Doctors speak out on NHS reforms

NHS Hertfordshire has warned that proposals for GPs to control health spending must not stretch services for patients, while doctors fear budget cuts could leave them taking the flak.

In response to a consultation on government plans to devolve power from primary care trust managers to GPs, the Herts PCT broadly welcomed ministers’ ideas for reforming the health service, but said its success is dependent on the right support for doctors.

Dr Jane Halpin, chief executive of the trust, said: “GP consortia will need the right level of management support to enable them to not only take on their new commissioning role, but also to continue to deliver good quality services in their surgeries. We believe that we have experienced staff within the PCT to help them develop the skills and knowledge for both these roles.”

She added: “With all the changes proposed we feel that it is more important than ever that GPs develop strong and challenging relationships with hospitals.”

The Government White Paper also suggests giving local authorities a stronger role in promoting health and wellbeing. This, Dr Halpin said, was a double-edged sword.

“Whilst we welcomed the opportunity for local government to play a stronger role in promoting health and wellbeing, we also noted that moving responsibility for health improvement away from GPs could have a negative effect,” she said.

The trust said proposals to move from a system of target hitting to measuring results in patient outcomes was “the right thing to do”, but called for this to be presented “in a clear way”.

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Stevenage GP Tony Kostick, chair of the PCT’s clinical executive committee, said that GPs are in the best place to determine what patients need and what works for them because they see the results of choices in their surgeries every day. He said the way forward is to make care less reliant on hospitals.

“The idea is that we will be able to bring consultants into the community rather than have to go to hospital,” he said.

He added that a large consortium of GPs from across East and North Herts was probable, to enable economies of scale while still focussing on individual areas.

But he also feared a negative public response to doctors if cuts affected services. “We have to be realistic,” he said. “Money will be tight for the next few years. Colleagues are concerned that any blame will be directed at doctors.”

The Government response to the consultation is due by the end of the year.