Are health reforms a cure-all for ailing NHS?

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Changes are afoot in the National Health Services with major alterations in the way the NHS is funded.

Features editor Joni Ager finds out more about what this means for patients.

The National Health Service is on the brink of the most radical reform in its history.

The controversial plans will see control of local health budgets passed from primary care trusts to the doctors themselves working as clinical commissioning groups.

The Government says the reform is essential because of the immense pressures on all public spending, not least the NHS.

It says costs in the NHS are rising at a much higher rate than inflation because of factors such as the aging population, the cost of new drugs and lifestyle factors such as obesity, which are all taking their toll on the health service and its resources.

While those in favour of the reforms say doctors are best placed to make the decisions about where money should be spent in the NHS, critics says they should be focusing on patient care and not budgets.

Plans are already under way for the transition in April 2013 when PCTs will be phased out and the clinical commissioning groups will take over the reigns.

In Northamptonshire, an organisation called Nene Commissioning will be responsible for almost all health services in Northamptonshire with Corby Healthcare taking on the commissioning of services for people living in the Corby area.

Dr Peter Wilczynski, a GP and partner at Lakeside Surgery in Corby and chairman of Corby Healthcare, said: “Corby has a strong community spirit and its own unique health challenges, which is why it makes sense for local GPs to join together in this way.

“We understand better than anyone what the local health needs are, and we want to build an organisation that listens to our patients, involves them, and make a real difference to the way that healthcare is delivered locally to Corby residents.”

The commissioning groups will be responsible for buying and commissioning services including:

Elective hospital care

Community health services

Urgent and emergency care

Mental health and learning disability services

Rehabilitation care

An NHS Commissioning Board will be responsible for directly commissioning pharmacy services, general practice and denistry services.

Ben Gowland, chief executive of Nene Commissioning, says GPs are better placed to use their experience of what patients need to ensure that money is spent in areas where it can bring the greatest benefit.

He said: “I think there is too much talk about whether GP commissioning is a good idea or not. What there is not enough focus on is the detail of how we are going to turn this idea into something that creates real value for the populations we serve.”

But one of the more controversial areas of the reform is the plan to encourage greater competition, with many elective surgeries such as hip and knee replacements to be carried out in the private sector.

This is done today to a certain extent but GPs will have greater power to commission private healthcare organisations and social enterprises to deliver these services in future. But retired consultant paediatrician and former hospital trust chairman Brian Silk, of Sudborough, said: “At a time when workers in different parts of the health service are working more and more co-operatively and survival rates from cancer and heart disease are improving, the GPs’ college sees the intrusion of the market as a threat to co-operative working. Accident and emergency services, out-of-hours emergency care and services for our increasingly elderly population are all under strain. However, opening up the NHS to the market will not improve these services.”

But what do patients think about the impending changes?

Cancer survivor and charity worker Dawn Green, of Broughton, said: “Speaking as a rare cancer patient, I’m more than aware that sadly the quality of patient care does quite often depend on budget and finance.

“Maybe if they can personalise and have greater control on the way they spend their budgets, this could in turn increase the quality levels of patient care that they are able to offer.”