GPs cast doubt on health procurement reforms

Bit of a 'healthy' day today so far....The Royal College of GPs has written to the Government about the proposed changes to the NHS and their leader has been all over the BBC this morning.

She's making some points that we've raised before, in particular, how 'any willing provider' will work without it leading to cherry-picking and the most profitable work drifting away to private providers? They've also raised the spectre of patients having to pay for treatment, something I hadn't seen as a likely consequence, and the reforms leading to the end of a truly 'national' service, as each local consortium makes different contractual  arrangements for services.  But the GPs are, perhaps not surprisingly, happy about the general principle of GP Commissioning.

Well, they would be, wouldn't they. We're still worried about conflict of interests here; we need safeguards to ensure GPs don't cherry pick themselves the best bits of work, acting as both the purchaser and the provider. And let's remember that the GPs have a long history of absolutely slaughtering the Department of Health in their pay negotiations, so let's hope the Government doesn't look to buy them off again here.

And as my friend David Atkinson pointed out on Twitter this morning, as he queued at his GPs surgery, not for treatment, but just to make an appointment (being unable to get through on the phone), why should we trust GPs to spend £60 billion a year of public money when many of them can't even run a halfway decent customer-centric appointment system? Here's David on Twitter (@DAtkinson4PC) :

If we give commissioning to GPs, patients won't die on the ward; they'll expire whilst hanging on the phone trying to make an appointment.

Anyway, my overall take is that it looks bleak for the Health reforms in their current guise. They may end up watered down so much that we don't get the benefits that I do believe competition could bring; yet we'll still see considerable disruption and cost of change, even if the change becomes relatively minor. And as the flood of (unaffordable in the long-term) increased health funding under Labour becomes a trickle, my guess is that whatever happens, the NHS will be a problem before the next election.

So if I was Mr Cameron, and being cynical (which I don't think he is) I'd actually be very happy to let the Lib Dems take 'credit' now for changing the plans; then when it all goes wrong anyway, the PM can say, well, our reforms would have worked of course, but Clegg and friends screwed it up... The press has made much of Clegg acting as a 'human shield' for the Tories in terms of the cuts generally; why not let him carry the can for the NHS as well?

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