The rhetoric used by the government to support their proposals is
about giving control to local GPs over local services. This seems
remarkably similar to the rhetoric that was used by a previous government
to justify the invention of PCTs. I suspect that in a few years or less,
GPs will have no more control over the consortia than they do over the PCT
now.
In practice, most GPs I know seem to be busy enough looking after
patients, without having time to manage large budgets and commissioning
negotiations. In secondary care, agreeing a service model with one or two
local PCTs is a lot of effort - repeating the exercise with multiple
commissioning consortia will be a nightmare. And if the consortia are as
big as the current PCTs, what is the point of the cost of reorganisation?
The market model will never successfully deal with public health,
student and junior professional training, and complex cases. Muliple
consortia with different priorities will result in increasing postcode
lottery, and increased management costs as providers have to negotiate
with multiple commissioners.
When the LibDems were perceived by students to have broken their
manifesto promise over tuition fees, the students took action. Whether or
not you agree with the students position, or the mode of action taken by
some, at least they have given a clear message to the government of their
unhappiness. The larger coalition party has broken its election manifesto
promise not to introduce major NHS reorganisation. Most of us are unhappy
with the proposals. Why can we not send as clear a message to the
government about the NHS as the students did about fees, albeit in a
hopefully more mature and less destructive manner.
Rapid Response:
Support for Peedell and colleagues
I support this letter.
The rhetoric used by the government to support their proposals is
about giving control to local GPs over local services. This seems
remarkably similar to the rhetoric that was used by a previous government
to justify the invention of PCTs. I suspect that in a few years or less,
GPs will have no more control over the consortia than they do over the PCT
now.
In practice, most GPs I know seem to be busy enough looking after
patients, without having time to manage large budgets and commissioning
negotiations. In secondary care, agreeing a service model with one or two
local PCTs is a lot of effort - repeating the exercise with multiple
commissioning consortia will be a nightmare. And if the consortia are as
big as the current PCTs, what is the point of the cost of reorganisation?
The market model will never successfully deal with public health,
student and junior professional training, and complex cases. Muliple
consortia with different priorities will result in increasing postcode
lottery, and increased management costs as providers have to negotiate
with multiple commissioners.
When the LibDems were perceived by students to have broken their
manifesto promise over tuition fees, the students took action. Whether or
not you agree with the students position, or the mode of action taken by
some, at least they have given a clear message to the government of their
unhappiness. The larger coalition party has broken its election manifesto
promise not to introduce major NHS reorganisation. Most of us are unhappy
with the proposals. Why can we not send as clear a message to the
government about the NHS as the students did about fees, albeit in a
hopefully more mature and less destructive manner.
Competing interests: I am employed in the NHS.