Biggest threat yet to health service

From: Mike Simpkin

Sheffield S8

Your front page story of January 20 says that the city’s GPs are “leading the way” at the forefront of the government’s health reforms. Forefront is an ambiguous word, which could mean sharp end (true) or vanguard (maybe/maybe not). I do not know what proportion of local GPs actually support the reforms, but I suspect that many may not.

Consistent hard work and collaboration between agencies over many years have endowed Sheffield with many high quality and leading services across both primary and hospital care. In the last few years good NHS Primary Care Trusts did their utmost to develop networks of local GPs to become meaningfully involved in healthcare commissioning and I imagine that the current consortia of Sheffield GPs were developed in this way. However the current government proposals go much further. They will place most local commissioning in directly in the hands of GPs who will either themselves have to extend their involvement in business matters (and become less available to patients) or will have to employ commissioning managers and advisers to assist them. Who will these be? Almost certainly private companies perhaps employing many of the self same former PCT managers. And who will provide health care? There will no longer be any preference given to NHS providers, which in practice means that more and more health care contracts will be awarded to the private sector especially for less expensive and more profitable work. It is not surprising that evidence is emerging of the large scale contributions of private health care companies to Conservative Party coffers.

An editorial in the British Medical Journal warns “What do you call a government that embarks on the biggest upheaval of the NHS in its 63 year history, at breakneck speed, while simultaneously trying to make unprecedented financial savings? The politically correct answer has got to be: mad…..Informed opinion about GP commissioning, past and present, has been almost universally negative.”

This week even the Department of Health said it will actually withdraw the purchasing of ‘flu vaccine from GPs. And the costs (in money, people and material) of reorganisation will be far more than is currently admitted.

Sheffield health practitioners have often developed pioneering and successful initiatives to defend and improve our National Health Service. Our GP consortia may be better prepared than many to implement the new structure but, if so, this should be viewed as a defence against the dangers of the new proposals, not as the yellow brick road to a healthcare Oz.

I hope that our primary care leaders will not be seduced into becoming a flagship for the biggest threat to the NHS yet to be devised.