TORY coalition Health Secretary Andrew Lansley addressed the BMA doctors union conference in Brighton yesterday, telling delegates: ‘Every step we take we must take together – I want to draw on your views and your expertise, starting today.’
He was treading very carefully, but definitely looking for collaborators. On the previous three days of the ARM, the doctors had rejected the commercialisation and privatisation of the NHS, the Private Finance Initiative programme for bankers to make tens of billions out of leasing hospitals to the NHS, the Darzi plan, polyclinics, and had voted for ending the process of Transforming Community Services, and against wasteful ISTC’s.
In the opening speech of the ARM, the BMA chairman Doctor Meldrum declared: ‘when it come to protecting doctors’ jobs and pensions I will not be reasonable.’
Lansley did not mention a single one of these issues.
He told the ARM that doctors had told him: ‘How their judgements and activities are restricted by the rigidity of the system, and how their clinical priorities have been distorted by narrow process targets.’
He declared that he was going to ‘liberate’ them, adding: ‘we are beginning to dismantle this system.’
Instead: ‘I am calling for your help in constructing a National Outcomes Framework for the NHS.’ This will be ‘A framework that I can use to hold the new NHS Commissioning Board to account.’ GPs are to be part of the new Tory dictatorship!
He spoke of the new targets: ‘Together we need to develop a small but balanced set of national outcomes measures that encompass the three things that we need to focus on to improve quality – the effectiveness, experience and safety of care. We’ll be announcing a full consultation soon.’
The jewel in the crown is to be GP commissioning. As well as tending to their patients, Lansley will give ‘control of commissioning to General Practitioners, working in local consortia, supported by an independent NHS Commissioning Board.’
It is under this regime that Lansley hopes to complete the privatisation of the NHS. He wants to see ‘GPs coordinating healthcare so they are best placed to coordinate commissioning – but all clinicians must take on a much greater role.’
He told the ARM ‘I have discussed our plans with the GPC, and I will publish our proposals soon.’
He added: ‘So let’s be clear – our aim is a major transfer of responsibility to the GP community, in order to empower clinical decision-making and improve outcomes for patients.’ Lansley made it clear that the issue ‘is about making sure that the really important decisions about the services available to your patients – and the quality you expect from the people providing those services – are driven by your clinical insight and by the holistic view you have of your patients’ needs.’ He leaves out the issue of the cash available.
He told GPs: ‘you need the power to design services that are right for all your patients.’ And that ‘to get the priority right for each patient, you need to set priorities for all your patients.’
Lansley made it clear that GPs need to be ‘central to the future design of HRGs (Healthcare Resource Groups) and payments; and to the quality inspection process, so that we have consistent measures of quality, and incentives for quality, and we do away with conflicts or distorting targets and measures.’
He however insisted: ‘We’re not protecting the NHS in order for things to carry on as they are. . . Still less for the NHS to go on recruiting non-essential, non-clinical jobs whilst across the rest of the public services vacancies are not filled and tough decisions are made to stop spending programmes. We must be at least as tough on ourselves.’ Plus: ‘In giving you clinical freedom, I ask for responsibility for efficiency and effectiveness too.’
The Tories want tough GPs playing a major role deciding what is to be cut and what is to be closed, and also who is to be sacked. This is to be the content of their ‘liberation’ from regulation, with the Tory-led coalition hiding behind them, but holding the purse strings. GPs will reject this role and will step up their defence of the NHS. They will not be Tory coalition stooges.
