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More NHS shake-up is the last thing patients and our wallets need

14 July 2010

This week, Coalition Government health secretary Andrew Lansley has announced yet another re-organisation of the NHS in a Government White Paper.

Under his proposals the NHS, already weary from years of restructuring under Labour, now faces the prospect of reorganisation on an even bigger scale.

GPs - our local family doctors - are likely to be asked to manage a budget of more than £60 billion so that they will have responsibility to commission - essentially to buy in and decide what types of healthcare services are needed for their local communities.

At present NHS primary care trusts working across an area about the size of Brighton and Hove undertake this vital function. They have the expertise and professional background to enable them to do it.

But no one has really asked GPs if they are able to do it and if they want to do it.

Why would they want to practise healthcare management with all its budgets and bureaucracy when they opted for a professional vocation caring for individual patients - providing medical care?

Meanwhile, primary care trusts and their regional health authorities will be abolished with more than 20,000 people likely to lose their jobs in the process.

In these challenging times for public finances, further disruptive reorganisation is the last thing the NHS, patients and healthcare professionals need if we are to achieve the highest quality patient care.

Nigel Edwards at the NHS Confederation, which represents NHS organisations, has warned that the reforms could lead to the health service looking more like the "gas and telecom market" than the NHS we've been used to, and that the proposed changes will create "a market dynamic."

Increasing the role of the market in the NHS will not make it more efficient, nor make the NHS more responsive to patients needs.

Instead, an increased role for the market will fragment care and increase the costs of provision.

As any economist will tell you, markets need mechanisms to operate.

For the NHS, that means increasing the number of managers and accountants, which will result in a cut in front line services, just the opposite of what Andrew Lansley announced he wanted a few weeks ago.

By expanding the role of the market, handing powers to consortia of GPs, privatising hospitals, and scrapping important targets, the Coalition Government is creating the perfect conditions for high costs, poor practice, unaccountability and long waiting lists.

Lansley's plans will also ensure that there is even less health care to go round with our aging population.

I'll do my best to put the case in Parliament that there are better ways to ensure value for money and achieve high quality patient care than this needless, wasteful reorganisation.

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