19th January 2011
Royal College of General Practitioners responds to the Health and Social Care Bill
RCGP Chair Dr Clare Gerada has issued the College's response to the Government's Health and Social Care Bill.
She said:
“The RCGP supports the overall principles of a National Health Service, led by clinicians with patients at its centre, that strives to deliver the best possible care and outcomes for all.
“As GPs, we work in partnership to understand what our patients want and need from their health service. It makes sense for health professionals - both GPs and our specialist and social care colleagues - to be involved in the planning of services and in the allocation of contracts for these services. It also makes sense for doctors to work with managers to help implement, monitor and review these contracts and to encourage the development of new services as needs arise.
“The College believes that good commissioning is about being a good GP. It is about understanding the impact of clinical decisions on the public’s health and purse, the need to practise safely and effectively based on evidence, and how the needs of patients can be best served through the design of services that meet their needs. Good commissioning is about engaging in clinical dialogues with colleagues in health and social care, and establishing effective channels of communication between patients, the public and elected representatives.
“It is our view that this is best achieved through co-operation, collaboration and competition, but only where it adds value. We continue to have concerns about how the Government plans to implement its proposals.
“Depending on how the reforms are implemented, we must guard against fragmentation and unnecessary duplication within a health service that is run by a wide array of competing public, private and voluntary sector providers, that delivers less choice and fewer services, reduces integration between primary and secondary care and increases bureaucratic costs.
“While we recognise the principle of patient choice - and know that many patients value being given access to information and choices about their healthcare - the Government needs to strike a much fairer balance between the rights of the individual and the efficiency and effectiveness of the NHS as a whole, as well as taking the broader needs of society into account.
“The College is concerned that some of the types of choice outlined in the Government’s proposals run a risk of destabilising the NHS and causing long-term harm to patient outcomes, particularly in cases of children with disabilities, those with multiple co-morbidities and the frail and elderly.
“While the Government has sought to reassure us, we have yet to be presented with sufficient evidence to underpin these reassurances. We look forward to reading the detail in the Bill and having further dialogue with the Government about this.
“At a time when the NHS is being told that it needs to find £20 billion of savings no evidence has been presented that demonstrates that the health care market approach has increased quality and helped to manage costs. Not only will the reorganisation be hugely expensive but the administration and transaction costs of running a market are vast. The previous Health Select Committee report on Commissioning found that the last 20 years of commissioning had led to increased transaction costs estimated to be 14% of the total NHS budget.
“The publication of the Bill is a key stage in the development of the Government’s plans for the future of health and social care, but it is not the end point. GPs want this to work for the sake of our patients and we will work constructively with the Government, the Department of Health and others to achieve this. However this cannot be done in a way or at a pace which puts quality or patient safety at risk.
“The NHS has for more than 60 years delivered a fair and efficient system of healthcare for millions of patients. We acknowledge that improvements can always be made, but we must work with the Government to protect the founding principles of the NHS; the stakes are too high to lose it now.”
Source: The Royal College of General Practitioners
FURTHER INFORMATION
RCGP Press office – 020 3188 7576 / 7575 / 7574
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