Govt, NHS Reforms and Me

Posted on November 16, 2010 by jojimmy.com

What about the dramatic reforms that’s happening in the NHS now.

The idea is to give powers to people – sounds good. So who knows people’s health needs best – of course their GPs. So that’s why they call it “GP lead commissioning of health services”. Well, sounds good again. So all of us will get what we need? Uhmmm – not exactly. GPs will decide it – they know better what you want

Current system:

On a general overview it’s like this. England is divided into 10 regions; each region has a Strategic Health Authority (SHA). And under each SHA there are some Primary Care Trusts (PCT) and Acute Trusts. Acute Trusts provide care through hospitals, etc; PCT’s main responsibility is to commission health services in their areas, including GP services; and SHA has the overall supervision and monitoring for the region. For each patient treated in Hospital/seen by GP, govt pays for it. These payments are routed through / approved by PCTs and SHAs.In short, acute trusts and GPs provide care, PCT commissions primary care, SHA is sort of senior responsible officers. This is only a rough idea of the system, it’s in reality very complicated.

New proposal:

One theme new policy proposal is to give the commissioning powers to GPs and abolish all PCTs. GPs will be given the budget money directly and they can spend it directly. Merit – GPs know well about patients. So getting some GPS collectively make decision on what health services are to be commissioned will be good. Demerits – GPs don’t know commissioning at all; GPs are not exactly employed by anyone but by themselves – GP surgeries are business, not like your hospital or community nursing care. Giving them power and money? There are all possibilities that quality of care will be compromised as business minded GP service owners will be looking for cheaper options rather than best quality options. PCTs were public employers and there was nothing for them to gain if they compromise quality or value for money. So people were assured that if they get some service they would have been of acceptable quality. And quality and performance of these services including that of PCTs were constantly monitored by SHAs.

There are further issues on how these GPs will cork collectively as govt mentioned “GP consortia” – the more likely chance is that more tax-payers money will be wasted on sorting out the issues with these consortia, within these consortia, and between these consortia –  let alone setting them up.

Another aspect of the new proposal is information in decision making – by whom? By patients itself. About their health care. How? They are supposed to feedback on the care they received and organisations will be rated on the basis of these feedbacks and later patients can go for the care provider who has the best rate. Would all these really work? God knows! First how many patients have the time and facility to provide feedbacks. If somebody provides the facility to monitor and manage feedbacks and ranking system, who is going to pay for it (no doubt, citizens). Then, again, how can we make decisions until these feedbacks reach a minimum number/minimum period that a reliable rate is available? Thirdly, how do people get these ratings readily accessible when and where they want to make a decision? What are the provision for emergency decisions? Then again, when a care provider has a good raking, there are all possibilities of a rush of demand for services from them, which will indeed end up in huge waiting lists or people has to go for the poor performing low quality  providers. Also, how will patient’s personal bias be eliminated from the rating system. So many questions to answer.

There are so many other aspects – You can write thousands of pages and for many months if you want – there are that many issues in there. I am bored.

I agree to the motives of the new government –the ultimate aim is better health in society. They are young blood, highly educated, need to show off, need to test their ideas, aggressive, can’t wait for anything, don’t want to ask people before announcing something, all sort of bad boy symptoms they have. They only think about and talk  the pros – they totally ignore cons. Forget all about it – imagine all above mentioned issues does not exist. Still is this the right time to do some experiments like this. When the country is in so called deficit for money (remember it’s the govt in deficit, not people, and govt is desperately trying to make us poor as well), such a large scale change is totally unnecessary. By abolishing PCTs, SHAs and a lot other agencies at this time of economic downtime is only help to create tens of thousands of people unemployed and their personal/family life ruined.

From my side, personally, govt is going to make me unemployed by April 2010. If they were doing all these experimental reforms some other time when economy and private sector were back in good shape, I would have some hope for another job. This is going to crash my financial position and my family well-being. This is not just my case – there are thousands of families going to end up in the same situation. Well done deaf and blind new government.

Whatever you ask the new govt, only one thing they have got to say – blame the old govt. – is this helping us in any way???

Posted on
Tuesday, November 16th, 2010
Filed under:
Society & Govt.
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JIMMY JOSEPH