“This is a government that is serious about real reform”

The coalition government is to press ahead with its programme of NHS reform, embodied in Equity and Excellence: Liberating the NHS, despite resistance from public sector unions.

Addressing the Conservative Party Conference, health secretary Andrew Lansley said: “We want people to be clear that this is a government that’s serious about real reform.

“We have already published comprehensive plans setting out our ambitious vision to improve the NHS with none of Labour’s delays and procrastinations.”

He re-iterated the government’s intention to cut management costs and bureaucracy while increasing competition between health providers and raising the quality of information available to patients.

There’s growing unease among unions and think tanks over the white paper. Unison, the largest public sector union, is seeking a judicial review over the lack of public consultation on the white paper.

The Royal College of GPs said the principles of greater clinician leadership and influence are welcome but GPs have expressed concerns that the scale of the change is not justifiable and there are concerns that the speed and cost of change will also prove disruptive.

It claimed many are worried that moving budgetary control to GPs during a difficult financial period could mean that doctors will be held personally responsible for subsequent shortcomings in services. Another concern is that the doctor-patient relationship could be damaged by a perception that services are set against practice income. It says the government will need to counteract this perception by demonstrating clear divisions between consortia budgets and practice level income.

The BMA also agreed with the white paper’s principles, and will discuss the proposals with the government, but is opposed to introducing more competition into the NHS.

A survey, by the NHS Alliance, shows that GPs, practice managers and PCT managers support GP commissioning, but are still divided when it comes to details of policy implementation. Many of those surveyed expressed concern that future GP consortia might be swamped with current PCT roles and responsibilities and that current timescales might be over ambitious.

The results also reveal that respondents are worried that the system seems to favour provider over commissioner.


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