NHS: Coalition Strains
April 11, 2011The toughest job in the Government at the moment is that of Andrew Lansley. He is paying a very heavy, but perhaps deserved, price for lack of candour during the General Election and screwing up on the communications for his important reforms to the NHS. The price he is paying is that the Tories are spooked, Cameron is running scared and the Lib Dems are in headlong flight. Yet this is the moment when he must stand firm.
There can be concessions about the detail of who sits on the commissioning authorities, but the fundamental pillar must remain. It is that the health management of patients has to come under the control of GPs. Your own doctor knows what you need and where to get it. He fixes for you to see the specialists and receive the treatment. He is always at the centre and never leaves your side.
At present the interests of patients are managed by shambolic and incompetent bureaucracies, calling themselves Primary Care Trusts, run by self serving and often overpaid career opportunists, obsessed by targets, procedures and practices, not to mention bonuses, whose ignorance of the real needs of patients and the natural flow of medical care, is almost total. This ghastly structure costs vast money and many lives. It must be shut down. For good.
The reason why the majority of GPs have signed up to the new deal is that they know it is much better. The era of medicine which allowed each supplicant, sorry patient, ten minutes before either a prescription or a referral is over. To bury it, Lansley needs the support of the GPs, which he has, but if the rest all run away, let them. Because once the box of this shambles of PCTs is open and it is now, no amount of threats, defections and resignations can close it.
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