The health White Paper: FAQs

The challenges are complex and will be difficult to overcome, but the opportunities to shape a new clinician led health service that is motivated to treat patients closer to home and prevent unnecessary hospital admissions is unprecedented. The risk is that we become so absorbed in sorting out the structural issues of establishing consortia and payment mechanisms, that we forget to think creatively about how we can provide services differently. For example, I wonder how many GPs are considering the role that ambulance services can play if they innovate and re-focus to develop as a mobile healthcare service and not just an emergency service? We must invest time and money now in developing creative and brave clinical leaders who can play a vital role in shaping innovation in service delivery and system change. Anne Tofts

Pity that such a highly informative, comprehensive article, written in a reader-friendly prose, is spoiled by "under the massive cull of bureaucracy...SHAs will be scrapped.." No doubt the names will change, but there will be no cull. SHAs will be replaced by other bodies, already mushrooming to accommodate the 'sacked' managers. PULSE should investigate not only how many costly pen-pushers are sacked at NHS London, but also how many are newly employed. The Sir Humphreys will not give up so easily and it is our real comrades who will suffer - our PCTs' staff. The White Paper will succeed only if the DH Budget Board gives the money directly to the consortiums, by-passing the very expensive middle-man.
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Kosta Manis, GP-principal. kosta manis

What does 'not bailing out loss-making consortia' mean?
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It means GPs must pay from their own pockets and many could go bankrupt in the first year. GPs are expected to take over loss making PCTs, Darzi centres etc. The average commissioning being £1000 per patient, if you go 10% over budget it means a £200k loss for each GP!
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We must insist that the govt limit our losses to say £30k per year. suman mohindra