Observations Body Politic

The biggest change in health care for a generation?

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c3128 (Published 16 June 2010) Cite this as: BMJ 2010;340:c3128
  1. Nigel Hawkes, freelance journalist, London
  1. nigel.hawkes1{at}btinternet.com

    Are general practitioners willing—or able—to take on as much as 95% of healthcare commissioning?

    Any GP hoping for a quiet life after the hurly burly of the Labour years had better take a deep breath. Behind the unexceptionable principles outlined by the new health secretary, Andrew Lansley, in his first major speech on 8 June lies a major structural reform that will propel GPs to centre stage.

    Mr Lansley sees GPs as the cornerstone of a patient centred NHS, where quality of care will be driven by better access to information and by “empowering professionals to deliver,” as he put it. But, as he wryly added, you cannot empower one group without disempowering others. The gainers, whether they like it or not, will be GPs; the losers, who are unlikely to like it at all, will be strategic health authorities (whose end is nigh) and primary care trusts.

    His speech eschewed any comment on structures, funding, or processes—the means in the NHS by which the rattling train is pointed, more or less, towards its desired destination. All health secretaries are full of good intentions; none …

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