Govt White Paper on NHS-reforms will cost billions to implement and will see further privatisation of healthcare.

No argument from me NL
PCTs have got bigger and bigger, ironically to commission better, world class in fact. I don't automatically think this new idea is a bad one but it does seems a bit knee-jerk "do the opposite of the last government" to me

"gp consortia will be nhs bodies"

PCGs then?

oops that was 3 things not two

couple of things

1. gps will not commission specialist, maternity or other family health services (dentistry, pharmacy etc)
2. gps will not get to retain a share of the profits from clever commissioning. the gp consortia will be nhs bodies. arguably, this may decrease the likelihood of success, as they have no financial skin-in-the-game. I suspect we will see more detail of how that particular circle is squared in coming weeks.
3. another big open q is what happens to non-primary care services that GPs currently provide as a business (eg dispensaries, physio, etc GPs often run businesses like this which sell services to PCTs). the white paper implies that this will not be allowed in the future. How they are going to persuade GPs to sell these businesses off is not spelled out it also pushes against full integration of care

right thats decided it - i'm off to read the white paper in bed and hopefully it wont give me nightmares!

(Oh, and the postcode lottery v. local choice issue is massive and not easily resolved at all. One man's freedom fighter and all that...)

To be fair (aargh!) to them, they did mention change But in that woolly, "all sounds great" kind of a way.

Pinky, sorry to hear you are in an effective PCT that will be wiped out.

Hogs, don't think your questions are easily dismissed. I know the MS Society, Motor Neurone Disease Assoc and Parkinson's Disease Society have set up a commissioning arm for long-term neurological conditions that has been working with three or four PCTs - maybe the idea is GP consortia will buy in services from people like them?

my concerns might not be valid and might be easily explained away!

I hope they are

sorry went lurking on another thread. I have a number of concerns with all this (including commissioning of services which the NHS is just starting come round to now where i am)and these are mainly around the services that are not (for want of a better word) particuarly `sexy'.

I'm talking about the services that private companies so far have not wanted to touch with a long barge pole because they are difficult to quantify and are bigger finincial committments (these tend to be services for longer term conditions with no identifyable end outcome). I also worry about the so called cherry picking of services to be provided by private companies.

I worry that whilst this might provide local services for local people it will also reinforce the `postcode lottery' of services throughout the country

no you are right NL - this is just Andrew Lansley's pet topic. no manifesto commitment, infact they said 'no reorganisation of the NHS'

Oh and please correct me if I'm wrong - but this wasn't in any manifesto was it? Nobody actually elected these muppets to do this did they?

I think this plan is a very, very bad idea. PCTS need a kick up the backside no question (sorry SPB) but dismantling these huge and complex organisations and chucking the whole thing up in the air for those who are interested to make a lot of money from is not the way to do it.
Patient care will suffer and clinicians will be driven out of the service because they cannot bear another re-organisation/innovation/cock up.

Sorry was obv wrong re commitment to free care at point of access there

Sorry that was to Stealth on those two questions

Yes, that's my understanding too.

only specialist services fall outside of the GP remit. they get community, primary care and mental health budgets (about 80%)

hogshead, yes, it says so upfront. that will be maintained.

and I'm fairly sure 2 will be these GP Consortia
aka PCGs

OK Q1
NHS commissioning Board

hogshead, no, but it does endorse the NHS Constitution which was established in the last HEalth Act and the constitution states that principle. So I don't think that's going to be eroded (yet)

Who will commission other primary care services?
Where do HNAs come into all this?
I am going to skim read, see if I can find some answers.

really and truly, there is nothing left once this plan is implemented. i urge you all to read the white paper

first line hogshead

"Our strategy for the NHS: an executive summary

1. The Government upholds the values and principles of the NHS: of a comprehensive service, available to all, free at the point of use and based on clinical need, not the ability to pay."

hospitals are required to expand provision for private patients and those that are not 'financially viable' will be closed.

I question where the priority will be