The most radical NHS reform in 60 years is now under way. Amanda Crook examines how the health revolution is beginning in Greater Manchester ...
FAMILY doctors are to be put at the heart of the new NHS – choosing and buying almost all the care their patients need.
GPs currently man the gates of the health system, directing patients to hospitals and other services. The reforms will give them the keys to the safe and allow them to build the services they want to see.
Across Greater Manchester, some GPs have already grasped the opportunity to replace unpopular primary care trusts (PCTs) – which currently hold the purse-strings – and eight local consortia have been set up and chosen to start the scheme.
In south Manchester, a consortium says it will recruit staff and is planning new services from as early as this summer.
Pioneers target 'inefficient and wasteful system'
In Heywood, Middleton and Rochdale, GPs are still at the drawing-board stage. They do not know how many consortia they will have or what form they will take.
Some doctors are excited by the chance to change a system they regard as flawed and hope to spend a couple of days a week running their consortia.
Others seem more reluctant. Two GP practices in Trafford – the Partington Family Practice and the Partington Central Surgery – have chosen not to join Trafford’s consortium.
Unfortunately for them, there is no other option. All GP practices must join a consortia by 2013 when the region’s 10 PCTs are disbanded. Consortia will receive around 80 per cent of the NHS budget but will not have to run public health schemes.
Responsibility for providing GP care, nursing care and most hospital, out-of-hours, mental health and ambulance care will transfer to the consortia.
The change comes as the NHS budget stops growing, but as new treatments become available and the population ages the service must become four per cent more efficient to provide the same level of care.
Glossop-based Alan Dow, secretary of Tameside GPs’ local medical committee (LMC), says many doctors agree with the idea of consortia but are concerned about how they will work.
He says: "I don’t want GPs to become like PCTs – almost victims of a system where they were given so many targets to meet that they became untenable."
Dr Kailash Chand, chair of Tameside PCT, has long been a champion of GPs but fears consortia could ruin the GP-patient relationship by bringing money into the equasion.
He says: "The consortia plan will change GPs from heroes to villains. It is a last desperate thrown of the dice for the NHS now it has run out of money.
"It is GPs who will lose – they are being handed control but no cash. They will have no choice but to make decisions on a purely financial basis."
Mohammed Jiva who represents GPs in Bury and Rochdale, is concerned by the lack of progress in some parts of Greater Manchester. He says: "I am concerned that GPs are not engaging with the process from the beginning," he says. "If they don’t, they won’t be able to create the consortia they want."
Many health professionals are concerned about the short-term impact of such radical change at a time when money is short.
Adrian Roberts, finance director at Central Manchester Hospitals trust, says: "Dealing with over 20 different consortia each with their own specific priorities for changes, will be a significant challenge for us."
Pioneers target 'inefficient and wasteful system'
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Another step forward in the Tories' march to privatise the NHS, while filling the coffers of their 'City' friends, who will be offering cut-price, mediocre treatment to those who can afford it.
It won't affect me and mine, we're already 'well-covered' in that department, it's the poor, long-term sick and the old, I feel sorry for.
And while i sincerely hope that the pretend Tories, who plague this website, are among the first to experience what Conservative NHS (don't) care really means - I can't help but pity them - despite them hitching their clapped-out caravans to a party intent on selling the nation's birthright.
So GPs are to spend two days a week running, among other things, the amubalance service and hospitals?
Is this right, and if so a good thing?
A financial analyst has suggested that putting multi billion pounds of health procurement in the hands of "generalists" rather than specialist procurement managers is madness. I agree. GPs are only interested in doing work for money. They have no incentive or qualifications to purchase effectively on behalf of their patients.
GPs should never be handed so much public money. Will it all get spent on patients? I wonder !
I feel that people do not fully understand the devastating implications for our NHS of the Health and Social Care Bill. I feel there needs to be public consultation and referendum before this reform is considered.
The coalition government in effect are throwing open the NHS to the private sector which could have implications for existing NHS providers. Private industry will bid for contracts as a loss leader to get a foothold into the NHS.
There is uncertainty for General Practitioners whether if over budget and expelled from a consortia the implications for their NHS contract if contracts are lost, this then could open the doors for private industry to take on GP contacts, which would jeopardise continuity of care and the special relationship many patients have with their family GP.
It is also concerning that The Bill will remove the cap that restricts the amount of money hospitals can make from private patients that pay for their care. Hospitals are likely to prioritise treatment for private patients to bring in extra money, pushing NHS patients to the back of the queue.
The Bill is being pushed through by the Coalition Government in spite of the widespread concerns raised from a wide range of professional groups such as the BMA.
The “Condem” Government are condemning our NHS and have been reported nationally to have been funded by private Healthcare companies; this is surely a conflict of interests and questions motives.