Posted by: Nigel Praities Editor's Blog1 October 2014
A mere seven months before the general election, and in the midst of party conference season, it seems an opportune time to review the Government’s progress on the NHS.
The coalition agreement – forged by the Conservatives and the Liberal Democrats in the heady days after the 2010 election – makes interesting reading four years on.
The promise to ‘stop the top-down reorganisations of the NHS’ has been famously and comprehensively broken. But what of the other pledges?
The ‘greater involvement of independent and voluntary providers’ in the NHS? That can be ticked off with the controversial section 75 regulations. A ‘strengthened’ CQC? Oh, yes. Enabling GPs to commission services. A big tick for that one.
There will be complex arguments over whether health spending has, as promised, ‘increased in real terms’ each year, but I am not clever enough to decipher them. Pass.
A bonfire of the quangos? With the formation of NHS England you now have a quango you can see from space. So, no. Giving every patient the right to register with any GP they want? Er, not yet. Incentives for GPs in deprived areas? Dream on.
So at best, it is a mixed picture for ministers – but there is still time.
A Pulse survey shows that while half of GPs are so disillusioned with politicians that they do not trust any party to run the NHS, most remain undecided on how to vote next May.
So my challenge to Messrs Cameron and Clegg is this: have a read of your Rose Garden agreement again and perhaps focus on fulfilling just one pledge before May. I suggest the following: ‘Doctors and nurses need to be able to use their professional judgement about what is right for patients and we will support this by giving front-line staff more control of their working environment.’
A laudable aim that has been buried in mountains of over-prescriptive bureaucracy, the continual raising of patient expectations and the imposition of new regulations and contractual requirements.
So here is a three-point plan to achieve this by May (and I know you like those). Firstly, slim down all the CQC criteria to just one question: ‘Are you a risk to patients?’ and restrict inspections to practices identified by local GPs as below standard. While you are at it, scrap all those infantile ‘Ofsted’ ratings for practices – and the 17-page document on how to display them. They will not improve patient care.
Secondly, get rid of all requirements on GPs that are not proven to have a directly beneficial effect on health and simply give practices the attached resources to support their patients better. Take, for example, the unplanned admissions DES: the mountains of care plans take hours, leaving less time for actual patient care. GPs know which patients need special attention and all they need are the resources to give it to them.
Lastly, and most importantly, stop bashing GPs in the media and work with the profession. Your words have an effect, so stop harping on about how practices are failing patients while saying they should be open every day from dawn until dusk. This raises expectations far beyond what is desirable or affordable. Oh, and forget ‘naming and shaming’ GPs; it will have the opposite effect from what you intend.
Job done. Now watch the votes from GPs roll in.