All Change!

Just as we thought when we started learning about the structure of the NHS - it's all different as soon as we get a new government in charge.

The Conservative-LibDem government has decided to do away with Primary Care Trusts (PCTs), strategic health authorities and most NHS targets.

GPs are now to be the 'managers' and decide where the money goes in their area.

Read the full article from the BBC here.

Here are the opinions of two GPs (also from the BBC)

FOR

Dr Darin Seiger is a general practitioner from Northampton. He helped set up a GP association, Nene Commissioning, in 2007. With 650,000 patients and 350 GPs, Nene is the biggest example of commissioning by family doctors in Britain.

"If GPs are the drivers of their patient care then that's a good thing.

It's better that practices get extra support to achieve their outcomes than falling short. There will be a variety of providers out there which they can choose from.

If doctors are determining the support they need then that's an improvement.

This is all about redesigning care for the benefit of patients.

Conflicts of interest would have to be declared, of course, but with proper accountability and supervision, problems can be overcome.

Safeguards could be put in place too.

As long as GPs have the right kind of support this can work, particularly if they are split into two groups.

If the 'strategic commissioning' GPs with an interest in redesigning healthcare and the 'providing' GPs more focused on providing excellent healthcare can work together I have no doubt this will work.

The success of these proposals rests on clinicians talking to clinicians and redesigning care for the benefit of patients."

AGAINST

Dr Kambiz Boomla is a GP who practises in the East End of London.

"Firstly it's a very large budget to deal with and we know that there are probably spending cuts coming.

GPs are busy people. We don't have time to do this in between seeing patients, so we're going to have to buy in commissioning support from private companies.

My fear is that the government has a hidden agenda - to allow private companies to buy out GP practices.

But we are responsible to our patients in a way that private companies are not.

Unlike us, they are responsible to their shareholders, wherever they might be in the world.

There's also the danger of conflict of interest.

We could end up with a situation where a private company is placing contracts with sister companies which own hospitals, putting commissioner and provider in business together.

And there will be disputes over costs, which will take time and public money to sort out in the courts.

All markets in healthcare result in inequity.

People who live in better off areas would be able to purchase better healthcare than those in poorer areas.

In my view, there is no place for them at all in healthcare."

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In my (inexperienced, yet opinionated) view, whilst GPs are the first contact for many patients and those in charge of referring onto hospitals, a lot of senior (sounds better than 'older'!) doctors are still not computer literate and certainly didn't sign up to be managers when they went to Medical school.

Even within a single town, GPs from one area will feel most of the money needs to go into care of the elderly and diabetes, where as another will think it needs to go into maternity or infectious disease control- depending on the demographic of people who come to their surgery.

GPs are busy enough dealing with their own patients, let alone endless management meetings.

An organisation as big and important as the NHS surely does need some competent managers and a central strategy in order to be efficient.

It does seem to me that we are taking a step backwards.

.......Oh well, it may all change at the next election anyway!.........