As Ministers slam the brakes on controversial plans to transform the NHS, a leading Birmingham GP urges them to rethink the proposals. Jonathan Walker reports.
The Government’s troubled health reforms could force doctors to make decisions which undermine the NHS, a senior GP has warned.
Ministers claim the planned changes will put GPs in charge of commissioning but Fay Wilson, Birmingham representative of the British Medical Association, said doctors were concerned that they would be forced to commission care from the private sector.
She said: “GPs are anxious that they won’t have any real power but they will have to take the blame.”
Dr Wilson, a practising GP in Birmingham, welcomed the Government’s decision to suspend the passage of the Health and Social Care Bill through Parliament so Ministers could listen to objections.
But she said: “What matters of course is that they really do listen.” Ministers have taken the unprecedented step of announcing a two-month “pause” in the Bill’s progress to hold a lengthy listening exercise, following opposition to the proposals.
David Cameron and Nick Clegg, the Deputy Prime Minister, are spearheading the consultation, apparently signalling a lack of confidence in Andrew Lansley, the Health Secretary.
However, a number of Conservative MPs have expressed support for the proposals, and urged the Government not to back down.
Under the Government’s plans, the health trusts that currently commission and pay for health care from GPs and hospitals are to be scrapped.
Instead, GPs will be asked to form consortia to commission services.
The Department for Health has already approved plans for a series of GP consortia throughout Birmingham and the West Midlands.
Dr Wilson said some GPs were enthusiastic about the planned new system but others had agreed to join consortia because they felt they had to accept the Government’s proposal.
She said there was particular concern about the planned role of Monitor, a Government watchdog, which currently oversees Foundation Hospitals but would gain a new role as the economic regulator for health care in general.
“These proposals are presented as putting GPs in charge but one of the big problems is actually that they won’t give GPs enough influence.
“They get the responsibility for commissioning and balancing the books but in fact they will have to follow instructions about how they commission care with the market enforced by Monitor. There is anxiety that they will have responsibility for balancing the books and satisfying patents but Monitor will tell them to allocate contracts in a certain way.”
Monitor’s role would be to enforce the creation of a market in health care, she said.
“The anxiety is that GPs will be told they have to use a private sector provider and will be prevented from using the public sector.”
This had the potential to undermine NHS hospitals which required a certain number of patients in order to operate smoothly, she said.
It might also allow private clinics to accept patients who were easier to treat and leave NHS hospitals with the more expensive cases, she said. For example, some private clinics refuse to take patients with mental health issues.
“If you take the easy bits out then how are hospitals going to be able to do the difficult bits?”
Tory MPs who backed the reforms when Mr Lansley announced the “pause” in the House of Commons included Nadhim Zahawi (Con Stratford-on-Avon), who described them as “a brilliant piece of legislation”.
