Wednesday, 4 April 2012

NHS Reform – what next?

As predicted, Andrew Lansley, UK Health Secretary has had his way and the Health and Social Care Bill has been passed.

It was interesting to watch Mr Lansley being interviewed on TV over the weekend. With the legal mandate safely secured, he was much less defensive and more confident in trying to explain just how the reforms will improve patient care and save money. One has to admire his resilience and self-belief, and his absolute determination to push ahead with this top down reorganisation of the NHS despite so much vociferous opposition from powerful adversaries.

Maybe it’s the pseudo petrol crisis, the hoo-hah about tax on hot pies or just the prospect of unlimited chocolate on Easter day, but all seems very quiet on the NHS reform front at the moment. A lull before the storm? I don’t think so – possibly the reverse. The storm has blown itself out and the lull follows.

After all the excitement (the debate has kept the pages of this blog busy for over a year), it all feels like a bit of a damp squib. The posturing and politicing, pausing and reflecting, debating and demonstrating, letter writing and voting has all been to no avail for the anti-Bill lobby. Just for the record, anti – Bill is not the same as anti-reform and I suspect that the majority of those closely involved with the NHS would agree that some improvements and efficiencies were badly needed.

As extensively reported, many of the changes listed in the Bill are already underway. Hospital managers are looking at ways of controlling increasingly tight budgets and coming up with constructive ways to work with the private sector to make best use of resources and reduce costs or increase income. Some GPs are either engaged in learning more about the commissioning game and enjoying some new found power while others are suffering in silence and struggling to balance patient time with administrative burden. Other GPs, possibly an alarming number, will be seriously considering early retirement to avoid the new regime. Health workers will be an unwilling audience as some layers of beaurocracy are deconstructed and replaced with other, unfamiliar ones.

What does this all really mean for the millions of stakeholders directly affected by NHS reform? Only time will tell.

And what about patients? They will be the real judges of what happens next.


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