The NHS has to change

The RCGP has written strongly worded letter to Number 10 about the health bill – it’s all over the news today. Some parts of the government plans are welcomed, such as the greater involvement of GPs in buying and planning care. But the RCGP doesn’t like the prospect of more competition – and wants the entire section on competition in the bill to be rewritten.

The trouble is that:

This discussion is becoming about what GPs want –  it should be about what patients need.

We are concerned that there is a danger of creating a climate where it is possible to believe that any change is bad and unnecessary – when actually the NHS fundamentally has to change. And if GPs are to have total budgets, which they want, then they should be more accountable and public should have more choice, which means competition and information. This is what the public needs. We think it’s unacceptable that the public has such little knowledge and choice over their GP – what services they provide, how up-to-date their training is, what improvements they have introduced, what information they provide. Often it’s just the threat of competition that is required for a hospital or service to improve its efficiency and responsiveness – as was shown when ISTCs were introduced. We need the best of both worlds and one can learn from the other.

Another false hypothesis being circulated is that there is a private and public sector battle raging, when in many circumstances they actually work in partnership and have done for decades.

The worry about market failure is not new – but is distracting. In reality the current model not robust. Patients need continuity and as Hinchingbrooke Hospital has shown us, when the public sector fails, the private sector is willing to step in to try to help. There is no inconsistency in having both markets and regulation alongside to ensure universal coverage, guaranteed minimum standards of care and fairness. But of course, unsafe services should be closed.

We all know that monopolies stifle innovation and promote mediocrity in care. We must beware vested interests that oppose competition as they would have to work harder and be more accountable, especially those who spend more time sailing than on their professional development.

Above all we should ensure our focus is on quality of care, not who provides it. And someone needs to be brave enough to admit that WE ARE NOT BEING HONEST. We can’t afford everything – we should be thinking about core services and where people can top-up their care.


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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