We're facing a fundamental change to way general practice functions – where the care of the patient is placed in the context of the resources available.
The White Paper has been described as both radical and a significant change in the present direction of the NHS.
It is both of these and more. At one stroke the whole concept of central direction, managed change and micromanagement has been taken out of the NHS and we are left with a an artificial market place in its stead.
We also are facing a fundamental change to way general practice functions – to a place where the care of the patient has to be contextualised within the resource available. GPs are going to have to rise to this challenge which will encourage them to move to a more corporate way of managing care, and reduce the existing variation within primary care.
This change is to be welcomed. Yes there is doubt as the detail is not yet written in, but I welcome that absence as we can fill it.
There is also doubt about the balance to be truck between autonomy and accountability and the role of local democracy via local authorities. Depending on where that balance is struck, will depend on whether the reforms lead to enhancements in patient care or more stasis.
Finally there is doubt as to whether the whole system will manage the transition from where we are now to where we need to be in the future.
The debate needs to continue but I believe I will never get a better chance than the one I have been offered to improve the health of my population and also to enhance the role of primary care.
Dr Charles Alessi is a GP in Kingston-upon-Thames
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