Cornwall Councillors this afternoon had the chance to discuss the authority's response to the Government's 'listening exercise' over the reforms to the NHS. It was a pretty packed meeting which, unfortunately (and inexplicably) only lasted for an hour.
During that time, member after member criticised aspects of the changes proposed and there was very loud agreement for the oft-stated proposal that the entire Bill should be ripped up and the process of reform started again from scratch.
In my opinion, the major problems with the proposals are:
- that the proposal to put spending power in the hands of GP consortia means that nurses and other key people within the NHS will not be involved and nor will there be any democratic accountability. I agree that doctors should be more involved and can better reflect the needs of their patients, but there should be a mix of GPs, other professionals and councillors.
- the ambition of putting competition above all else is deeply damaging and will, in certain cases, lead to the effective privatisation of key parts of the NHS. I have no problem with the small scale involvement of private providers in certain circumstances - such as we have now to reduce waiting times for operations that the NHS is failing to do quickly enough. But the principle must be that the NHS is the first choice provider. The first priority has to be keeping the range of services available across the country. The second priority is the price.
- the proposal that an NHS hospital could close if it is not doing enough business is hugely concerning for anyone who doesn't live in a city with more than one hospital. No one in Cornwall lives close enough to two hospitals to make choice a realistic option.
- the focus for the NHS should either be on making savings or on restructuring. It is nigh on impossible to do both at the same time and do so effectively.
- we are told that patients will have more choice over who their GP will be. In Cornwall, most people live in areas with only one option. Apart from a few people who drive to another town to work and may find a GP in their work town more convenient, who benefits? And if the NHS is restructured to assume that choice exists, then it becomes very possible that those of us in single GP areas will end up with a worse service.
For all these reasons (and, no doubt, more) I believe that the best option is for the Government to tear up the current NHS Bill and to start again with far more modest reforms based around the consortia proposals. I hope that, by the time the consultation closes next Tuesday, Cornwall Council will have sent a response along these lines to the Government.