The Freedom of Information Act has been a revelatory tool for journalists but should we really expect to read all Whitehall correspondence as a result?
Those pressing for the NHS reform risk register to be published argue not to do so denies the public the opportunity to make up its own mind about whether the risks of health secretary Andrew Lansley’s NHS reforms are those worth taking.
But, hold on a minute, what sort of content would you imagine a risk register includes? Yes, worst case scenarios in the NHS inevitably speak of lives lost, patients denied care and treatment rationed. Risks by their very definition are possibilities of suffering harm or loss, or danger. Are we, or, perhaps more pertinently, is our media, able to have mature debates about such matters? Isn’t this exactly the sort of document that should be made available in the public interest?
Well, frankly, no.
Does risk inclusion mean such events will happen? No. Would publication make civil servants less likely to document such risks in future? Quite probably. Would that deny ministers the opportunity to base their decisions on all (however glass half empty) opinion available? Yes.
The battle to have the risk register published has been an interesting story to cover but Labour should now draw a line under that particular report and let it gather dust. Mr Lansley has even published some elements of it now to counter lack of transparency accusations.
With a coalition government still at the helm and a Health Act now passed, we appear to be well on course to finding out whether the ‘risks’ the register contains will actually be realised.
Although, non-publication means most of us will never actually know for sure.
She wasn’t at The King’s Fund’s International Integrated Care Summit in London on Tuesday but ‘Mrs Smith’ was undoubtedly its star. Read More »
One word, eight letters long: A-U-T-O-N-O-M-Y.
According to NHS Alliance chairman Dr Michael Dixon health secretary Andrew Lansley mentioned it 10 times in his speech to 150 clinical commissioning group (CCG) leaders in London on Tuesday. It is the one promise the meeting had been wanting to hear all day. Read More »
Of all the things I could have been doing last weekend, I really didn’t expect to be at my father’s bedside in the coronary care unit of Surrey’s Frimley Park Hospital (the hospital where I was born, wrote stories about for my first newspaper and have even DJ-ed at).
And as he told me the story of how he came to be there, I couldn’t help but think what a brilliant example he is of how exemplary NHS care can be; from the GP who realised immediately how ill he was and called an ambulance to take him to hospital, to the nurses who allowed my family to flout the two visitors only per bed rule (my sister and her husband-to-be had travelled 100s of miles to be there).
I remembered a conversation I’d had with former health secretary John Reid years earlier about his frustration with a media which concentrated on the 1 in a million problems with the NHS at the expense of the everyday stories of professionalism and expertise which, fingers crossed, will see my dad leaving Frimley Park today with a spring in his step and a newly fitted pacemaker: a story unremarkable in the big scheme of things but of huge importance to my family and me.
Journalists inevitably focus on the unusual (the Shipman case, for example, so untypical of GPs) but there’s no reason why, as Mr Reid suggested, we can’t tell the good stories too, which is why I’m blogging this.
Do we need the Health Bill which gained royal assent yesterday? It’s probably a question for a different blog but I pose it here because there’s no doubting the coalition government’s ambition to build on the best of the NHS and improve what it is: a national health service of which we can all be proud.
Government policy to abolish practice boundaries has long been an issue of much concern for GPs.
Will ‘home’ practices risk becoming destabilised if their commuter patients are seen elsewhere? Will city practices be able to cope with a sudden influx of the mobile unwell? Do the IT systems exist to enable the sharing of patient records between practices? Read More »
What a difference a year makes. Rewind 12 months and GP joined 140 representatives of the 52 first wave of GP pathfinder consortia at a 10 Downing Street reception hosted by prime minister David Cameron.
The mood was determined and upbeat. There was no doubting the enthusiasm with which the prime minister threw himself into proceedings, he spent up to an hour having his photograph taken with all of them in what he described as his ‘modest Georgian home’.
Conspicuous by his absence was BMA chairman Dr Hamish Meldrum but through no lack of an invitation. As the first cracks in Health Bill support began to emerge, he was unable to attend because of a BMA Council meeting which had voted for a special meeting to discuss the impending legislation.
Fast forward a year and the BMA and RCGP weren’t even invited to the latest number 10 health summit as Health Bill opposition grows. Guests reportedly still aired many of the concerns that representatives of the BMA and RCGP might be expected to raise.
Afterwards the BMA aptly described the summit as ‘selective listening’. It is exactly this sort of childish behaviour that will antagonise GPs further and go no way to persuading an increasingly sceptical public that the NHS is better off in the coalition government’s hands.
A better strategy would be for Mr Cameron to articulate more clearly the successes that clinical commissioning groups (CCGs) are already enjoying, establishing common ground with the BMA and RCGP and continuing to seek to convince them of the merits of his plans. Or at least parts of them. An invitation for BMA and RCGP representatives to be in the room at future such summits would be a start.
Mr Cameron will find that he won’t have to shout quite so loudly about the merits of his plans if he can quietly convince more GP bodies of his Bill values.
Whether you love or hate Mr Lansley’s reforms, you may well have a feeling that 250 individual commissioning groups will quickly create 250 mini versions of the NHS.
For some, this will be a chance to truly reflect the local needs and differences of distinct patient populations, for others it will be the end of the national health service. Read More »
The centenary meeting of the GPC takes place on Tuesday (28 February).
One hundred years after its birth, is it, and LMCs (some of which are slightly older) fit for purpose?
Whatever your thoughts about the Health Bill, one undeniable consequence is that it gives GPs greater control over clinical commissioning groups (CCGs), the bodies designed to replace PCTs.
Speak to LMC representatives and they will tell you that ahead of CCG authorisation they are pulling out of involvement with CCGs, to enable them to speak with an independent voice and to avoid any accusations of conflicts of interest.
In the new order, commissioning GPs will have these potential conflicts of interest to consider and LMCs will play a vital part in promoting the best interests of the GPs they represent.
CCGs seeking to address practice variation could easily slide into the sort of behaviour synonymous with PCTs; target setting and punishment based on poorly conceived ideas of what brings about ‘good’ and ‘bad’ performance.
Reforms pit GP against GP because so many managers have been removed from the bodies that are becoming CCGs. It is imperative for GPs to have representation in any argument with a CCG, and who better to do this than the LMC, which will be forging a good working relationship with the CCG? Perhaps these debates will not be quite so adversarial, with GPs on both sides.
The possibility of an end to the UK-wide contract, which becomes ever more likely should Scotland become independent, also means the GPC will have a great deal to consider to maintain the unity and strength that representation of a larger number of GPs brings.
Who would have dreamt that the GPC and LMCs would be as relevant in 2012 as they were 100 years ago?
Potential conflicts of interest between the commissioner and provider roles of GPs have been clear from the start of the government’s plans to axe PCTs and replace them with clinical commissioning groups (CCGs).
Read More »
Will clinical commissioning groups (CCGs) become ‘rebadged’ PCTs in everything but name only?
It’s probably one of health secretary Andrew Lansley’s biggest nightmares as the number of CCGs (currently 240-ish and ever dwindling) plunges towards 152 (the number of PCTs there were when it was decided CCGs would replace them). Read More »
