The Health and Social Care Bill that is currently going through parliament has brought about a lot of discussion on the future structure of the NHS. In a special report the Elements team will be delving into a number of different areas surrounding the proposed NHS reforms and the effect they will have on healthcare workers, the NHS as an organisation and, of course, attempting to find out what it might mean for patients.
As editor, I will be reporting on the effect that the reforms will have on the healthcare professionals who aren’t doctors, and whether or not they think that their jobs will be affected by the changes.
While one of the most obvious results of the NHS reforms is the creation of GP commissioning consortia, the abolition of the Primary Care Trusts will have knock-on effects elsewhere. Dentistry is one of those areas, and Beki Hill will be investigating exactly how this aspect of health care will be affected.
Partisan commentary has thrown up different claims as to the motivation for the NHS reforms: political ideology, a failing health service or suspect political donations. However, it has been said that there has been a change to the social contract at the centre of the NHS and the move to GP commissioning is simply a logical further step on the road to individualised healthcare. Jack Serle will report on the two sides of this debate.
Now GPs are being given additional tasks does the NHS reform herald a shift in morality where the ‘greater good’ comes in to play? What is the potential for this to result in a ‘tyranny of the majority’, with the rights of the individual taking second place to the benefit of the whole? Richard Masters will be looking at the ethical effect the reforms will have on how GPs do their jobs.
Abi Millar will look at the extent to which the reforms are evidence-based, or whether they’re mostly grounded in ideology. She will discuss whether empirical evidence alone would be enough to justify the changes.
Jennifer Appleton, who is currently in Australia, will be comparing the health services that are available in Australia with the NHS. She’ll be speaking to doctors working Down Under to get their views on the good and bad within the two systems.
Fareha Lasker and Debora Miranda will be finding out what the future generations of doctors think of the proposed reforms. Were any of them asked of their opinion before the British Medical Association (BMA) meeting? Will they be less likely to go into general practice as a career now that the reforms are under way?
It has been suggested (and not just by critics) that the current wave of NHS reforms will benefit private companies who will gain a firm foothold in the running of the UK’s healthcare system. But what about those companies whose business is already inextricably tied to NHS? James Brooks investigates how the pharmaceutical industry might be affected, not only by the NHS reforms, but also other measures that the coalition government has proposed, such as “value-based pricing”.
Andrew Lansley defends his proposals for GP consortia claiming that “GPs know patients best”. Although GPs agree they know the needs of individual patients many are concerned this does not translate into understanding the public health needs of whole communities. Lorna Powell will speak to doctors who work as GPs and also those who don’t to determine their views on Lansley’s plan.
Anka Lindemann and Mike Jones will reflect on whether patients trust their GPs to take on the responsibility of the health budget. Make sure you take part in our poll on the Elements homepage which Anka and Mike will incorporate into their report.
We’ll also have a number of graphics created by Elements Editor, Djuke Veldhuis, to clear up some of the confusion about how and when these reforms will take place.
Thumbnail image from Wikimedia Commons by Conrad Poirier, from Bibliothèque et Archives nationales du Québec.
Other Elements articles in which you might be interested:
My step mum is head of medicines management for a PCT (she’s actually a trained Pharmacist), I’ve not talked to her much about the new reforms but I do remember her job used to involve a lot of telling GPs that despite how upset their patient was, there was no budget to pay for whatever “cure” they wanted. I think GPs are actually in a very poor position to make these decisions because of their closeness, the reason N.I.C.E existed was to make the necessary cold hard decisions needed when money in finite. This is now a complete reversal of that method and will be a disaster for GPs when the public backlash comes.
Surely taking GPs away from patients and putting them in bureaucratic positions goes against everything the Tory’s have been saying for the past ten years, that “front line staff” - another ridiculous term to anyone who knows how a hospital operates - should be maintained.
Large scale provision of health services has been shown to be a complete failure in America, where over 30% of health care spending goes on admin due to the complexity created by myriad providers. The NHS might seem cumbersome and like a lot of money gets wasted but it is in fact a very efficient machine due to the level of centralisation and sharing of resources.
An institution that almost everyone has grown up with and been cared for by is irreversibly being dealt the final blow.