EBME Forums Forums Free discussion Free discussion Government Plans for the NHS

The new Health Secretary has announced in his white paper for NHS reform that (amongst other things) Primary Care Trusts will be abolished. Yes, just as everyone was getting used to them!

The white paper apparently puts groups of GPs in charge of £ 80 billion worth of public funds. Is that a wise move (and how will it work)? How willing (or, indeed, capable) is the GP community to take on these new responsibilities?

How will patients (and tax-payers) benefit?

Let's have the debate!

I remember the last time GPs were given control of the money; a lot of shiny new Doctors Surgeries were built.

Lee

Watching this from a distance (I read the BBC web news during my lunch if I get the chance, keep up with thing in the ol' dart and in NI) I have to confess I am greatly puzzled as to why this is being done. GPs?, are we talking General Practitioners here or have I got the abbreviation wrong?

What on earth makes the government think that GPs can run the NHS? While I can perhaps see the political "gain" in claiming to take medicine back to the people (via the GPs) frankly, I think the plan is barking mad. And I can just see the lobby of "consultants" taking this well

However, before going further on this, perhaps I should let those closer to the coal face say their bit.

Having intimate knowledge of how a PCT operates (my wife is a speech and language therapist in Bromley) I can tell you now that they are preparing for the worst.

Not meaning to tar all GP's with the same brush, many do not support areas of a PCT, which the NHS on the whole does. Those areas include certain therapies, which are not drug based.

SLT is likely to suffer heavily, as will, I'm sure other areas within the PCt if GP's are handed control of the funding.

I understand the cuts, but why cut the funding AND hand control to a different administrator. It doesn't make sense. The first year under a new controller is always going to cost more than anticipated since the system isn't entirely known by them.
It's a dangerous move IMHO.

OK, for those of us outside the UK system can we at least add explanations for abbreviations please.

PCT?
SLT?
IHMO?
LSD? (oh no, hang on, I know that one...... )

PCT stands for Primary Care Trusts. These are local NHS Trusts that are lead by bigger SHAs, or Strategic Helath Authorities. The PCTs control funding for GPs (General Practitioners), clinics, health and social care at a local level for the local population. They would also drive local campaigns for community social and health issues like smoking, drinking etc... amongst other things.

The problem in the UK is that the budget to pay for administration and management costs have soared over the past five to ten years, and these costs are being targeted by the new coalition government to be reduced drastically.

Collectively, PCTs are responsible for spending around 80% of the total NHS budget. I presume the PCTs have been targeted, with the NHS hospital budgets being ringfenced and protected, although cuts still have to be found within each hospital to deal with the future budget freezes and cuts.

From today's Guardian newspaper:

"£3bn NHS shake-up will distract from patient care, says British Medical Journal editorial

The government's ambitious plans to reorganise the NHS will cost between £2bn and £3bn and distract from its core business of providing high quality care to patients, according to a highly critical editorial published online by the British Medical Journal."

More here: http://www.guardian.co.uk/politics/2010/jul/16/nhs-reorganisation-patient-care-bmj

Round and round in circles we go, where we're going, no-one knows......

Have a great weekend folks!

Rob

I have purposely held back to see what comments were made before I dived in!!!
As I am currently working for a PCT I will give you the view from the coal face.
As Primary Care Trusts are currently responsible for commissioning clinical pathways and services, the coalition government have decided (through extensive discussion with doctors, GPs, nurses and other front line staff) that there is too much bureaucracy and want to hand the responsibility of commissioning those services with the GPs.
What has not been said is that the government has not discussed in any detail how this can be achieved with any of the PCTs or SHAs. In order for the GPs to be enabled to carry out a commissioning role, they will have to employ a whole gambit of people that currently do various roles within the current PCTs or form partnerships with private health companies who will also have to employ contractors, analyists etc (who currently work for the PCTs).
The upshot of it all is that the 64,000 people in the PCTs and SHAs who currently cost the NHS approximately £2.5 billion will probably be employed by GP consortia or private health companies. In fact it has been calculated that there will be a need to employ approx. 80,000 people minimum as there will be more consortia (about 600) than there are PCTs (about 150)!!!
Two things to bear in mind, the DH will no longer be responsible for that £2.5 billion spend for 64,000 staff and will not have to pay out on their pensions (unless the unions insist on a straight TUPE procedure with the same conditions of service), but they have had to set aside £1.7 billion for the redundancy packages etc.
It is also worth noting that the DH is looking to re-negotiate all pension rights for all NHS Staff as they cannot afford the bill. The NHS expenditure went up by 46% from 2009 to 2010 and is expected to rise to a totally unaffordable position by 2015.

What will happen is those in the PCT will move and be absorbed by the GPs. We will then need to employ more management to implement this (implementation/facilitators)which will cost even more money.
What they need to do is if you are not on the coal face then you have to justify your job as there are far far too many faceless buerocrats within the NHS. This could also be carried on to the MOD, Civil service. Get rid of this nanny state and implement a scheme that you pay into as you work that will cover you if you become unemployed and also see you into your old age. The more you work the bigger your pot.

Here endth the rant for now!!!

Never comment on the "faceless Bureaucrats" until you know what they do!!!
A more proactive result is to get everyone, whether it be in the NHS, MOD or any government body, to justify their job and role within the organisation.
There are quite a number who just keep their heads down and do little for the organisation!!!