GP Consortia – next steps to privatisation?
The proposed Conservative plans to give GP’s the ability / right to contract health services don’t sound that radical right?”
The problem is that in practice most doctors will not be contracting the health services themselves, they will be coming together in large consortia which in plain language means that our health service will now be via private profit driven businesses with little or no democratic control. The main issues seem to be:
“Any willing provider”. The British Medical Association has said that “Forcing commissioners of care to tender contracts to any willing provider, including … commercial companies, could destabilise local health economies and fragment care for patients. Adding price competition into the mix could also allow large commercial companies to enter the NHS market and chase the most profitable contracts, using their size to undercut on price, which could ultimately damage local services.”
Accountability. One of the generally accepted lessons learnt from the 2008 financial crisis was that it is not a good idea to split responsibility in too many directions as was the case with the tripartite split between the Bank of England, FSA and the Treasury. In these new reforms there will be five key national bodies: the Department of Health, the National Institute for Health and Clinical Excellence, the Care Quality Commission, the NHS Commissioning Board, and the economic regulator Monitor. Although the remit of each is set out in legislation, it is not clear how these national bodies will interact or how they will provide coordinated and consistent governance of the NHS.
Pace and timing of change. The proposed changes coincide with NHS Chief Executive Sir David Nicholson’s so-called “Nicholson challenge” under which the NHS is expected to make 4% “efficiency savings” per year, culminating in a total £20 billion by 2015, supposedly in order to find additional funds for increasing costs associated with an ageing population and new drugs and other technologies. The House of Commons health select committee described the savings target as “without precedent in NHS history”, adding that “there is no known example of such a feat being achieved by any other healthcare system in the world.”