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national health executive Editorial


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Commissioning / Deputy Editor Adam Hewitt


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EDITOR’S COMMENT


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‘N


o retreat’ proclaims David Cameron; well, he would


say that.


If there are to be further changes to the Health and Social Care Bill to take account of medical and public opinion, then looking at the precedent set over the past months they will be gradual, be- hind-the-scenes, and everyone in- volved will deny anything is chang- ing anyway.


The Government certainly isn’t in the mood to drop everything just because the BMA or Lib Dem ac- tivists say so, and the comparisons between the BMA and Bob Crow’s RMT union made by one Conserv- ative offi cial are illuminating.


Unfortunately, the offi cial forgets that the public trusts family doc- tors far more than strike-prone train drivers, or, for that matter, politicians.


Average circulation for the period 1/1/2010 – 31/12/2010 is 8,008 per issue


Indeed, the BMA was actually far less militant at its special rep- resentative meeting than some doctors seemed to be hoping. By voting in favour of the principle of clinician-led commissioning and ignoring excitable calls to blacklist Health Secretary Andrew Lansley or march out on strike, it got its main points on the reforms across in a powerful way.


TT-COC-002610


Environmental Policy As a business the environment is very important to us. As such our magazines are printed using paper from a well-managed source. All inks used are vegetable based (soya or rape seed). Our printers are currently certifi ed to ISO 14001 Environmental Management.


But the bigger danger for the Gov- ernment, if that is possible, is the public anxiety over cuts seeping across to the NHS.


Stay informed, stay in front


Jobs are going at some NHS trusts but have hardly been on the front pages to the same extent that po- lice and council cuts have been, and of course the Government can always point to its pledge to in-


crease NHS spending in real terms – even if it means the occasional ‘top up’ to beat rampant infl ation.


But on the local level, the ration- ing of treatment to save money has been happening for some time now, and it is being thrust into the public spotlight by the need to save money and the increasingly ‘political’ nature of the decisions having to be made by PCTs when commissioning care thanks to the wider context of the NHS reforms.


The PCT Network’s director David Stout has said that trusts are “re- luctantly” and “temporarily” re- ducing activity levels to cut costs, specifi cally by asking providers to extend or freeze waiting times while remaining within the statu- tory limit, or deferring treatment. He admits the actions are “unde- sirable and may be unpopular with patients and providers”.


This argument would not normally make much of an impact on wider public opinion, but the context cre- ated by the proposed reforms in the Health and Social Care Bill sud- denly imbues every commissioning decision with new potency as evi- dence is seized on by supporters and critics of the shake-up.


PCTs aren’t, of course, making po- litical decisions – but whether they like it or not, their decisions are be- coming politicised.


Let’s remember that patient out- comes is the new name of the game – we must concentrate on how the reforms affect them, rath- er than just the service provision side of the health service.


Adam Hewitt Commissioning / Deputy Editor national health executive Mar/Apr 11 | 3


Once more unto the breach


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