GP’s are the pivotal point in all health care. They are the first port of call for private and NHS patients alike. Health insurance companies need a GP referral before they can process a health insurance claim and NHS patients cannot be seen by a consultant without GP referral.
The Government have published a draft legislation which is designed to allow GP’s to be in charge of commissioning services for their patients by the year 2013. The theory behind the changes is that not only will costs be reduced but that it will allow for a more direct and meaningful decisions to be made by the people who have the most contact with patients.
The controversial bill is the most revolutionary change in the NHS for sixty years. It is estimated that it will cost up to £1.5bn to make the necessary changes but that up to £8.8bn could be saved by the reduction of the costs of commissioning in the NHS.
The British Medical Association were quick to jump in in response to the bill. BMA chair Dr Hamish Meldrum said:
‘The benefits that clinician-led commissioning can bring are threatened by other parts of the bill. In particular, the legislation will allow competition to be forced on commissioners, even when they believe the best and most appropriate services can be provided by local hospitals.’
‘Forcing commissioners of care to tender contracts to any willing provider, including NHS providers, voluntary sector organisations and commercial companies, could destabilise local health economies and fragment care for patients.’
GP’s should have fabulous relationships with their patients. They are the front line of medical care for all patients. Getting them to commission drugs and services takes their role to another level. How will patients feel about this. Will GP’s be compromised to make decisions that may not be popular with patients because they have to look after the ‘bottom line.’
If GP’s have a bigger budget with more decisions to make how will patients feel that they are making financial decisions that directly affect their health care. It was easier before for GP’s to explain unpopular decisions away by explaining that ‘the trust won’t provide for that.’ There is almost a sense of solidarity between patient and GP – making the most of what’s available.
A Patients Association spokesperson said that is was ‘very concerned’ that the trust between the public and doctors could be affected. Chief executive, Katherine Murphy said:
‘Patients may wonder whether they will be referred to the best services, and not the hospital which the GP may see as making money for him.
‘Could the healthcare needs of some patients be compromised because GPs are now holding the purse strings and are more concerned with the consortium’s bottom line than the patient’s needs?’