In today’s Independent Nick Clegg has set out four demands for changes that will determine whether the Conservatives get the Lib Dems support for the Health Bill. We have the solutions….
* “We must ensure that GPs only get involved in commissioning decisions once they are ready and willing” – Sensible really. Conscripts don’t make good volunteers but if PCTs are going, we can’t have a vacuum. Solutions are to put back the compulsory date or to assign them to an existing consortia. Either way, it’s right for GPs to be more accountable for their use of NHS resources.
* “The removal of any suggestion that we are pursuing a dogmatic obsession with competition [rather than] the best healthcare system in the world”. Absolutely – focus must be on the best known care and the safest possible delivery. This also means having humility and being open to competition as the evidence shows that it drives up quality.
* “Preventing the cherry-picking of services by private providers to make sure NHS providers are not needlessly pushed into financial trouble and NHS research and training can thrive” We need to recognise some facts here: who makes the decisions about where patients go for treatment? It’s the commissioners – not the private providers. The latter were key to Labour getting waiting lists down and now they’re being branded as imposters and source of instability. There are difficult decisions ahead about viability of NHS services based on safety, not just costs. And he’s right, we must encourage research and training, but that will also mean we need to keep the NICE mandate on access to medicines.
* “Enhancing governance and local accountability so decisions are transparent to all” Yes – and competition would enhance this. Shouldn’t we know what services our GP offers, what extra training they have had or awards they have been given and what they have done to assess the needs of their population? Then we will have the information to choose who we see – and Health and Wellbeing Boards should have a role here too, making sure commissioners are taking into consideration the wider determinants of health.
So on the whole, we agree with you Nick. And we understand that you need to look tough on the NHS, but don’t let your party forget the focus must be on patient not Party outcomes.