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Royal College of GPs chair attacks NHS reforms

Clare Gerada tells the New Statesman: "This reform is so large you can see it from outer sp

By Alice Gribbin Published 09 November 2011 17:25

In this week's magazine, Clare Gerada, physician and chairman of the Royal College of General Practitioners, talks to the New Statesman's Sophie Elmhirst about her fears for the future of the NHS, David Cameron's betrayal, and the ways in which patients will suffer as a result of Health Secretary Andrew Lansley's reforms:

We've got three big things going on at the same time - a massive reorganisation of the health service, alongside a serious financial situation, alongside the NHS having to make £20bn efficiency savings. So it is difficult to say which one is going to cause "X, Y, Z", but certainly patients are going to experience longer waiting lists; they'll see less choice available. Irrespective of whether the government says there is going to be more choice: there won't be more choice.

In line with the General Practitioners' Committee's stance against the reform bill's Quality Premium, Gerada is outspoken about performance-related bonuses for GPs:

In the [reform] bill, the government is suggesting that GPs be rewarded for keeping in budget. There is no problem in GPs having an incentive to practise good, evidence-based medicine. Where it becomes a step too far is where we are rewarded for keeping patients out of hospital. Because you have to trust me, you have to trust that I have stopped you from going to hospital because it is in your best interests, not because I am going to get £10, £15, £20 or whatever it is. And that begins to distort the doctor/patient relationship, which has to be fundamentally built upon trust -- otherwise what's the point of it?

Gerada speaks of being "absolutely surprised" by the reforms proposed by a coalition government she has had no discussions with:

Like others, I heard David Cameron say "no top-down reorganisation of the NHS". I was so relieved, because I had lived through 15 reorganisations . . . [But this reform] isn't so much putting GPs in charge of commissioning, but about dismantling the systems and the architecture of the NHS.

The NHS is our NHS. It is one of the last things that we as the people - the taxpayers - own, and by owning it our Health Secretary and our parliament is responsible for it. For £120 billion of taxpayers' money, somebody has to be accountable to parliament. . . . It is symbolic if [Health Secretary Andrew Lansley] is no longer accountable for our national health service.

Tags: andrew lansley NHS

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5 comments

Wed, 2011-11-09 18:00 — Ian5

I visit my GP for medical advice because he has a medical degree, when he's qualified as an accountant I might trust them with MY funds...but not likely. This is privatisation with big business just sitting waiting in the background.

Wed, 2011-11-09 19:17 — Barry Ewart (not verified)

Excellent points by Clare Gerada. Some argue big business or capitalism has run out of markets and to survive it must penetrate the public sector including our NHS. For the NHS Reform Bill "Liberating the NHS" read "Liberalising the NHS". The Tories voted against the establishment of the NHS in 1945 AND IT iS NEVER SAFE IN THEIR HANDS!

Wed, 2011-11-09 19:27 — Barry Ewart (not verified)

Ooops! 1948 but my point remains valid! And er what difference has the Lib Dem fig leaf made?

Thu, 2011-11-10 01:17 — Mrs.Josephine Hyde-Hartley (not verified)

Yes I can understand a step too far being where we are rewarded £10,£15,£20 for keeping patients out of hospital - but what if NHS concerns could go about their business using some kind of tokens instead of cash?

Then G,P's could save up the tokens they receive in order to help NHS patients when appropriate or necessary - they might even give these totally dedicated NHS tokens to their patients eventually - especially to avoid the dreaded rationing by waiting culture we used to have before the 18 weeks people sorted it out.

And when we speak of being accountable to Parliament..even an ordinary member of the public may kindly attend our Parliamentary select committee meetings for questioning.Surely Parliament itself is the best place to raise and share important concerns ultimately - concerns which don't fit easily into the way we do things normally at work - ie as if in fear or favour of court type disciplinary/appeal scenes- scenes which may sometimes be unnecessary, inappropriate and lead to more of the same frustrations that are spoiling everyone's work/life balance.

So being accountable to Parliament doesn't have to depend on government workers like eg health secretaries. What about local as well as national chief executives and chairs? These could do with a good grilling from time to time, I dare say.