It seems that the Health and Social Care Bill, the legislation designed to cut bureaucracy and fix an NHS that is not quite broken is in trouble. For months now, health unions, professional bodies and respected ‘Think Tanks‘ have described deep flaws within the proposed legislation. To us, despite the length of the numerous papers produced so far, firstly as white papers, consultations and discussions and now as a Bill, it has produced many more questions than answers. How will specialist services be commissioned and managed? How can we be sure that GPs will be willing and able to commission all of the services needed? How can we prevent GPs being part of businesses that are set up to provide services and then giving them huge profits? How can we be sure there will be sufficient levels of accountability? Will there be enough money / people / resources in the system to actually do the work? Will patients really get more say in their care? Do people really want choice or do they actually want a well-functioning local hospital which they can access? Can we be sure this isn’t the thin edge of the privatisation wedge?
It turns out there really are more questions than answers and apparently the bill is to be delayed while more of the answers are explored.
Meanwhile people within the much maligned PCTs are leaving. Last week we had 3 retirement lunches in one particular meeting room, two on one day. 2 colleagues within my own team have found new jobs and will be gone by summer, a third has an interview at the end of next week. We all check the job adverts weekly or even more regularly. The GPs that are currently sorting themselves into consortia are beginning to worry that even if they have the management budget to pay people there may be insufficient useful people around to employ within the new system (that is if they actually employ them since it is now rumoured that there will be some kind of commissioning hub).
I might be a PCT employee but I am not daft. Greater GP engagement and accountability in commissioning would be welcome. Less of a head count in the PCT was desirable and probably necessary. Perhaps public health might be better placed in local authority. But it actually didn’t need to be as nasty as this.
What next? Maybe little will change? Maybe progress will slow? The damage is already done though. We have been tarred as useless managers who do little for the actual patient. When actually I believe we have the potential to do much that is good. We wait and we will see!
Comments on: "A bit of a mess?" (2)
Trouble is most people do not really know much about the running of the NHS and who does what and why. The changes over the past two decades have been put in place with very little public knowledge or understanding. This legislation instigated and led by Andrew Lansley, who really should have known better with his experience, has been slapped together with no forethought or consideration for public interests. This government, as Labour under Blair, thinks it is the employer of, rather than the employee of, the people.
Dave & Nick are strange bedfellows with only money and privileges being the link in common, but that, like the hand-shake and old school tie, speaks volumes. Rotten is what they are, rotten bounders with little understanding of real life. From the NHS to the Armed Forces they are dastardly meddlers. Shame on them and shame on Lansley for doing such a poor job of managing the NHS – but then again the government really do not want to have to run the NHS, Education or Welfare, but they do not want to let go of the purse strings, as I am sure I have said before, and without subsidies neither does the private or charitable sectors.
This was illuminating:
Public Health delocalised
Under the Health and Social Care Bill the responsibility of public health will move from PCTs to local authorities.
First, a definition of “local authorities”, this is from clause 8 of the Bill which inserts a new clause (2B) into the National Health Service Act 2006:
http://torylies.blogspot.com/2011/04/public-health-delocalised.html
One has to say DOH!