The NHS will be safe in our hands

DR Ian Wilkinson, chairman of the GP Commissioning Consortium Committee and a senior partner at Woodland Medical Practice in Chadderton

THE Government’s plans to hand £60 billion of the National Health Service budget to GPs, as part of a radical reform of the way the NHS is run, have been met with plenty of opposition.

Critics claim we are seeing a move towards privatisation.

MARINA BERRY spoke to the Chadderton doctor at the forefront of the reform plans in Oldham.
OLDHAM’S health services are safe in the hands of local GPs, according to one of the borough’s leading doctors.

Dr Ian Wilkinson is chairman of the organisation which will evolve by April, 2013, into a body that will buy health services for the people of Oldham.

The GP Commissioning Consortium will use its spending power — about £300 million of NHS money each year —to decide what services will be provided in the borough.

And its decisions will rely heavily on the local knowledge gleaned by family doctors from treating patients, and from views members of the public will be encouraged to put forward.

The Chadderton family doctor is keen to allay fears that his colleagues may create a system to suit themselves, and not their patients.

Progression
“That is not what Oldham GPs are about, they have a very strong commitment to their patients and to continue to improve health care,” he said.

“Since 2007, GPs have been working almost as an advisory committee to NHS Oldham (the primary care trust that currently buys health care for the people of Oldham).”

“This next stage is a natural progression.”

Another local worry is that GPs will desert their surgeries and turn into managers, but Dr Wilkinson said that won’t happen as the biggest GP role will be as chairman, who will spend around half a day a week away from their surgery.

Dr Wilkinson said the strength in the changes would be for decision makers to retain a clinical role, to stay in first-hand touch with the needs of their patients.

He said: “The majority of people in Oldham know who their GP is and where to find them. We see patients every day of the week, we hear where the system is not going right and where it is going well, and how they think it could be improved.

“Together, GPs have hundreds of years of medical experience out there in the community.

“Until now that richness of information has been lost and not fed into making improvements. We are very keen to harness that knowledge into commissioning better services for patients.”

The new body will be made up of both GPs and managers. “GPs won’t be sitting adding up columns on spreadsheets, managers will do that for us,” he said.

“We will know how much we have to spend and we will have to prioritise and spend it as wisely and efficiently as we can.”

There are more than 100 GPs in 50 GP practices in Oldham, all of whom are part of the group working towards forming a GP Commissioning Consortium.

Their backing for change is vital to its success, and Dr Wilkinson (57) explained: “Before progressing we felt we had to have a mandate from our GPs in Oldham.”

A vote on the issue resulted in 71 per cent of GPs responding, of whom 93 per cent voted in favour of the changes.

“If we didn’t feel we could make a difference and make things better I don’t think any of us would want to be involved,” he said.

“I believe we can make a difference and we can make things better, but we can’t always make those changes happen by being a full-time GP.

“Without strong clinical leadership it’s very difficult to make changes.

“I am pretty much a pragmatist. We can oppose changes being imposed upon us, or we can say those changes are inevitable and ask how we implement them in ways that are better for our locality.

“There was an inevitability about the changes. Economically and financially we can’t continue in the way we have in the health service.”

Dr Wilkinson said the new consortium would aim to bring as many services as possible as close to patients as possible, providing they were safe and high quality.

Supportive
“Some tests and investigations have to be carried out in hospital, but many don’t, and I think most people would rather have them done close to home at their local surgery rather than go to hospital with the travelling and waiting that goes along with it,” he said.

“We will have to increase the capacity of primary care to do that, but that doesn’t mean we are in the game of wanting to shut hospitals.

“We are very supportive of wanting to keep our local hospital and keep it viable.”

The father-of-three is fiercely loyal to Oldham, where he has been a GP for 31 years.

It takes him minutes to travel from his home to his surgery at Woodland Medical Practice, based at Chadderton Town Health Centre, and he said, like most of Oldham’s GPs, had a vested interest in making sure the changes work.

He said: “I live in Oldham, my family live in Oldham, I pay taxes which pay for health care in Oldham and I get my own health care in Oldham.”

He is only the sixth GP in his practice since it was established in 1890, and his daughter it set to join him as a GP after she finishes her medical training.



NHS reforms Q&A

What will the shake–up do?
Health Secretary Andrew Lansley’s plans will fundamentally alter the way the NHS works in England, and he argues they will improve patient care.

Under the Health and Social Care Bill, GPs will take control of around £60 billion of the NHS budget and hospitals will be given more freedom from central Government.

Groups of GPs will form into groups to commission services from April, 2013, although it is unclear how many doctors plan to be directly involved in buying in services.

It is thought that people currently working at primary care trusts (PCTs) and strategic health authorities (SHAs), which will be scrapped under the plans, may be re–hired to do the work.

An NHS Commissioning Board will oversee the way services are bought. Mr Lansley says patients will have a greater say in the way services are designed through a network called HealthWatch.

Doesn’t this sound a bit familiar?
The Conservatives created a system in the 1990s called GP fundholding to give doctors control over local budgets.

The system did not take off as planned, and only half of GPs signed up. Labour replaced fundholding when it came into power, but its version — practice–based commissioning — was also unpopular.

What is the independent NHS Board?
The Tories have long called for an independent board to run the NHS, accountable to the Health Secretary.

The Conservatives believe this will set the NHS free from day–to–day political interference. However, MPs on the Health Select Committee argue that the public will “rightly” continue to regard the Health Secretary as accountable for the NHS.

How much will the reforms cost?
The changes are expected to cost £1.4 billion but ministers are hoping for savings of about £5 billion by 2015.

Savings will come from reorganised care but also redundancies among NHS managers, according to Government calculations.

Why are MPs, unions and campaigners critical of the plans?
Unions have grave concerns about the reforms and are united in their opposition to an increasing role for private, profit–making companies in healthcare.

Doctors attending a British Medical Association’s emergency meeting said Mr Lansley was privatising the NHS but hoped to sweeten GPs by offering them control of budgets.

The Royal College of Midwives (RCM) is calling for a stronger voice in the way maternity services are commissioned and other unions, including the TUC and the Royal College of Nursing (RCN), have pointed to mass job losses occurring in the NHS.

Worries also centre on the speed of the reforms and the Commons Health Committee has been critical of the reforms, saying the NHS has been tasked with finding up to £20 billion in efficiency savings each year while the reforms are implemented.