Practical steps we can all take to stop the NHS bill

Like anything else, it depends on the individual G.P. My own Gp who works a solo surgery is close to retirement, and cannot wait to bundle patients out of his surgery. He’s not a bad doctor – it is just that he is getting to the stage where he frankly can’t be bothered.

As for GPs transferring treatment from one hospital to another – thats fine if you have a car to go to another area, or lots of time to travel, but what about elderly people and those with young children?

I suspect everyone will live to regret these changes – not least the government

 Efficiency of NHS: recently, Professor Nick Black from the Department of Public Health and policy at the
London School of Hygiene and Tropical Medicine has concluded that the ONS suggestions of no productivity gains are incorrect and that there are likely to have been productivity gains over the last decade.  It was reported on the BBC and in the print media. 

There seems to some confusion here AOB.

I don’t think anyone is saying GP’s are at fault in imposing
this system. Actually- it’s they who will probably experience
the greatest brunt as frontline commissioners of care-
potentially juggling individual clinical decisions about
patients, but with responsibility for far greater competing
demands and fragmented services/pathways of care.

It will also be about costs, at a time of unprecedented
cuts to budgets, which also includes that in social care
and local councils/community services.

PCT’s are being or have been dismantled, who would have taken
on the role of intermediatary and management of services
across the whole sector; also linked to secondary care.
These were whole teams- and many senior people
and expertise from different professions.

I think the rhetoric about this was to reduce bureaucracy
and layers of management.That might be OK in principle
if gradually phased, but managed carefully- and some
important functions and structures left in place.
It should all be based on established and well researched
“identified needs” in each community- but also, national
statistics within the realm of public health, for example.
By the way- I hear about 5 additional layers of management
 have since been added since- which is surely going back
on their stated aims.

As it is, it appears a small group of GP’s have been selected
to carry out some sort of pilot project, followed by
some sort of imposition of change in practice to the majority.
(I don’t know details on this- but the govt claims this proves
that most GP’s accept the reforms, and it’s “working.”
And yet in a recent high profile poll, about 97% of GP’s
rejected reforms.)

I’ve read on informed blogs that GP’s had no choice
but to accept these changes, and yet- this is before legislation
has been passed.
(I think I may have heard D.Owen commenting about this also.)
There’s so much information and concern it’s hard to keep tabs
on what’s happening.Also- peers in HOL- many medical experts
there reported, and constant changes and amendments;
one has to question why so much energy and huge cost
has gone into this- when very few actually support.

Also as said- it’s not just about GP’s.
It’s all the integral parts, professionals, patients and people that are joined up
to deliver a care package that are tailored around individual needs.

For example- in primary care- teams consist of community
professionals such as midwives, health visitors, paediatricians,
district nurses, school nurses, practice nurses, mental health teams,
counsellors,physiotherapists, occupational therapists,
haemotologists, care assistants, reception staff and administors.
(Not sure where occupational health fits in.)

Very doubtful as to whether any of these groups have been involved
or consulted in the planning stages of reform, and yet expected
to carry them out?

Then there’s the referral pathways, eg to social care, social services,
hospitals, NHS direct etc; ambulance workers.

My point is-by breaking up services and creating a postcode lottery,
based on competition, partially profit based by influx of private companies;
(eg management/finance in GP surgeries) this is likely to create
far more complexity and even conflict of interest.

GP’s are generalists- not specialists; some of them have specific skills
through additional training- there’s also great variability in level
of experience.They are certainly not trained to be managers
and accountants- but purely clinicians.Their role may be compromised;
the scale of these top down imposed changes could create unbearable pressure
upon a system already dealing with very large caseloads and huge demands.
Frankly, I doubt the capability of some to cope with the immensity
of becoming frontline commissioners in addition to their challenging role.

The principle of professionals having autonomy over care provision
is OK- but this is totally the wrong approach.
Not only that- but the reforms are being enacted at the same time
as expectation of ?millions to be saved in a short space of time.

It’s a recipe for disaster, and it seems a far greater consensus
out there than a few individual blogs: professionals, patient representatives,
research journals, medical and public health experts, and a lack of confidence
from the public themselves, judging by polls and petitions.

Thanks, J.