country has a truly world-class health service.”
The Deputy Prime Minister Nick Clegg said:
“The NHS is our most cherished national institution and this Government will never waver from the basic principle that you get treatment when you need it. Not when you can afford it.
“At the heart of our reforms are some simple common sense ideas – less bureaucracy, more power to local communities and more responsibility to those who know most about their patients. These ideas stay true to the vision of the founders of the NHS.
“But there are concerns that need to be addressed and some people have come forward with good proposals to improve our plans. That is why we are taking the time to pause and listen so we can build a better NHS for the future.”
Health Secretary Andrew Lansley said:
“Good progress has been made so far in modernising the NHS, such as the 6,500 GP practices and 90% of local authorities signing up to play their part in improving services for patients.
“We are taking the opportunity of a natural break in the passage of the Bill to pause, listen, reflect and improve. This will help realise our ultimate goal of modernising the NHS to protect it for the future.
“This is an opportunity for people to share their views and have their voices heard.”
With all due respect to the government and paying heed to the financial issues that are the current worry of our lovely little block of rock, jobs and services within and around the N H S can be safeguarded despite a reduction of the N H S budget!
How to achieve this?
Get the buyers to purchase individually wrapped incontinence pants/nappies within a shell wrapper, this will stop the health and safety officers insisting on nine of a newly opened packet of ten being thrown away when only one is needed for being “non-sterile”, yes the unit price will be pushed up but when more than 25% is wasted in this way, it will create an overall saving by virtue of less needing to be purchased!
There are other savings to be had in the same way if this kind of intelligent spending is applied!!!
Lots of people will want to get involved in this. However the time scales are vague – what do ‘the coming weeks’ mean? Other than amendments to the legislation will there be any other feedback? What time scales is the department now working to for the legislation?
How could government make anybody more accountable for patient care than GPs running a GP Consortium?
If GPs running Consortia do a bad job then it is their patients and their colleagues who would be aware and the consequences would be personal, professional and public. It has to be the ultimate in accountability.
By comparison the involvment of locally elected politicians would be marginal: they are accountable for much more than health and their role would be unclear.
Involvement of local politicians would make decision making politicial. Would GPs still want to be involved? I don’t think so.
GP Consortia are a brilliant idea in my view. What is needed now is clarity about how much they will take on and how soon and the NHS management structure needed to secure success
Please don’t deviate from enabling clinicians to lead the commissioning process.
There will need to be clear and open accounts made available including that of ‘profits’ kept by consortia if GPs are allowed to commission services. There would also need to representation from other experts ie patients nurses and acute sector staff into these structures to ensure user and practitioner views are taken into account, there must also be a risk to our most vulnerable as the safeguarding of childrens processes will take a back seat.
In addition private enterprises who may tender for services are often those with a monopoly in the field of health / care / environment and curently a small number of organisations such as CAPITA and SERCO are providing many of the privatised functions including care to patients for minimal cost whilst filtering off large executive bonuses from the tax payers. We would need to be reassured that this is again transparent.
The NHS is still the envy of the world ‘free at the point of delivery’ ,
I think the ‘reforms’ will destroy the NHS and should be halted before it is too late
The collective principle asserts that… no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.
—Aneurin Bevan, In Place of Fear, p100
I agree Dr Cole, however to stop Mr Lansleys claim of 90% of the country being covered by consortia, GP’s need to back track and pull out of clusters/consortia to send the message that it’s not what most GP’s want to do. You all trained to be doctors not managers. I cant beleive the way that GP’s have been shepherded into consortia pens by PCT shepherds.
Leave the NHS alone.
Doctors are doctors not managers.
Thank you. That is what I said to our MP who said he would follow the party line anyway. It got into our local paper, then the proposal to postpone went through and he looked a bit of a Charlie.
What we need to watch out for now is that the changes are not made one piece at a time, hoping that nobody notices.
If the governmentwant to change the NHS for the better they need to start talking to the real professional dedicated health workers the doctors and nurses on the front line of the NHS their coopperation is vital. What I have witnessed in the north west is decission first consoltation with the working staff the hub of the NHS second. Please wake up and see the roses before its to late. NHS patient.
I Absolutely agree that the majority of “frontline staff” are dedicated to the NHS but so are us backroom boys who’ve given
25years service to ensuring patients have access to good quality services. Who do you think makes sure you have health buildings to visit, orders the equipment, drugs, pays the bills etc. etc.??????
I have worked in the NHS since 1979 and I have seen many changes. It is always used as a political pawn. My greatest fears and concerns are that the current government is keen on following the American model of healthcare provision and there will be many people losing out.
This system was tried out with GP fundholders during Mrs Thatcher’s government and was unsuccessful and yet they still want to bring this system into place.
My healthcare trust had to pick up the pieces resulting from complications following major surgical procedures performed abroad and from the private sector. In the long run it costs the government more money and suffering endured by the recipients.
In my opinion GPs already have a difficult job to do, apart from having to be accountants. This is a conflict in interest to patients
I agree. What’s more it costs the country a lot of money to train a person to be a doctor. I don’t want to see that money wasted by them having to spend time they could be seeing patients doing accounts.
Grow the economy. Grow the NHS.
The NHS belongs tithe people.
Labour and Conservatives come and go but the NHS is forever.
You can’t spend too much on healthcare.
Grow the economy, grow the NHS.
Cameron promised no more reorganisations, so did Blair and Brown. He’s broken a promise, he has no mandate for this and has lost the high ground. I have worked in the NHS for 20 yrs, have been through 11 reorganisations, everyone has destroyed the morale, taken the focus away from patients and has not brought the claimed gains and efficiencies. There has been no public involvement in these reforms until this stage.
Please if you must progress, scrap pointless health and well being boards and ensure that GP consortia MUST have representatives from nursing, social care, public health, medicine, locally elected representatives and members of the public. Gps should not be allowed to commission on their own they dont understand population health and don’t do partnership. The role of nursing is key, where is the role for nurses?
I am an experienced Foundation Trust Public Governor and I am pleased that the Government is taking the time to listen and find ways of improving the proposed legislation to achieve the necessary NHS reforms. My particular interest is in the second of the four key areas of focus –
“how to ensure public accountability and patient involvement in the new system”.
I look forward to the opportunity to be heard.
in relation to reforms in the nhs there is definatley room for improvement , i understand that the nhs is vital in that it means individuals and families can get the health care that they need .
however what i would question is the nhs good enough and what can be done to make it better , in particular giving patients for more of a choice and a say in their health care , better commuinication between patients and health care staff less waiting time on operations and gp or other health care appointments , better maternity care for mums to be and new mothers ,
raising awareness of mental health issues , and health issues such as depression , and more importantly just getting the treatment for any health issue when you need it and not having to wait .
a fairer prescription charge , see i think there is lots that needs to be changed and i think its right that mr cameron is launching his listening exercise because thats whats most important is listening to the public ..listening and taking all of that on board .. !
As a retired healthcare professional (not a GP) I am pleased to see that there is to be further consultation on the proposed NHS reforms.
I have two particular points of concern:
- the fact that competition and ‘any willing providers’ are central to the reforms makes me concerned that patients’ needs will take a secondary role. Private providers from large multi-national companies will be at an advantage over voluntary sector providers and more locally-based agencies. Any competitive element needs to be treated as a factor which is secondary to patients’ needs.
- the commissioning bodies need to be more broad-based and more representative than what is currently being proposed and I hope that secondary care providers, public health professionals, local councils and community representatives, among others, will be included as equal, voting members of these bodies.
I await the outcome of this consultation with interest.
Yours sincerely,
Dr Bob Cant
Not every new idea is a good one; for many reasons even good ideas don’t always work as planned.
This is simply a bad idea and wrong. DON’T DO IT.
Listen, be humble and leave well alone. People will think better of you for it.
I represent 5,000 Unison members who work on the front line of NHS sevices in acute hospitals and in the community.
We have repeatedly written to the Secretary of State, Deputy Prime Minister and Prime Minister to understand where these listening events are to be held and how these staff may be involved and express therir profound concerns on the Bill.
We have heard nothing and recieved no response.
The staff have also heard nothing through their NHS Trusts.
It appears the there is no way that front line NHS staff will be able to express their views on the Bill.
The present exercise appears as the BMA put it, to be more respray and PR relaunch than fundimental rebuild of the Bill.
I am really cross at the way that the good work of the PCT and the ‘managers’ within them has been de-valued! What is often not publicised is that approx 50% of ‘managers and bureaucrats’ in the NHS are also clinicians (or have been), and have combined clinical skills with mangement skills. These are the people who want to manage and get involved in things like patient safety, transfering learning from national enquirees and clinical governance rather than the majority of GPs who appear to be dragged kicking and screaming into this kind of work. A further point is that the NHS and indeed primary care is not only about GPs, what about dentists, optometrists and pharmacists who have no control over budgets at all in the new world. My final point is that the group of clinical staff that the government now want to be involved in consotia replicate the professioanl executive committees that have always been heavily involved in PCTs and have now been replaced with Clinical Commissioning Executive. While i believe that there was a need to review spending and make cost savings, these reforms have gone too far and have thrown the baby out with th bathwater!!!
Hi Aly, completely agree with you
Currently Jim Easton and the Institute of Innovation and Improvement through the SHA’s are promoting Social Movement Theory to deliver large scale change to achieve the QIPP agenda, and I think it has real potential to save the 20 billion pounds required. It’s the social movement theory to achieve change from within the NHS with patients, not political movement theory causing more chaos and a great deal of anxiety in the workforce, and I suspect patients and carers as well. Large scale structural change was absolutely the last thing we wanted yet again. I cannot understand why politicians with no competence in health care, continue to believe they have the solution. Please please please stop this insane belief you will achieve a solution through an act of parliament within a term of office.
Is it any wonder that GP consortia are champing at the bit to hold the reins for future control of funding and how and where this will be spent? They are certainly well placed to know their patients needs and could not do a worse job than NHS Managers/Accountants currently. I have been in the NHS for 40 years and there have been constant restructuring exercises for the whole of that time – cost to the NHS – millions & millions – only to be undone and replaced by another political “cunning plan”. It seems that we are going back to the old tried and trusted ways of LOCAL GP run mini hospitals run for the benefit of the patient – about time! Big is definately not beautiful.
6,000 responses, weeks of consultation and now this? I take it you are listening in the hope that what you are hearing will change? It will not. There are many areas where staff do not agree with the reforms and you already know that.
And why have 2 sites for responses on one web site?
Thanks for your comment and question.
This site allows people to comment on most of the articles we publish. All of the comments that we get will be considered, along with the responses to the more specific questions that we will be asking.
Considered by who??? Will the prime minister or Andrew Lansley ever read these comments? It appears that they have already decided what the outcome will be as they have categorically stated that going back on the health bill is not an option!
All these comments will be passed on to the NHS Future Forum for consideration, and there will be more information on this website about how this process will work.
The Government announced its intention to ‘pause’ and listen on NHS reform, various Health & Social Care organisations were delighted when the Bill was first announced and the Government promised that ‘no decision about me without me’ would be central to the new plans. However, as the Bill progresses through the Commons it is becoming clear that what is being said doesn’t match what is written in the Bill. For example:
* There is no requirement in the Bill as it stands for the National Commissioning Board or Commissioning Consortia to involve patients or patient groups in decision-making. Currently these bodies are only obliged to ‘obtain advice’ from expert professionals. How is ‘no decision about me without me’ to become a reality if our concerns and views are not even placed on a par with those who treat us?
This is the most radical change our NHS has ever seen, and we need to be sure that the new system will work for everyone who uses it., we need to remind the Government and our local MPs that the NHS belongs to all of us and they promised not to leave patients out.
Allowing unlimited private beds in hospital will allow a two tier health system. Any hospital manager faced with a NHS patient and a BUPA patient would always take the private patient.
why is it that a health service the envy of the world is regarded by successive U.k governments as broke; it ain’t broke, except financially through the cost of repeated reorganisation.
Yesterday I met up with G.Ps in the PPG group I attend as a patient representative. They work hard, sometimes too hard, and the last thing that they need is managerial responsibility on top of their wonderful but stressful patient care.
Agreed. Also, the NHS is not supposed to be a profit making organisation.
The reforms are on the wrong track by giving GPs the majority of control when modern healthcare services involve a wide variety of players including hospital consultants, modern matrons, home carers, health promoters, physiotherapists and above all the patient as the ultimate “expert”. SHAs and PCTs should be merged to create Community Healthcare Commissions drawing upon local expertise across the health professions, local authorities and local lay people. Commissioning powers should not be exclusive to GPS, specialist hospital units shouls also be able to form consortia to fund areas such as cancer care and maternity services. Streamline the bureaucracy but retain an element of local control and accountability in the vast space proposed between the central NHS funding board and local GP consortia.
The NHS currently has the highest public/patient satisfaction since it was set up. It has an excellent value for money record and has a very good record of equity of treatment and care. There is therefore no need for such a dramatic change in the system as set out in the Coalition’s Bill.
To make it more effective we need to get back to recognising the importance of integrated care and the need for genuine democratic accountability.
Hence the need to remove the costly purchaser/ provider split, renegotiate the hugely expensive PFI deals and reestablish a proper planning and providing system where clinicians and managers work together to provide the most appropriate care for each patient and best value for money for the community as a whole.
Enforcing competition by your response to lobbying organisations is not the way forward. Hospitals need to work together with other hospitals and with primary care to ensure proper care pathways and effective care networks.
I welcome the fact that the government is now listening but why did they not do that before? The answer is that they view it as a PR exercise and they will then go ahead and do exactly what they want to do after they have ‘listened’. They still mean to go ahead with this policy. The people are gaining momentum to overturn this stupid policy and by pausing they will halt that momentum which they hope will not be so easy to start moving again. They should leave the NHS alone and not slice it off to their buddies
The NHS and the National Blood Transfusion Service were founded in 1948 at a time of hardship, rationing and debt. They were not founded as businesses but as an act of unity. The Coalition did not seek and was not given a mandate to propose privatisation of either.
When you came into office this time it was time for evolution, not revolution, as with the VW philosophy for the golf and polo cars, which remain recognisable from the very earliest models, which people trust. In a revolution with large scale structural change, innovation is interrupted, motivation is generally lost and established systems and processes break down. The talented people move on. The PCT as a concept was fine, working really well in many areas, and they were starting to make a difference. Yes they needed to still improve commissioning through outcome measurement, and yes there needed to be far fewer of them. But it is only through large scale commissioning bodies that we can really start to shift resources to the community to reduce hospital admissions, and transform were and how services are provided to patients close to home. But their culture was only just establishing and cultures and relationships take much longer to emerge than you appear to understand. The PCT’s must remain and evolve. How can 500 GP clusters reduce management costs and the post code boundary lottery for the quality of care and service? This is complete madness.
While welcoming this pause I must like others admit to being sceptical. I attended a number of consultation events on the white paper as well as contributing to my local LINks response to the white paper. I note that apart from the concerns over moving scrutiny to the Health and Wellbeing Board which was a stupid idea and I am glad to see it was dropped most of the other concerns I heard raised seem to have been ignored.
In particular the proposal to have an independent consumer champion called Healthwatch which is accountable and funded by the local authority which is the main provider of social care which this body is supposed to monitor was heavily criticised but is still going ahead. leaving aside the fact that there is, as the government should know they have been tod enough times, a serious conflict of interest in this arrangement can the government seriously hink tat patints and the public will have confidence in a body that is funded and contract managed by one of the bodies it is supposed to monitor on thier behalf.
I am a Charge Nurse in a District General Hospital and am very scared of what this bill will do to the NHS. The scrapping of the private patients income cap will undoubtedly mean that NHS patients will be put to the back of the queue when it comes to treatment as Trusts are finacially stretched. My Trust is already closing wards and departments (as so the Government statement that the NHS is protected is untrue) as my Trust has to make £2.9M savings this year. This bill was not in either the Conservative or Lib Dem manifesto so if they really want to “consult” and “listen” a general election should be called. Satisfaction rates of the NHS have risen from 37% in 1997 to 67% in 2009. If its not broke don’t fix it! We do not need yet another reorganisation.
Since Thatcher brought in private sector mentality the NHS has suffered endless costly reforms which has shattered and divided our National Health Service into competing clannishness. These proposals which stem from these original plans are a disaster for the majority of the public and our children will not forget or forgive what we are due to deny them. Shame. Us staff are currently being set up to fail – for to succeed will scupper the plans for a competing market place. If staff are treated so deceptively and heartlessly what hope for the patient? These reforms are capitalist and will as capitalism does benefit only the minority. Attitudinal change is all that is required – stop the abuse within and without the NHS ie restore the pride and value to us all of this greatest of social enterprises. Stop the cash cow mentality and the monopoly of giant pharma.
Its not the ‘ageing population’ thats the problem, its the people from other countries (who do not pay NI) using NHS for ‘free’ operations & treatment. UK should do as other countries do – if you don’t have medical insurance, you don’t get treatment. SIMPLES. Sorry if I offend anyone, but I speak what I believe.
Please see DH guidance on charges for overseas visitors.
I think it would be helpful for all to recognise that GPs will not be able to make commissioning consortia work on their own, so we should stop calling them GP Consortia.. Local Commssioning Consortia should be more appropriate… perhaps some of the recent “Doughnutting” of consortia, related to the active GP driven avoidance of “unpopular, financially / clinically risky” practices joining in a co-terminous way may then be avoided…
The current proposals for commissioning consortia are unworkable – consortia will need to be statutory bodies, cover large populations and have hospital doctors & public health doctors on their Boards as well as GPs and patient representatives. Indeed, many of the emerging GP consortia are not well established and GPs have been mainly “corralled” into them. As someone once said “Just because the passengers on the Titanic climbed into the lifeboats it didn’t mean they supported the idea of the ship sinking.”
Those GP commissioning groups that have already achieved change have done so under current legislation supported by their PCTs (so why exactly is a new Bill necessary?).
Current proposals for any willing provider and the role of Monitor as a competition and market enabler need to be scrapped. The potential for conflicts of interest and harm to the Dr:patient relationship are also real and should concern to us all.
Patients and committed NHS professionals deserve more from this listening exercise than mere lip service consultation. However, there is a view is that this is all that’s on offer – it’s now up to the politicians to prove the cynics wrong.
I have worked in the NHS for nearly 34 years and have seen so many reforms, most not good.
The last government at least gave us stability. It is not a nice culture to be working in when one hospital feels that a neighbouring hospital is ‘poaching’ their work all the time.
I do not want to go to private companies making huge profits from NHS workers in’partnerships’ – it will only be shareholders who benefit not patients or staff.
Once the NHS is lost we as a society will never get it back!
I find it very interesting that in launching this exercise ministers have started to refer to the changes as the ‘modernisation’ of the NHS. The ideologically driven, top-down reorganisation of the NHS may or may not lead to a modernisation of the service (the jury will be out for years), but the clear intention is to try to frame the debate as being between those in favour of modernisation (ie improvement) of the service and those against it. It’s a very subtle way of undermining the legitimacy of the opponents of the changes, and it tells you all you need to know about the purpose of the ‘listening exercise’.
Why is it that I feel this is just another attempt at stalling the process that has already been decided by Mssrs Cameron, Clegg and Lansley. Its not that people are stupid and don’t understand, as they appear to believe, more a case of people not liking what they can see is happening. The NHS is made up of far more services than just GPs, and must be run by more than just GPs. The “expertise of the NHS in Britain” has, and always will be, the workers behind the scene.
I have been a Practice manager in GP practices for 12 years, previous 25 years in business, I have worked with many doctors and despair at the thought of any of them trying to run the Health Service or managing budgets. They are not trained in financial management, employment law, property management or IT. We are talking about highly trained and skilled people being asked to retrain and do something completely different and they are making a mess of it. Recently I have seen budgets that made no sense and no foundation in the truth, IT solutions that are badly planned and doctors speaking about the cost of treatment rather than the need to care for the patients.
The PCTs were really bad but this is worse.
Yes, doctors and local health centres should be about treating patients, not filling in spreadsheets (or paying companies to do so.)
An utter shambles! Why not convert PCTs to Health Boards and appoint GPs as directors to held to account. Agree PCTs need to be scaled back, but to rid of all expertise is crazy-remove top tier and middle tie management and retain the experts!!!
The opportunity to pause for thought is most welcome. However nothing short of a root and branch rewrite of the bill would restore sanity. The euphemism “liberating the NHS” smacks slightly of “Arbeit macht frei”. There has been a significant lack of joined up thinking at the highest level. The proposals came soon after an election in which the Tory manifesto promised stability and not drastic change. The notion that abolishing PCTs, making numerous experienced managers redundant, and passing responsibility to GPs within a tight timescale can possibly achieve greater equity is naive in the extreme. All of us GPs will have the goodwill, many of us lack the interest or experience, and all of us lack the time to do this important job justice. It would be entirely impossible to implement the reforms without a massive injection of new money, and this is most certainly not on the table. It is no surprise that there is such a strong consensus among both professional bodies and think tanks that a rethink is required
We won’t get anywhere until we have a good clean NIPHE – National Institute for Policies in Healthcare Excellence. Until national healthcare policies are evaluated using best available evidence and used to inform national health care providers and government about best health outcomes, cost-effectiveness and equity we will forever be locking horns with governmental dogma-based top-down re-organisations. Let’s initiate a new way of doing things.
Where does mental health fit into this plan? It’s already a Cinderella arm of the NHS. The other great faultline in the Lansley vision is that with GPs controlling the NHS budget, they are bound to cherry pick funds for primary care at the expense of hospitals and mental health units. PS It would handy if contributors to these threads picked up on other’s points more and developed a debate, not just a series of similar statements saying much the same thing.
well said
Mental health will be overlooked as usual because the British public could not care less about people with mental illness/personality disorder and services themselves have simpliy replicated hospital settings in the community since Thatcher opened up the asylums in the eighties. Until mental wellbeing is perceived as being as important as physical the DOH will get away with treating it as you describe as ‘a cinderella service.’
As for GPs my experience is that they know nothing about mental illness/personality disorder and are happy to keep it that way.
Thanks for your comment Deborah. You may be interested to see this information about the Mental Health Strategy: http://www.dh.gov.uk/en/Healthcare/Mentalhealth/MentalHealthStrategy/index.htm
I feel Andrew Lansley’s dream of returning the control of the NHS back to the GPs is inspirational and brave. I fear the interference by politicians and vested interest parties will ruin the basic simplicity of the concept.
Having been bold enough to propose the concept why isn’t the Government now bold enough to ask the GPs to formulate their own plan on how to effect this change. The GPs will have to manage the change so let them decide how to effect it, and make them responsible for effecting it. Don’t tie their hands by imposing politically driven decisions on the details.
Isn’t the NHS an issue which should rise above party politics? Why can’t we have a political consensus on what’s best for the NHS and therefore for all of us?
The Health Bill is pure ideology. GPs are providers of health care not commissioners, they will be in a conflicting position. Any willing providers means we will be open to competition from EU private health clinics, this could result in local hospitals and services being lost. It may also result in a high number of litigation suits. Commissioning boards need representation from a wide range of health professionals so that decision are made based on expert knowledge. The NHS is the envy of the world, so why would we want to adopt an American system based on ability to pay rather than health need.
These are good points. Turning GPs into spreadsheet slaves will take up even more valuable consultation time that needs to be spent seeing the person behind the NHS number. If anything, GPs need freeing up from admin duties, not becoming part-time administrators.
If doctors had more time to speak to patients this would cut down the NHS drugs bill as half the time a patient feels better for simply being listened to. It would also allow time for patients to present symptoms or health worries that might be indicators of underlying problems which if negelected, need expensive treatment.
This may be why homeopathy “works”, nothing to do with the sugar pills, it is just that alternative therapists spend more time listening to their clients. But that’s another can of pills…
Can we get the basics right?
Clinicians are experts in the provision of healthcare and as such should lead and contribute to the commissioning process. This would work well if it wasn’t for the inherent conflict of interest evident in the present proprosals in this Health Bill.
As independent contractors running small businesses GPs have a huge conflict of interest if they unilaterally lead on commissioning of health services for their patients. All clinical professionals involved in pathways of care should have a say during the commissioning process.
Also in the bill it is suggested that the quality of provision of primary health care should be ‘peer reviewed and challenged’ by primary care itself.
If we do not have clear open and transparent systems that separate the commissioning from provision in primary care we will recreate the conflict of interest that is evident in the present structure. This may explain why the changes required to sustain and maintain the NHS for future generations is still fraught with getting to grips with this basic issue.
Primary care needs to subject to the same quality agenda, as the rest of th NHS.
Regarding the graphic on page 11 of the “Working together” document. This states that 95% of people want more choice over their healthcare. The source for this figure is said to be the 25th British Social Attitudes Survey from NatCen published 2009. I have the relevant NATCEN report here. A quote from page 60:
“we asked our respondents to state which of four possible priorities for the NHS was ‘most important for the NHS to achieve’. No less than 78 percent chose ‘makes sure people who are ill get treatment quickly’. In contrast, just six percent say ‘make sure people have a lot of choice about their treatment and care’…”
I can find nothing in the document that justifies this 95% figure, although this quote might justify the reverse claim. This consultation is a sham and your document a fraud.
David Cameron states;
‘it is only through modernisation that can we protect the NHS.’
What he was meant to say was;
‘it is only through modernisation AND MASS PRIVATISATION! that can we protect the NHS.’
The Councils are going through this don’t expect the NHS to be any different!
The demonisation of an entire profession in ‘Working Together for a Stronger NHS’ is both unjustified and offensive. The ‘we’re not listening we’re preaching’ document is a study in soundbites and misdirection. Many managers in the NHS are highly qualified professionals in multiple business and clinical disciplines. Managers have jumped to the tune of successive governments implementing half baked polictical and bureauocratic backside covering idea’s beacuse they’ve had to not because they agreed. As a country we can’t afford the NHS with year on year rising demand – we get it – we are not stupid. However, there won’t be any ‘listening’ to how we could tackle this without destroying the best of what the NHS has to offer and there won’t be any meaningful debate with the country about that because it’s far easier to blame managers (sorry bureaucrats!!) and transfer the responsibility to Doctors then politicians can blame them instead. Lansley reforms will not deliver anything but more cost and then more bureauocracy to try and stem that rising cost.
I am very concerned about the governement’s current agenda, as they seem to use the deficit as a mandate to savagely cut public sector services, when ideologically, regardless of the deficit, this would have been their stance anyway. The NHS is a fantastic British institution, providing a high quality service. Hi-jacking the vital work of medical professionals, to force them to take on extra work in accounting, sales, competitive tendering, buying stocks of drugs for pateients- is ludicrous. They simply do not have the time, and did not spend years at medical school to do this. Leave the NHS alone. Stop trying to privatise it.
I work for the NHS in a cancer psychology service. This is currently funded by a PCT. Referrals into the service come from hospital based staff, (eg: consultants, specialist nurses in cancer services). As the service is small and time limited (two psychologists work 0.5 WTE / week), referrals are ONLY accepted from hospital staff – none from GPs.
My concern is that once GPs control funding, they may cease to fund services, such as the one I work in, as they do not have direct access themselves and cannot refer their patients.
The government ought to keep its nerve. Always organisation and people with vestiges of interest would try to gain concession. It’s reasonable to include nurses and public health physicians into the commissioning board. However, the hospital doctors and managers must be kept out. Commissioners and provider don’t mix in the same group. Please keep your nerve. This must be done if the NHS has to improve
Little is said in these discussions about how this massive and unpopular change will deal with the
crippling burden of Pfi which is a major haemorrhage of finance
Martin Eastwood
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