Senior clinicians warn reforms could reduce quality of care

The coalition Government is all set to publish its Health and Social Care Bill later this week, which would see the biggest transformation of the NHS in its six decade long history. 

The Bill would propose that GP consortia would take over healthcare commissioning in their local communities replacing the Primary Care Trusts and Strategic Health Authorities, and would control almost £80 Billion of the NHS budget. Senior clinicians from the BMA and Royal College of General Practicioners have argued that these reforms could undermine the health care of patients.

However, the Government rejects the claim that its reforms would harm healthcare in England.

They believe that reforming the current PCT structures would have achieved the same results without compromising quality of healthcare. Further, heads of six health unions have written in the Times expressing “extreme concerns” about the government’s plan to bring about more competition within the NHS and provide a bigger role to the private sector.

A report published by the NHS Confederation published over the weeked claimed that hospitals might be closed due to the reforms, as GPs could commission services from private health care providers. The Government has rejected these arguments, but face growing criticism.  The decision to seek £20 Billion in efficiency savings within the next four years while these reforms are being implemented would force PCTs and other health bodies to pursue a “dangerous” path which would reduce the quality of care provided by the NHS, John Black, the President of the Royal College of Surgeons have claimed.

According to Mr. Black, increasing number of NHS trusts are scrapping elective surgeries in a bid to save money.  His concerns were echoed by the Patients’ Association, which is getting worried calls from patients whose operations have been cancelled and not rescheduled.

“Why are patients having to suffer in order to balance the books?” said Katherine Murphy, its chief executive. “I would say to the NHS, think again and think hard, don’t make patients the victims of budget cuts and save the money elsewhere.”

Leading GPs argue that the Government could have achieved better commissioning by putting more GPs on the board of the PCTs which are currently responsible for commissioning health services. Presently, each PCT board must have one GP on it and some have two or three.

“You could have simply mandated to ensure GPs had more of an influence on PCT boards – and achieved largely the same results,” said Dr Clare Gerada, the chair of the Royal College of GPs. “You would probably want a majority of clinicians, mostly GPs but other NHS staff too. It is not too late to change.”

“By doing that GPs would have become heavily involved in making the decisions, we could have still made management savings, but without all the upheaval that the NHS is going through,” she added. The BMA’s Dr. Laurence Buckman agreed with Dr. Gerada but he expressed concerns about the creeping privatisation of the NHS.

However the government rejected the suggestions arguing the PCTs are “too remote from patients.”

“Simply putting more GPs on a PCT board would not have delivered the changes that are necessary, and would have simply added more layers to the existing NHS bureaucracy,” a Department of Health spokesperson said. “”Commissioning by GP consortia will push decision-making much closer to patients and local communities and ensure that commissioners are accountable to them.”

NHS senior managers in Whitehall also pointed out that the government does not want the efficiency savings at the cost of patient care.  Professor Sir Bruce Keogh, the NHS’s medical director, said: “Providing the best possible care for patients is our priority.”