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 is a social pioneer, writer and campaigner. She studied visual science at City University and became a member of the College of Optometrists in 1991, later specialising in visual impairment and diabetes. During her career in optometry, she lectured at City University, was a visiting clinician at the Royal Free Hospital and worked with Primary Care Trusts. She ran a domiciliary practice across south London and was a Director of the UK Institute of Optometry. Julia formed 20/20Health in 2006. Becoming an expert in digital health solutions, she led on the NHS–USA Veterans’ Health Digital Health Exchange Programme and was co-founder of the Health Tech and You Awards with Axa PPP and the Design Museum. Her research interests are now in harnessing digital to improve personal health, and she is a PhD candidate in Human Computer Interaction (HCI) at UCL. She is also dedicated to creating a sustainable Whole School Wellbeing Community model for schools that builds relationships, discovers assets and develops life skills. She is a member of the Royal Society of Medicine’s Digital Health Council. Julia has shared 2020health's research widely in the media (BBC News, ITV, Channel 5 News, BBC 1′s The Big Questions & Victoria Derbyshire, BBC Radio 4 Today, PM and Woman's Hour, LBC) and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week.
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