David Blackburn

A question of accountability

A question of accountability
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In theory, curbing bureaucracy in the NHS should have you reaching for the Champagne. But giving GPs control of £80bn is an enormous risk. GPs know their patients' needs, so Andrew Lansley’s thinking is that empowering GPs will improve patient care, and therefore patient outcomes. Many GPs will be chomping at the bit to get their hands on budgets; on the other hand, many will not – it takes a certain kind of mind to be thrilled by balance sheets. Also, those that are may fight their corner rather too vigorously, which would merely deepen imbalance in the health service. The success or failure of Lansley’s initiative depends on ensuring that GPs will be accountable for the public money they manage - the White Paper must address that question.

Lansley proposes the most substantial upheaval in the NHS since its creation. Health Authorities will be abolished, the remit of Primary Care Trusts limited. But the reforms are not as dramatic as they look: the NHS’ structure will not change. Certainly, there will be savings, but the fundementals of healthcare provision remain sacrosanct. Replacing PCTs with GPs will create associated costs as hundreds of groups of independent practitioners debate what is needed where. One has to wonder if the experience of patients nationwide can dramatically alter.