Lancashire medical staff have cautiously welcomed the Government’s NHS reforms, which were set out in a white paper last Thursday.Advertisement
The Coalition Government plans to abolish the country’s 152 regional Primary Care Trusts, which are responsible for first-contact services as well as buying “secondary care” from hospitals. Under the reforms, Preston’s Primary Care Trust – NHS Central Lancashire – will see its commissioning responsibilities handed to GPs by 2013.
Dr Ronnie Lowe, who has been a GP at Fishergate Hill Surgery, Preston city centre, for 15 years, said: “It’s an opportunity that GPs should grab with both hands.”
Supporters of the system say it will make healthcare more personal, with more power given to doctors who know patients directly.
Under the new system, family doctors will work in “consortia” with other local GPs. These associations will be able to buy secondary care services from hospitals or private companies out of their own budgets.
Dr Lowe said the NHS needed to undergo changes. He added: “We are now in an environment with a 33 per cent reduction of resources.”
He said the population was getting older, and that people were living longer with diseases that in the past might have killed them – and costing the NHS more.
‘Pre- war times ahead’
But Dr Lowe added it was unlikely Preston would get more GPs to cope with the extra responsibility. “There aren’t enough GPs anyway,” he said. “People are going to have to step up to the plate.”
There is also concern that private companies will attempt to undercut NHS hospitals in order to win contracts for secondary care. This could lead to compromises as different providers compete to offer the cheapest service possible.
“Private companies could cherry pick operations,” Dr Lowe added. “They could say, for instance, ‘I will do you 24 hip replacements, but won’t take any high-risk patients such as diabetics.’”
A Lancashire County Council social services worker, who wished to remain anonymous, said she was worried about the reduction of services available on the NHS. “At the moment, you can’t even afford dentists because of the prices,” she said. “There’s not many NHS dentists any more.”
She added: “It’s better facilities for those who can pay for it. It’s like going back to pre-war times.”
The new system will mean job losses at the PCT – almost a quarter of jobs in commissioning will go by April this year.
NHS Central Lancashire, which won “Most Improved PCT in the North West” last year, will play a part in helping GPs set up consortia, but will be broken up once the changes are put in place.
The shake-up of PCTs goes against David Cameron’s election promise of “no more top-down reorganisations” for the NHS – and will be completed within a single parliament.
Brenda Fox, 70, of Garstang, said she did not agree with giving GPs more responsibility. “I think doctors take advantage of the situation at the moment,” Mrs Fox added. “I think it might get worse.”
NHS Central Lancashire’s clinical commissioning executive committee chair Dr Gora Bangi, who is a GP in Leyland, said:
“A huge amount of work is ongoing across central Lancashire to support the development of GP consortia. There are currently three developing locally: Preston, West Lancashire and Chorley/South Ribble.
“Each will be taking part in elections in the near future to agree their leadership. In addition, a new GP commissioning sub-committee to the PCT’s board is being set up to support the transition to the new GP-led commissioning arrangements.
“We know how important it is that emerging consortia understand how to engage and involve individuals and communities in the designing of services. To this end we have secured funding from the Department of Health to develop a learning programme, which a range of people outside our PCT will be invited to take part in.”