Intended for healthcare professionals

Rapid response to:


Reorganisation of the NHS in England

BMJ 2010; 341 doi: (Published 16 July 2010) Cite this as: BMJ 2010;341:c3843

Rapid Response:

Re: No Evidence, No Consultation, to Reorganisation of the NHS

Very well said Dr Gada. We need an NHS where local GPs, Consultants,
Managers and local 'Lay' representatives from Council and patient
representatives make decisions. I do hope the White Paper gives us
that opportunity.

Practice Based Commissioning (PBC) leads would work with the Trust
Medical Director and local consultants to decide what is best for our
patients. The NHS should always be for the patients, by the patients and with
the patients and hence there has to be strong patient representation as
well representation from the councils and of course managers. We should
not forget that modern medicine is about team working and we do need
representation from our nursing colleagues. A Public Health Director must be
an integral part of such a team.

Such a team which has good clinical representation and true clinical
leaders working with the patients and public is the ideal way to manage
our NHS.

It is only when we have true Medical Leadership that we can make our
NHS a very strong institution.

Here are some tips to save money:

1. Each doctor reducing prescription cost by 10% would save £1
Billion to the NHS.

2. Increasing efficiency in our theatres would save probably 2
Billion a year.

3. Cost effective prescription by every PCT would save £500 Million a

4. Reduction in patient safety incidents would save £3 Billion a

5. GPs and consultants working together and avoiding unnecessary
admissions, early and effective management of patient illness and early
discharges would save another £6 Billion!

We have got to work as a team and make our NHS good value for the money
and the best healthcare system in the world. The white paper probably gives us
some opportunity.

Together we can and together we will.

Competing interests:
Dr Prabhu is a Medical Director.

Competing interests: No competing interests

25 July 2010
Umesh Prabhu
Medical Director