Monday, 5 September 2011

The 3-step cost-saving plan.


This morning, I wrote to my MP to highlight my concerns about the Health Bill. Today, at work, at the prompting of Clare Gerada via Twitter, I encouraged some of my colleagues at work to do the same. A few of them told me that they didn’t like the sound of the Health Bill, but they were really confused about how it would change the delivery of health care.

Today’s blog, therefore, is my cheat sheet on what I think the main causes for concern are:
  1. The Health Bill removes the responsibility and accountability of the Health Secretary to provide a comprehensive health service. Andrew Lansley argues that this is a conscious decision to put patients and doctors in the driving seat, but it is much more than that, as we will see shortly.
  2. Commissioning consortia will be responsible for the patients enrolled at the GP practices that make up the consortia, rather than the population of people within the geographic area covered by the consortia.
  3. The limits on the amount of private work that hospitals can take on will be lifted.


These three issues add up to some significant changes in the way that we deliver health care.

The services that will be needed by Consortia’s registered populations will differ from the services required by unregistered patients - the latter tend to be poorer, more poorly educated and in poorer health than the former.  But Consortia have no obligation to provide services for these needy, unregistered patients. Unregistered patients will therefore experience worse access to primary care than they currently do, and will no doubt have to resort to emergency services more often than they do now.

However, the hospitals that these patients will present to, will be hospitals that will be increasingly geared towards providing private care for their more affluent, insured patients. Our unregistered patients will experience long waiting times, high cancellation rates, poor facilities, and perhaps even poorer quality care.

When they get fed up with a poor level of service, they may eventually complain to the Health Secretary, but he will plead powerlessness - after all, he will argue that he has given the power to organise and commission local services to local patients and doctors. He will say that the service you receive is the service that you and your fellow citizens have asked for, and what’s more, he is not responsible for it anymore.

We all know that health care will experience significant cost challenges over the next decade, but who knew that the government wanted to meet this challenge by ensuring that more and more people would effectively be excluded from health cover?

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