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Letter: In defence of the NHS reforms

Read the full text of a letter from 42 GPs heading up commissioning consortia in support of the Government’s controversial NHS reforms.

Dear Mr Cameron,

We write as the Chairs of GP Consortia across England to express our wholehearted support for the Coalition’s health reforms for GP Commissioning. Together, our Consortia include nearly 1100 practices caring for over 7 million patients. The reforms have received a very bad press lately but much of the criticism has sadly been noticeably misinformed.

Firstly, the reforms are not revolutionary but an evolution and a natural conclusion of the GP commissioning role that begun with fundholding in the Nineties and more recently, of the previous government’s agenda of GP polysystems and practice-based commissioning. Many of our Consortia have, therefore, already worked on commissioning together with PCT staff for three or four years. All that has been proposed is that instead of clinicians working under the direction of bureaucrats, the balance of influence and responsibility should change. Our patients should feel comfortable that decisions about the local provision of health care are to be taken in future by their family doctors, many of whom they know personally. We caution the Coalition of the danger of confusing and diluting the responsibility for effecting change in any amendments to the current proposals. Many GP Consortia already have a proven record of improving patient pathways and that innovation should not be constrained.

Secondly, concern has been raised that GPs are not skilled enough to commission care. This wilfully ignores the existing history of commissioning mentioned above but also misunderstands what will happen in the future. As GP commissioners, we will not be keeping the books personally, nor writing reports or contracts, nor compiling statistics. That will continue to be done by very able staff, who are already appropriately skilled and experienced. Our role as GPs will be to offer strategy, direction, clinical insight and local knowledge to the commissioning of healthcare in our areas. GP Consortia will continue working closely with colleagues from hospitals, community trusts and the Voluntary Sector to design the optimum care pathways for their area.

Thirdly, the reforms emphasise the role of patients in their own care. The reforms promise a place on every board for a patients’ representative. On average, our patients see their GP four times a year, and if they are dissatisfied with the services provided on their behalf, will have no difficulty in saying so. When was the last time any patient managed an audience with a PCT Chairman?

Lastly, the reforms are not all about GPs. One of the most important elements of the reforms is that they are the first significant attempt to co-ordinate all aspects of care – primary, secondary, community and social – into a coherent and seamless whole via the Health and Wellbeing Board partnerships. If successful, there will be enormous benefits to the most elderly, infirm and vulnerable people in our community, whose care is often currently too fragmented.

Now that there are considerable financial constraints nationally, difficult decisions will have to be made on the provision of care. Surely it is better that these decisions are taken locally by professionals, who are in daily contact with the patients who will be affected by them, rather than by remote administrators. We believe that Mr Lansley’s reforms deserve from everybody the support they already have from us.

Yours faithfully,

Dr Jonathan Munday MA MB BChir MRCGP

Chairman, Victoria Commissioning Consortium (Westminster)

And 42 other GP Consortia Chairs as follows: –

Chair’s Name – Consortium

Dr Tim Dalton – ALPF Health (Ashton Leigh)

Dr Gurkirit Kalkat – Barking & Dagenham

Dr Rashid Bhatti – Birmingham Inner City

Dr Ethie Kong – Brent

Dr Arnold Fertig – Cam Health

Dr Tim Berriman – Cannock Chase

Dr John Matthews – Care First North East

Dr Mike Ellis – Carrick

Dr Ruth O’Hare – Central London Healthcare (Westminster)

Dr Peter O’Brien/Dr Steve Allen – In Spires – Coventry

Dr Stewart Findlay – Durham Dales

Dr Joseph Chandy – Easington

Dr Paul Bowen – Eastern Cheshire

Dr Paul Weston-Smith – Erewash

Dr David Eyre-Brook – Guildford and Waverley

Dr Tim Spicer – Hammersmith & Fulham

Dr Ian Goodman – Hillingdon

Dr Nicola Burbidge – Hounslow

Dr Hamish Stedman – Hundreds Health – Salford

Dr Michael Eeckelaers – Manchester Central

Dr Bill Tamkin – Manchester South

Dr Alan Middleton – Mid Cornwall

Dr Tim Richardson – Mid Surrey

Dr Shane Gordon – North East Essex

Dr Derek Hopper – North East Lincolnshire

Dr Alistair Blair – Northumberland

Dr Darren Moore – Premier MK

Dr Marilyn Plant – Richmond

Dr Phil Garnett – Scarborough

Dr Ramila Patel – South Birmingham Independent

Dr Oluwatoyin Ogunsanya – South Essex

Dr Elizabeth Johnson – South Reading

Dr Steve Powell – Stafford and Surrounds

Dr Andrew Bartlam – Stoke

Dr Jonathan Cockbain/Dr Brendan Hudson – Sutton

Dr Peter Crouch – Swindon

Dr Shikha Pitalia – United League (Wigan & St Helens)

Dr Mark Hayes – Vale of York

Dr Rysz Bietzk – West Essex

Dr Chris Trzcinski/Nick Pulman – West Leicestershire

Dr Malcolm Skinner – West Norfolk and Wisbech

Dr Stephen Madgwick – Wokingham

Dr Simon Gates – Wyre Forest

Letter: In defence of the NHS reforms Letter: In defence of the NHS reforms