The Royal College of General Practitioners (RCGP) has written a letter to the Prime Minister, recommending changes to the Health Bill to protect the principles of the NHS.
Extracts from the letter say:
We understand that the NHS needs to change. We acknowledge and welcome the focus in the proposed reforms on patient outcomes, choice and value for money. We welcome placing General Practitioners (GPs) at the heart of planning services for their patients, and increasing professional and patient involvement in health service design and funding decisions, and accept competition in commissioning where it adds value to existing services. We welcome the planned reductions in management costs and an increased focus on prevention, reducing health inequalities, and improving joint working between health and social care.
However we have a number of serious concerns and suggest the following recommendations:
1. Comprehensive health care
That the Bill should make it clear that the Secretary of State has a duty to provide, or secure provision, of a comprehensive health service throughout England.
2. Charging for health care
That commissioners or providers should not be able charge patients for health care services that are currently provided free by the NHS or are recommended by NICE.
3. Issues relating to market forces in health care
That the Bill should place a duty on Monitor, the National Commissioning Board and GP Commissioning Consortia (GPCC) to enable collaboration to provide integrated services to meet patients needs without fear of a competition referral.
4. Issues relating to EU competition
There needs to be clarity as to the legal implications of EU competition law (particularly when, and in what circumstances, it is enforceable) and other contractual and regulatory details.
5. Accountability and conflicts of interest
Consortia must remain publicly accountable for all commissioning decisions, so that Board minutes and financial decisions are open to public scrutiny, including details of payments made to GPs or Practices for non-general medical services, including payments to private companies in which GPs have a financial interest.
6. Resource allocation and risk pooling
That there is clarity as soon as possible as to which allocation formula will be used for allocation to GP consortia for commissioning hospital care.
7. Practice boundaries
The proposal to undermine the relationship between a local GP and local patients by abolishing practice boundaries is revised.
8. Workforce and training issues
Given that the education and training proposals mark a revolution in medical education and could be harmful in primary care, we urge a careful and detailed reconsideration ahead of any implementation.
9. Confidentiality
That there is as an absolute assurance that the Bill will not force doctors to breach their duty of confidentiality.
A paper sets out the RCGP’s concerns in greater detail.
