Wednesday, 15 December 2010

NHS reforms – is Lansley throwing the baby out with the bath water?

Andrew Lansley the UK Secretary of State for Health announced today that he is giving even more powers to GPs by handing them responsibility for maternity services. So yet another item is to be added to the already unrealistic ‘to do’ list for GPs.

Lansley insists that the consultation process demonstrated that a ‘very large number of people were happy about the changes’ as he outlines his plans in an operating framework which surprisingly (not) appears to differ little from the original plans published. I wonder how large is ‘very large’ and, thinking back to David Cameron’s recent foray into happiness measurement of the nation, I wonder what ‘happy’ means in this context too.

Certainly there is a ‘very large’ number of people in the know, working in and alongside the NHS, who are ‘not happy’ with this operating framework.

Dr Laurence Buckman, chairman of the BMA GP committee stated ‘Andrew Lansley doesn’t appear to have heard our concerns and has not changed anything much’

Dr Claire Gerada, Chair of the Royal College of General Practitioners (RCGP) supports the reforms in principal but states ‘we still have a number of questions. These include the pace of change and how this sits alongside having to make unprecedented savings, how to balance patient choice with health inequalities….and how the policy of  any willing provider may impede the development of effective coordinated services as well as drive up the cost’.

These two organisations are not the only ones who have questions for Mr Lansley.

Why the indecent haste for these changes? The already wobbly ship of the NHS is becoming even harder to steer as the speed of reform increases. GPs, many of whom are still unsure about forming consortia are now faced with additional responsibility – for commissioning maternity services. Generalists are being given an increasing slice of a pretty unpalatable cake which would taste so much sweeter if each section was allocated to the appropriate area of expertise,

Ask any patient what they would like from their GP and I guarantee that a ‘very large’ number would state – ‘more time’. I wonder how Andrew Lansley supposes that these reforms can provide patients with increased, higher quality contact with their local GP?

So we have a government galloping headlong into change, without stopping to appreciate the excellent work already in process in hospitals and PCTs. Change for changes sake? I don’t think that anyone would disagree that the NHS warrants some reforms, but to heap all the responsibility and funding onto only one part of the patient pathway and to reject the opportunity to build of the expertise already gained really is an extreme example of throwing the baby out with the bath water.

As the beloved Harrier Jet took it’s last flight today, whoever would have thought that an RAF pilot and an NHS manager would have so much in common?


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