Tuesday 2 April 2013

NHS - Discussion, not Insults

Today is the first working day of the NHS reforms which allow doctors in clinical commissioning groups to make financial decisions. Everyone knows that the NHS isn't perfect so maybe it is better to allow more services to go out to tender. Competition allows for choice and if clinicians are making that choice then surely standards must be raised.

On the other hand doctors have been trained to treat patients. Professional managers surely make for better management and it would not be difficult to take the views of the clinicians into account. An additional bonus is that doctors would then be able to remain aloof from any decision that is detrimental to their patients. It isn't the doctors fault that they can't help their patients in the way that they want. It is the fault of those nasty managers. Doctors may have great expertise in saying no to their patients but now they have one less explanation available to them.

There are two polarised views. We have the Health Minister, Anna Soubry telling us that "the health service will improve, work smarter and, importantly, build an NHS that delivers high quality, compassionate care for patients." We have Andy Burnham telling us that "far from letting 'doctors decide', ministers are forcing the medical profession to open up all NHS services to the market... Hundreds of new private companies now risk fragmenting patient care when more integration is needed." Andy seems to have forgotten that Labour Governments have been advocating a mixed economy in the NHS for years.

The reason for my blog is not the NHS changes which seem to have been in the news over the last few years, it is a Facebook comment today from a Labour supporter: "We will be outside Lancaster Infirmary tomorrow night (tonight) 8 pm as the staff shifts change over to remind the public and staff of all the cuts for the NHS this nasty Gov are doing and going to do, when top bosses are on hundreds of thousands of pounds on pay and bonus's." Which cuts? Why nasty? 

There may be concerns about who is supplying the care and about continuity of that care but those concerns were there last year and they were there when Labour were tendering the services. The two key questions are does it matter who makes the decisions, and does it matter who provides the care. Ideological debate doesn't make one side nice and one side nasty but it is nice to discuss the changes rather than listen to insult.

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