NHS MESS

NHS MESS

The new NHS reforms being proposed by Andrew Lansley (health secretary) are seeing more power for GPs and doctors and the abolishment of Primary Care Trusts that currently determine what the NHS budget is spent on.

 Primary Care Trusts (PCTs) who are currently in charge of the health budgets in their local area will be abolished and the money will be handed over to GPs to plan and buy health services from hospitals and other providers. The GPs will decide on the treatment for patients and can choose to purchase it from a range of public and private-owned providers. A new NHS Commissioning Board will be set up which will be independent of the Government and will give out the NHS budget to GPs. The NHS will also stop being an organisation with a management structure, instead it will be a market of competing health service providers.

I interviewed a variety of people including doctors and patients in a local hospital to find out their views on the reforms and seemed to receive a mixed response.

I wondered if people were fully aware of the reforms and what they involved.

One doctor replied with "Yes, I know in detail what the reforms entail" whereas a clinic clerk stated that she knew of the reforms but "couldn't give specific details." To my surprise, most patients were aware of the proposed reforms but weren't sure in detail how it would affect them.

So, how would it affect employees in the hospital?

A member of the administration team stated that if PCTs were abolished then they would have less control over hospital decisions which may make it a harder environment to work in. A doctor replied with "the amount that patients trust me will decrease due to the fact that they don't know who to trust with money in this economy, people often think that doctors just want their money – they don't believe we actually want to help them." There seemed to be a fairly negative response to this question from the staff, they were in agreement that the reforms would create more work, particularly paperwork, and created a sense of trust issues between staff and patients due to the fact that doctors will ultimately determine what treatment the patients receive.

Is it a positive or a negative change?

The main response in the media today about the reforms is overall negative, I wondered what the people who would be directly affected by the changes would think.

One doctor thought it was an overall positive change as it will give him more direct control of patient care as opposed to PCT's deciding on money spending as "doctors see things first-hand so are more educated on what the money should be spent on". A patient agreed that the reforms were a positive change as she is more likely to trust the care that the hospital is giving because she knows her GP personally and he knows the kind of treatment she needs more than anyone else does. The response was mainly positive for this question but one patient I interviewed said "I am less likely to trust the doctors as I don't know if the care is benefiting me or the doctors themselves – if the doctor wants to save money then all he has to do is give me a cheaper treatment which I will be unaware of. I think the reforms are bad because the doctors have all the control over our treatment."

Lastly, I asked about the affect it would have on patient care in general.

One doctor stated that "patients will have improved care because doctors, who know them personally, will be deciding on their course of treatment." A clinic clerk disagreed that patients will have improved care as she suggested that as the doctors will have a lot more power over decisions made in the hospital, they will have less time on their hands and therefore less time for patients.

The general comments from the people I interviewed agreed that personal care for the patients may decrease as doctors will have more on their hands and will have more decisions to make resulting in it being more difficult to focus on the care of their patients.

The reforms are still not a confirmed change but the responses, especially from senior staff in the hospital, seemed to be positive. However, the patients in the hospital had a mixed view on the subject and many were concerned about their care if the reforms did take place.

Courtney Honisett