NHS reforms: GPs losing faith, BBC poll suggests April 2012
Dr Mike Dixon of the NHS Alliance December 2011:
Dr David Jenner:
Dr Rick Stern:
Ivan Benett FRCP FRCGP M.Med.Sci. Dip. Cardiol. GPwSI in Cardiology & Clinical Director of Central Manchester Shadow Clinical Commissioning Board:
The NHS provides universal coverage for healthcare and is a cherished institution, but this doesn’t mean it should be immune from reform. It is expensive and inefficient, by which I mean we could do twice the amount for the same money. This would be good for everyone. The question is, how do you do that?
The way NOT to do it is to introduce market principles into the running of the service through Privatisation. Unfortunately this Privatisation was begun by the Labour government and has been continued by the present government without a popular mandate.
However, we are where we are with the democratic process we have. There was opportunity to vote against Privatisation in Withington constituency the election before last!
So, I believe I must now work within the system to achieve our socialist aims. This for me means continuing the universality of provision and addressing the inverse care law, speaking up for the disadvantaged and disenfranchised, and improving access to health care for all. If NHS service need to be tested against private providers, I am confident that they are up to the challenge. However, I don’t see this scenario being the predominent one. Where efficiancies can be got, is through competition between NHS providers.
Take for example service X, which has always been run by NHS hospital A. They are set in their ways and there is no one to make them modernise, change or become efficient. With the NHS reforms, we as commissioners can now say to NHS Hospital B, can you provide this service at a lower cost, while maintaining or improving quality of service?
Where a hospital has a monopoly – neurology services at Salford Royal for instance, they are impervious to arguements for improvement. In cardiology there are two major hospitals providing this service and they can be made to listen because of the competition there is for work between them.
Another example. Much of health service expenditure is on management of long term conditions. If not managed well, then people get sick and need to go into hospital. If they were managed better they wouldn’t need that admission. Improving management means providing better, higher quality skills within General Practice.
The NHS reforms allow for investment in education and upskilling of General Practitioners to provide that care. For instance, we have halved the admission rate from heart failure by education of practices in this area. This is good for the patient and their families (not ill), good for the practice (professional pride) and good for the NHS (cheaper). That resource can then be used elsewhere to improve care.
Why GPs and not managers to run the NHS. GPs have daily exposure to patients who have their stories of the NHS. Where there are failing we get to hear about it. As clinicians we can also have clinical conversations about care pathways with secondary care counterparts and so improve care throughout the episode of illness, and even prevent the illness in the first placce. GPs also get to evaluate the specific health needs of each individual in the consultation and so rapidly become aware where the gaps in health care provision are. We can then feed that knowledge into commissioning new services or improving the existing ones. This knowledge is not available to non-clinicians.
The NHS reforms offer the opportunity for like-minded GPs to run the system along these lines. The alternative is to allow Tory-Libs to have their way and privatise the NHS. I want to be on the inside fighting for the NHS, not outside watching it’s collapse.
I hope this is clear and you can send on if you wish. Fortunately I am in just such a position, and will fight for the NHS from where I am against Tory Liberal and Labour governments.
Why the BMA is opposing the whole Bill
Doctors Warn NHS Reforms Will Do ‘Irreparable Harm” October 2011
NHS reform risks ‘wrecking patient-GP relationship’ October 2011
Doctors think NHS reforms bring more risks than benefits June 2011
GP group backs NHS reforms in Telegraph letter May 2011
Poll of Doctors’ opinions March 2011