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

[ArcticRoll]

Government are selling this to the public that it is about giving power back to clinicians rather than managers but really their main objective is to break up the NHS and line the pockets of shareholders in the private sector.
If the plans go through the focus over the next couple of years will be all abour re-organisation diverting resources from the frontline.

I work in a PCT presently, agree totally with your comments. This is privatisation through the back door BIG TIME. It is ludicrous for skilled staff to be made redundant (up to 90% of the workforce of PCT has been muted) while much of the commissioning work is said to be contracted out by GPs to private health firms, such as Bupa, Capita and US-owned comapnies.

How is this helping the NHS or out economy as a whole?

"Patients will get more choice and control, backed by an information revolution"

is it 1997?

A question should also be asked how the coalition will ensure equity of provision with GP's in essence being the gate keepers to secondary care/additional services?

Exactly. When the money runs out what happens?

good point PNB
How will they understand their population's health needs? I really don't get that

GPs will empire build that's for sure, so depending on where you live your provision may/will be different. Additionally, if your an "expensive" patient (multi attender of acute services etc) why an earth would a GP register/keep you on their books? it will not be worth their while monetarily, as they will be paying out of their own budgets (excluding specailist services) ....there will be massive disparity.

As for understanding populations health needs, currently in my area, multi disciplinary teams (involving clinicians, GPS & management) ensure an understanding of the managed populations needs ( most GPs do know/understand their population needs) applying the relevant expertise to ensure best use of a finite resource - not sure how this will be managed under the new system without increasing bureaucracy, thus cost.

This could well be the start of the end of the NHS in its current form.

Oh good got some responses!
Posted this earlier and checked and no-one seemed interested.
As Pinky said it will be bringing in privatisation by the backdoor.
Concerned that this is going to happen without much debate and protest.

To be fair, PCTs haven't been universally lauded or effective or popular. And there is sense in having commissioning decisions driven by clinicians. Many PCTs were also deliberately obstructive wrt practice based commissioning.

We've been here before, though. Not just fundholding but the original primary care groups, in the days when the new Labour government claimed they could decide whether to be PCGs or move up to PCT level.

Have huge reservations about these plans but am off to bed now, just marking my place

"Additionally, if your an "expensive" patient (multi attender of acute services etc) why an earth would a GP register/keep you on their books? it will not be worth their while monetarily, as they will be paying out of their own budgets (excluding specailist services) ....there will be massive disparity."

I would imagine there will be provision for that as there is now?

ArcticRoll, I started a similar thread a couple of days ago, which only got acouple of replies

Edam - "To be fair, PCTs haven't been universally lauded or effective or popular. And there is sense in having commissioning decisions driven by clinicians. Many PCTs were also deliberately obstructive wrt practice based commissioning"

I take you point and agree somewhat. My PCT however championed PbC, investing in a support team to work with the GPs to aid the process, but with drive being Primary Care, using various incentives I know this is not the same with all PCTs, even others local to us. My worry is all we have achieved with local services for our population etc will be lost and the wheel again will be reinvented.....

SPB - Currently the buck stops with the PCT (holding the budget) so hasn't been so much of an issue (clinnical relevence is a whole new ball game!).I would expect a centraly held pot for said patients - but then PCT's are on the way out...

Not sure if I understand you, sorry. The PCT itself has a cushion from very expensive patients, and I'd imagine so will the practices.
Yes, we worked hard at PBC as well, all flushed down the pot. It only seems a year or so ago all the PBC leads were appointed...

Does anyone know how the GPs will commission effectively without the help of a HNA? Or will the PCTs still be doing those on their behalf?

Maybe I should read the white paper...it is taunting me - not looking like the most exciting read at almost 10pm

There won't BE any PCTs from 2013. Previous plans were that PCTs would pick up the more complicated commissioning . God knows what is going to happen now, it is absolutely terrifying.

Who will commission other primary care services?
Really really must read that 60 page document

I will watch this thread with interest. The new developments seem terrifying. I think there are already many private comapnies hovering ready for a role in the conglomerations of GP practices that will form to facilitate this huge commissioning rol.

The upfront costs must be large, at a time of cuts

reading with interest!

it seems to be a little bit like DS's favourite game `round and round the garden like a teddy bear'

the NHS goes round and round in circles desperately trying to improve services whilst struggling against constant reorganisation

the NHS will become only a brand name to be used by private businesses.

GPs are private businesses, social enterprises (which all hospitals will have to be) are businesses and the commissioning and manageemtn support will be provided by private business as GPs have neither the time nor skill to do this. The white paper explicitly gives them responsibility but states they will need to purchase the services to action.

There is no NHS anymore

Eleison- Thats the issue that frustrates me the most. All the employees with the required knowlege etc cast aside, and pay top doller for private Companies. Where is the money coming from?

i must read the white paper - does it say anything about the fundamental underpinning of the NHS which was always `free at the point of access for the patient'?

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

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."

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

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.

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)