9 May 2011

College Puts Pressure On PM Over Health Reforms

The Royal College of General Practitioners has written to Prime Minister David Cameron listing changes that must be made to the Health Bill to protect the principles of the NHS. 

In its analysis paper, The Government’s Health Reforms: An Analysis of the Need for Clarification and Change, the RCGP provides evidence which refutes the need for wholesale reorganisation of the health service, and calls on the Government to protect the principles of the NHS by exercising necessary change or clarification on the following areas of the Health Bill:

  1. Comprehensive Health Care
  2. Charging for Health Care
  3. Issues relating to Market Forces in Health Care
  4. Issues relating to EU Competition
  5. Accountability and Conflicts of Interest
  6. Resource Allocation and Risk Pooling
  7. Practice Boundaries
  8. Workforce and Training Issues
  9. Confidentiality

Topping the list of changes is that the Bill should make it clear that the Secretary of State has a duty to provide – or secure provision of – a comprehensive health service throughout England.

At the heart of the concerns is the lack of clarity over the impact on patients. The legislation and reform agenda does not sufficiently spell out the protection of patients and services in the desired competitive market.

In addition to the nine key areas, the College has made 24 recommendations for the Bill, which include:

On Practice Boundaries

That the proposal to undermine the relationship between a local GP and local patients, by abolishing practice boundaries is revised.

On Charging for Health Care

That commissioners or providers should not be able charge patients for health care services that are currently provided free by the NHS or are recommended by NICE.

On Issues Relating to Market Forces in Health Care

That the Bill should place a duty on Monitor, the NHS National Commissioning Board (NCB) and GP Commissioning Consortia (GPCC) to enable collaboration to provide integrated services to meet patients’ needs without fear of a competition referral.

On Resource Allocation and Risk Pooling

That there is clarity as soon as possible as to which allocation formula will be used by GP consortia for commissioning hospital care.

and on Confidentiality

That there is as an absolute assurance that the Bill will not force doctors to breach their duty of confidentiality.

The recommendations aim not only to protect the principles of the NHS, but also to make provision for the NHS of the future, addressing issues including GP shortages and the need for enhanced GP training to ensure that future GPs are confident as well as competent in delivering high quality care to patients in an increasingly complex healthcare environment.

The paper argues that changes and improvements could be brought about by models of care such as GP Federations, where practices can pool expertise and resources to deliver broader services to patients close to their homes.

RCGP Chair Dr Clare Gerada said:

“We understand that the NHS needs to change, and we have said all along that the College is not opposed to health service reform."

“The Bill is attracting a lot of opposition, but this paper sets out our comprehensive analysis of RCGP concerns, based on evidence, which we hope the government will act upon as the Bill continues to pass through parliament."

“The RCGP will continue to promote the development of high quality, effective patient centred care, with GPs at the heart of NHS service delivery. The reforms promote competition without sufficient clarification of how services to patients will be safeguarded and improved. We believe that provider side reforms could deal with many of the issues without the need for repeated organisational change or by many of the proposed reforms.”


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