THE BMA’s GP Chairman Dr Laurence Buckman yesterday outlined, at the GPs conference, areas of the NHS which should be cut or reviewed.
With NHS Trusts under pressure to achieve up to £20bn of efficiency savings by 2014, Dr Buckman outlined a number of areas which could be ‘consigned to the dustbin of history’.
He said that these were: ‘Wasteful PFI schemes – The Private Finance Initiative is now funding over 100 new hospital schemes, valued at £10.9 billion, but set to cost the taxpayer £62.6 billion by the time the final payments are made in 2048.
‘Management Consultants – £308.5 million was the total spent by Strategic Health Authorities, Primary Care Trusts (PCTs) and NHS Trusts on external consultants in 2007/08. In some cases, the NHS is paying external consultants up to £1,000 a day.
‘Some tiers of NHS management – Many management jobs seem to exist with the sole purpose of supporting successive NHS reorganisations and top-down initiatives of the previous government. Micro-management of GP practices is expensive and unnecessary.
‘The GP patient survey – Survey results have been consistent since 2006, yet last year alone it cost the government £13 million to run the survey. The view of the BMA’s General Practitioners Committee (GPC) is that detailed and relevant feedback could be more usefully and more economically gathered locally from patient participation groups or local patient surveys.
‘The bureaucracy of the NHS market – It’s estimated that the “internal market” has increased NHS overhead costs from 8% in 1991-92 to 11% in 1995-96 and increased administrative staff by 15% and general and senior managers by 133%. Since 1995 Department of Health statistics show that the number of senior managers has risen by 91%, more than double the 35% increase in the total number of doctors and nurses.’
Dr Buckman also listed areas which should be reviewed:
‘Parts of NHS Direct – NHS Direct still refers many of its patients on to GPs or accident and emergency departments and there is little evidence that it relieves pressure on GP or hospital services. . .
‘Choose and Book – Many practices find the e-booking element of Choose and Book useful. However, the “Choose” element is laboriously bureaucratic and requires a lot of expensive NHS staff time, and management. . .
‘The current “consent to view” model of the Summary Care Record – the BMA agreed to the current consent model for the duration of the SCR pilots, on the basis that there would be a thorough independent evaluation before it was rolled out further. . .
‘The building of new Walk-in-Centres and Darzi Clinics – existing centres need to be properly integrated with local services. However, new centres should only be opened after adequate consultation and an assessment of local need has been carried out.’
Dr Buckman also warned against ‘spending money we don’t have’ on abolishing practice boundaries, which would not only be expensive but would ‘harm the NHS and patient care generally.’