{news} Fw: British MDs Warned to Expect UnrestOver Healthcare Reforms

[Justine McCabe]

> British MDs Warned to Expect Unrest Over Healthcare
> Reforms
>
> Exclusive: GPs'[general practioniers]leader
> criticises Lansley's reform plans and predicts
> that doctors will face demonstrations by angry
> patients
>
> By Denis Campbell, health correspondent
> Guardian (UK)
> November 19, 2010
>
> http://www.guardian.co.uk/society/2010/nov/19/doctors-warned-expect-unrest-reforms
>
> Doctors face demonstrations outside their surgeries and
> questions about their high salaries by angry patients
> because of the government's radical NHS shakeup, the
> new leader of Britain's GPs warns.
>
> Desperate patients denied life-extending drugs or
> surgery for their ailments may also vent their
> frustrations on GPs, because they are due to assume
> control of deciding how £80bn-a-year of health funding
> is spent, said Dr Clare Gerada, who takes over tomorrow
> as chair of the Royal College of GPs.
>
> In an outspoken attack on health secretary Andrew
> Lansley's NHS reform plans, she also hit out at his
> decision to transfer responsibility for rationing
> access to treatment from the National Institute of
> Health and Clinical Excellence (Nice) and primary care
> trusts to GPs in England from 2013.
>
> "At worst, the negative impact for GPs could be
> patients lobbying outside their front door, saying,
> 'You've got a nice BMW car but you will not allow me to
> have this cytotoxic drug that will give me three more
> months of life,'" Gerada told the Guardian in an
> interview.
>
> "I'm concerned that my profession, GPs, will be exposed
> to lobbying by patients, patient groups and the pharma
> industry to fund or commission their bit of the
> service. There could be letters from MPs and patient
> groups, and begging letters from patients."
>
> Making GPs "the new rationers" of NHS care could ruin
> the long-established bonds of trust between them and
> their patients, undermine "the sacredness of the
> consultation" and turn patients into little more than
> "customers" who shop around trying to get the best
> treatment for their ailment, Gerada added. Inherent
> conflicts of interest in the new system could also
> jeopardise GP-patient relationships, she warned.
> "Patients might think that the decision made about
> their healthcare will be based on self-interest - GPs
> saving money for themselves rather than spending it on
> patients." Certain treatment decisions, and a GP
> consortium's need to balance its books "could be
> misconstrued".
>
> The NHS will not survive intact Lansley's plans to
> scrap many existing NHS bodies, introduce GP
> commissioning and push through greater competition
> between hospitals, she predicted.
>
> "I think it is the end of the NHS as we currently know
> it, which is a national, unified health service, with
> central policies and central planning, in the way that
> [Aneurin] Bevan imagined," said 51-year-old Gerada, who
> represents Britain's 40,000 family doctors. Lansley's
> shakeup will lead to a much greater role for private
> healthcare companies, the likelihood that England's
> health system will look more and more like America's,
> and GPs being blamed for things such as the NHS's
> inability to cope with a winter crisis, long waiting
> lists and the decommissioning of services to save
> money, she added.
>
> GPs in their new role will bear the brunt of the NHS's
> need to save £20bn by 2014, which will lead to far more
> "postcode lotteries" in services such as IVF, expensive
> drugs, and even access to particular hospital
> specialists such as surgeons and gynaecologists.
> Leaving each of the new GP consortiums to decide
> individually what treatment should or should not be
> available locally will lead to disputes over access to
> care. "I don't understand why he's putting in a system
> that in Scunthorpe you can get a different service to
> Scarborough, when we've spent the last 60 years working
> against that", said Gerada. Her comments are the most
> detailed criticism yet made by any senior doctor of
> Lansley's plans, which have caused serious unease among
> medical organisations.
>
> John Healey, Labour's shadow health secretary, used
> them to portray Lansley as dogmatic and out-of-touch.
> "These criticisms from an influential GP again reveal
> how Andrew Lansley is failing to listen to the warnings
> of doctors, nurses and health experts to slow down on
> his high-cost, high-risk plans," said Healey.
>
> "With plans for the biggest reorganisation in the NHS's
> history, it is also becoming clear that he is running a
> rogue department, operating in isolation from his
> colleagues in government."
>
> Healey echoed Gerada's concern about patients in future
> questioning GPs' motivations. "Patients will worry
> about treatment decisions - are they being taken in
> their best interest or the best interest of the GP
> consortium's budget?"
>
> The British Medical Association warned the changes
> could see the NHS fragment. Dr Laurence Buckman,
> chairman of the BMA's GPs committee, agreed with some
> of Gerada's concerns. "GPs are fully aware of the
> difficulties facing the NHS as we enter a very
> difficult financial period and that tough decisions
> will have to be taken. The BMA has repeatedly expressed
> its concerns about the timing of the white paper
> proposals as well as the potential risks and benefits
> that may result from the government's plans," he said.
>
> Prof Chris Ham, chief executive of the King's Fund
> health thinktank, endorsed Gerada's view that Lansley
> should move more slowly. "With international evidence
> this week showing our health system performing well
> compared to other countries, and the NHS facing
> significant financial pressures over the next few
> years, evolutionary change building on existing
> arrangements offers a more promising route to improving
> the NHS than radical structural changes," he said.
>
> A Department of Health spokeswoman said: "Our reforms
> will indeed mark a new era for the NHS - one where
> patients and clinicians are at the heart of the
> service. Our reforms aren't an option, they are a
> necessity in order to sustain and improve our NHS. The
> reforms are far-reaching but they also build upon
> existing designs. We share a common goal with the RCGP
> that we all want patients to get the best health and
> care services."
>
> But she added: "We understand concerns around
> implementation. That's why we have consulted
> extensively on our plans, and have already announced a
> programme where GP consortia can start testing white
> paper principles. We will announce the outcome of the
> consultation later this year. We believe that both
> purpose and pace are vital to improve services for
> patients."
>
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