White Paper Reconciliation 1

Last week was an historic one. Most people picked up that something seismic had happened, but weren’t entirely sure what, as enquiries came in from pharmacists to MPs to venture capitalists.

We had set out a prescription for success that we deemed necessary for the White Paper and in this and blogs to follow I will be picking up on the hits and misses. The first miss was that we recommended ditching the word ‘commissioning’, because it is a confusing term, encompassing a huge range of functions (buying, selling, planning, strategy, monitoring, evaluating, performance management, specialism appraisals, data collection, reconfiguration, IT systems) and GPs can’t do them all. (David Stout of the NHS confederation makes the same point). They can delegate, contract and sub-contract and that makes them more like Trusts or Authorities. Considering that their consortiums will now, to satisfy Treasury rules, have to become statutory bodies, “GP Trusts” or “Practice-based Trusts” are probably more accurate descriptions and less confusing too. However we made the correct assumption that GPs would certainly be put in the driving seat of the NHS.

And secondly we hoped that top down reorganisation of PCTs was not included in this Paper, and that their future could be determined by the gradual reshaping of the system that would be led by the GP consortia. We foresaw their attrition but thought that this sort of bottom-up evolution should be in keeping with the aim of less political, structural reform and more progressive, clinically led service development. The challenge will now be in keeping PCTs viable as some able staff jump ship as quickly as they can (to the independent sector ready and able to expand commissioning support) and all staff battle with morale as the PCT vessel gradually sinks.


About Julia Manning

Julia Manning is a social entrepreneur, writer, campaigner and commentator. She is based in London and is the founder and Chief Executive of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal. Through networking, technology, research, relationships and campaigning 2020health has influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer at City University, a visiting clinician at the Royal Free Hospital, working with south London Primary Care Trusts and as a Director of the UK Institute of Optometry. She specialised in diabetes (University of Warwick Certificate in Diabetic Care) and founded Julia Manning Eyecare in 2004, a home and prison visiting practice for people with mental and physical disabilities using the latest digital technology, which she sold to Healthcall (now part of Specsavers) in 2009. Experiences of working in the NHS, contributing to policy development, raising two children in the inner-city and standing in the General Election in Bristol in 2005 led to Julia forming 2020health at the end of 2006. Julia is a regular guest on TV and radio shows such as BBC News, ITV’s Daybreak/ GMB, Channel 5 News, BBC 1′s The Big Questions, BBC Radio, LBC and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week. She is mum to a rugby-mad son, a daughter passionate about Shakespeare, and wife of a comprehensive school assistant head-teacher. She loves gardening, ballet, Zimbabwe, her Westies Skye and Angus, is an honorary research associate at UCL and a Fellow of the RSA.
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One Response to White Paper Reconciliation 1

  1. Capodimonte says:

    Interesting article, thanks.

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