URGENT! NHS reforms putting the healthcare of children at risk, say doctors

[KatienotPrice]

The British Medical Journal says the NHS 'reforms' in England are putting the healthcare of children at risk. The authors of the article include senior paediatricians, public health specialists and family doctors. They say healthcare for children already lags behind the best European examples. But they say giving GPs control over the lion's share of the NHS budget could make the system even worse. What can we do?

Maybe start by examining the specific details of why they are suddenly so concerned about children? If we already have terrible paediatric care under the current system, exactly how & why would it get worse when caring, professional GP's are responsible for the budget? And what are they suggesting would make it better?

Otherwise, I suspect that the BMJ.. not being wholly in favour of the plans... will claim various groups are 'at risk' in turn purely for PR reasons. Children, cancer sufferers, the elderly etc.

I've just been looking at BMJ and cannot find an article that says this.

The nearest I could find was this, but it says that children's health services are already inferior in many regards to those in comparable European countries, and that the proposed reforms will not (unfortunately) change that. Still a pretty poor picture of course, but no suggestion the reforms will exacerbate the existing situation.

For this who are interested, here's the BMJ page which links to a plethora of articles about NHS Reform. Looking at these, and reading the recent BMA statement, it is clear there remain areas of serious concern to doctors about the proposed reforms.

Are you thinking of the BMA? - the British Medical Association - the professional medical association for Doctors? Yes, you are right - they don't want these reforms. Neither does the Royal College of GPs, the professional body for GPs. But the BMJ or British Medical Journal is actually an academic medical journal - they aren't for or against the reforms. They have just done research which has found that too many family doctors lack specialist training and experience in looking after children.

Thanks meditrina for the link. very interesting. sorry, my last reply was to you Chil1234

The British Medical Journal doesn't say anything. The British Medical Journal publishes peer reviewed research that does not represent it's own views on anything. Unless this is an editorial you are referring to.

Family doctors, by definition, are general practitioners i.e. they lack specialist training full stop. GPs routinely refer a patient to a specialist in a particular field if they can't diagnose or treat the condition themselves.

General Practice is a speciality like the others, which has it's own specialist training and CPD, and its own Royal College. It does not seem right to devalue this speciality against all others.

Meditrina - I don't think that Chill was saying General Practice is inferior, just that saying that General Practioners don't have specialist training in other areas is a bit of a Tautology.

In fact GP's will often start to specialise through their CPD - our surgery has one GP who is the ENT specialist, others who have done RCOG courses etc.

I guess the implication of the report is that more GP's should do paediatrics as part of their training. That seems to have little to do with NHS reform, and everything to do with the standards set by the Royal College of GPs.

Chil did say that GPs lack specialist training full stop. That is not correct.

Paediatrics is already an important part of GP training.

Agreed... not devaluing the specialism that is General Practice. Just that the argument that 'GPs are not paediatricians' is rather stating the obvious if that's how it's phrased.

The main arguments I've heard against NHS reform (from people within the service) are 'GPs don't care about their patients, are basically incompetent, lazy and will give all the work to their mates'. Again, we're back to Royal College standards.

Paediatrics is obviously not an important ENOUGH part of GP training if "They have just done research which has found that too many family doctors lack specialist training and experience in looking after children." though.

I'm not sure the article actually says that. It is criticising the lack of integration between primary and secondary paediatric services, and looks to lack of understanding of the role of GP by paediatricians as well as vice versa. They mention potential over-referral, but balance that with reference to pressure from worried parents.

The difficulty in managing complex and long-term childhood conditions, especially when the patient has to visit multiple different specialists seems to be a greater concern. The article is about the state of services for children as a whole, not a specific concern about GPs (though it does rightly point out that further reduction in paediatric training for GPs - something that has been chipped away at in preceding years - should be resisted).

The Swedish model, which attracts particular praise, has a different underpinning system in terms of provision of hospitals, and also the Netherlands which has a transmural system.

The new proposed new role of GPs is described as unlikely to help solve the current lag between Uk and other European children's health provision.

The factor which they describe as likely to cause a deterioration in in care is the plurality of providers in secondary care.

That factor was also mentioned, for more than just paediatrics, in the recent BMA deliberations.