Cautious reaction to NHS reforms
By Pat Holt THERE has been a cautious welcome on Hayling to the Government's proposals for a radical reorganisation of the NHS system in England.
Doctors and patients on the Island have been struggling to grasp the full implications of the new white paper, which was published on July 12.
This 57-page document, entitled 'Equity and Excellence: Liberating the NHS', sets out ambitious plans to give front-line staff more control over spending and decision-making in the Health Service.
Key proposals
GPs would work together in groups - called consortia - to take responsibility for spending a large part of the NHS budget. This would be compulsory: every GP practice would have to join a consortium
Patients would have more access to the information they need to make choices about their own health care. The White Paper promises: "Patients will have choice of any provider, choice of consultant-led team, choice of GP practice and choice of treatment"
Management would be transformed. Primary care trusts and strategic health authorities would be axed, with the aim of reducing NHS management costs by more than 45 per cent over the next four years
Drugs: A new Cancer Drug Fund would support patients to get the drugs their doctors recommend
Dentists: A new contract is proposed, intended to increase access to NHS dentistry.
Timetable
Many commitments made in the white paper will require new laws, which would have to be passed by Parliament.
If this is achieved, there would be rapid change in the next three years. The Cancer Drug Fund would operate from April 2011.
Patients would have a free choice of GP practice by 2012 and GP consortia would take full financial responsibility from April 2013.
Reactions
Paul Fisher, who is chairman of Hayling Island Residents' Association, accepts the need for NHS reform.
He said: "As a patient, I am aware of the various strengths and weaknesses of the NHS as it is currently structured.
"I am also aware of the demographics of the situation – the massive increase in the numbers of people coming to retirement and later years, as the 'baby boomer' generation has its effect – all this at a time of great economic and market uncertainty, coupled with difficult financial conditions...
"Having given the subject a cursory look over, the proposals are well-presented and no doubt many aspects of the NHS are inefficient and over bureaucratic, with much wastage.
"You can't really argue with 'Equity and Excellence: Liberating the NHS'.
"There is much consultation yet to come before the reforms, in whatever form, are implemented.
"However, there is no guarantee that the reforms will work and the process is going to be very painful."
Mr Fisher thought the changes might improve the services offered to Hayling patients.
He said: "It is quite possible that this more direct control may have some benefits locally.
"For example, many more out-patient department (OPD) consultations could take place in the clinic, as well as minor surgery and other forms of treatment currently requiring a hospital visit."
He was more sceptical about the proposed abolition of GP boundaries, which would allow patients to register with any GP.
He said: "I have mixed feelings about this one. On the one hand, it could reduce some apparent unfairness and anomalies, but would a Hayling doctor visit a patient in Midhurst? I think not!"
Anne Torode, who is chairwoman of the Patient Participation Group at the Elms Practice at Hayling Health Centre, thinks the proposals could be beneficial.
She said: "I would like to know a heck of a lot more about this initiative before making an informed decision on the subject.
"But my personal view, as of today, is that I am a firm believer in reducing the layers of bureaucracy and I believe many
"GP practices will continue to provide and improve upon the level and number of services available to patients.
"However, alongside responsibility comes accountability. This is even harder, as we will expect doctors to manage budgets.
"What now constitutes a practice could fast become a viable/non-viable practice/business – unless these people have the right management capabilities – or employ the correct management, resulting in more overheads.
"We all know change costs a lot of money. Lord knows, it seems to be one of the major constants in the health service over the past few years.
"On balance, I'm for it, as long as the implementation is given enough time and there is unanimous willingness among the GP fraternity for it to work."
Doctors at the Island's Health Centre were still digesting the full implications of the White Paper, as the Islander went to press.
But Dr Hamish Meldrum, chairman of the British Medical Association Council, said: "The proposals announced in the White Paper will have a substantial impact on the NHS and patients.
"We are looking forward to discussing the details behind these new initiatives in more depth and playing an active role in the consultations that follow."
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Friday 25 May 2012
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