NHS

March 2006

Following a very interesting and useful meeting I have had with local GPs, I have written to the Secretary of State with a number of questions. I will keep the website updated with any reply I have.

I have made the following points to the Secretary of State for Health and asked her for her response:

1) They feel no-one is being honest and facing the facts that you cannot provide everything for the amount of tax that is being levied and the Government are trying to pin the blame for the failing health service on everybody else rather than tightening the belt and telling people straight what they can and cannot have for the money they contribute.

2) The lack of continuity of care at hospitals and identification of responsible clinician is an ongoing problem raised by doctors, patients and their carers and families.

3) Hospital follow-up arrangements are often unclear to doctors, local GPs and the patients, carers and families.

4) Fragmentation of primary health care with possible and probable demise of traditional general practitioner roles in the future. This was felt acutely in city areas and by many of the doctors I have spoken to shared this view.

5) Investment in the NHS is not going to patient care, but to "bean-counting" and initiatives (eg choose and book) that are not backed up by evidence that they are effective at providing.

6) The Government does not respect doctors’ knowledge/skills either in managing patient care or in providing a comprehensive public health function. Initiatives such as nurse-led units will not meet the vast majority of patients’ needs or will be seen as desirable by patients.

7) General Practice can be the most effective way of using resources to the best advantage to optimise patient care within primary, community and secondary care, provided that the GPs are freed to take this responsibility. It is unlikely to be successful through the current route of coercion, bureaucratic control and extremely limited freedom. What can be done to improve that situation?