NEWS
Government risks breaking NHS spending promise
Soaring inflation could undermine the Government’s pledge to raise the NHS budget in real terms. The Institute for Fiscal Studies said the Government is “sailing perilously close to the wind”, with spending likely to “barely meet” the pledge.
Labour went further, accusing the Government of ‘double counting’ parts of the NHS budget as re- gards social care. Shadow health secretary John Healey said: “The small print of the Budget confirms that David Cameron is letting the NHS down, and has broken his promise to protect the NHS.
“With the Office for Budget Re- sponsibility’s new inflation fore- casts, NHS England is in fact fac- ing a real terms cut of £1bn.”
Government sources have sug- gested the NHS budget will be ‘topped up’ if necessary to ensure the spending pledge is kept.
One in ten UK doctors qualified in EU countries, and those who qualify outside the UK are more likely to be excluded or suspended from their jobs, research has shown.
The GMC is concerned at the requirement of EU states to recognise each other’s medical qualifications, without checks of doctors’ competence and language skills.
The GMC document says current EU legislation “does not allow competent authorities to assure themselves that the migrant doctors they register have kept their skills and competence up to date since the award of their professional qualifications”.
The General Medical Council wants greater scrutiny of non- UK medical qualifications for EU doctors working in the UK. In its response to a European Commission review of a 2005
directive governing automatic recognition of different systems, the GMC said regulators “cannot have full confidence in each other’s medical training and education”.
Health Secretary Andrew Lansley wants more doctors available on call at night and on weekends, making foreign locums less necessary.
The NHS Confederation has come out with a “new way forward” for the increasingly controversial NHS reforms, with a discussion paper covering competition policy, GP commissioning, accountability, and the speed of transition.
Prime Minister David Cameron and his deputy Nick Clegg are thought to want to take ‘personal charge’ of the reforms as the Gov- ernment signals some changes to the Bill to appease critics.
The new NHS Confederation discussion paper, called ‘Where Next for NHS Reform?’ analy- ses concerns raised about the changes and suggests measures that the Government could take to address them.
It questions whether the ‘any willing provider’ principle is ap- propriate for complex care, for example, saying: “For these serv- ices it is likely to be better to al- low patients to choose from a consortia-approved provider or list of providers that have met a well-defined service specifica- tion, rather than any willing pro-
vider that is licensed to enter the market.”
It also suggests ways around po- tential conflicts of interest arising from GP-led consortia commis- sioning, saying: “Measures such as open-book accounting, which gives the public greater access to financial information, might be a simple way of ensuring effective scrutiny of GPs’ profits.”
Nigel Edwards
Nigel Edwards, the Confed- eration’s acting chief executive, said: “The Government has got to ask itself some hard ques- tions about how it manages the reforms from here on in.
“We are not saying we have all the answers but we do want to start a conversation about the solutions.
“The debate on the reforms has become very polarised and en- trenched, with little movement on the practical ways of manag- ing what are very significant risks. This is destabilising for an NHS that is already making structural changes to meet the Govern- ment’s agenda.
4 | national health executive Mar/Apr 11
“There is a recurring theme run- ning through our analysis. We have often found a reality gap be- tween ideas that are good in prin- ciple and the details of practical delivery, which have often looked opaque or too optimistic.”
The Government has already sig- nalled its willingness to shift its position on some of the reforms, with ‘any willing provider’ set to become ‘any qualified provider’, while deadlines for GPs to organ- ise into commissioning consortia could also be relaxed. Accounta- bility is likely to be boosted, while the law will be strengthened to ensure private companies cannot
‘cherry-pick’ only the most profit- able services – a key concern of Lib Dem activists and ministers.
Progress on implementing the Health and Social Care Bill, which has come out of commit- tee stage in the Commons before heading to the House of Lords, has come to a ‘natural break’ and now is a good time to re- examine some of its provisions, officials have suggested.
Health Secretary Andrew Lansley is understood to oppose any fur- ther ‘watering down’ of the Bill.
Labour leader Ed Miliband is stepping up his attacks on the reforms, saying they are causing “chaos”. He told the RSA think tank in a speech: “This is a direct consequence of a coalition based on power, convenience and am- bition rather than values.”
FOR MORE INFORMATION The full NHS Confederation discussion paper is at www.
nhsconfed.org/Publications/ Pages/Where-next-for-NHS-
reform.aspx
Image: NHS Confederation
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84