Health bill battle swings in government’s favour – but doctors still opposed
The controversial Health and Social Care Bill has cleared a series of political and parliamentary hurdles and looks highly likely to become law. However, a new survey shows 69% of physicians want the bill dropped and just 6% are in favour.
This Tuesday saw the bill complete its House of Lords report stage, after further concessions. Former SDP leader Lord Owen will have a final attempt to stop the reforms by calling for a delay on any further debate until after the publication of a report on the risks they pose to services. The government has lost a series of legal battles to keep the document secret.
The Royal College of Physicians has revealed the results of a survey which shows opposition at close to 70%. RCP president Sir Richard Thompson said: ‘The areas of most concern are training, education and research; use of the private sector; commissioning by clinical commissioning groups; and choice and competition.’
The Liberal Democrat Spring Conference showed widespread grass roots opposition to the bill with a motion in its favour, sponsored by party matriarch Dame Shirley Williams, being severely mauled. The tide though, appears to be turning in the government’s favour. Only five Liberal Democrat MPs defied the party whips to vote with the opposition in a bad-tempered Commons debate which resulted from a GP’s e-petition calling for the bill to be ditched.
In a curiously timed move the Royal College of GPs sent a letter declaring its willingness to help the government implement the changes. The move was widely interpreted as a u-turn. But college head, Clare Gerada, insisted that the best option is still to scrap the bill. She claimed that her organisation was simply acknowledging that it may have to make the best of a bad job.
Private company set to take over Devon children’s NHS services
Core NHS children’s services, including care of the terminally ill, appear likely to go to a private company with no previous experience in the field. Serco, Virgin Care and Devon Partnership NHS Trust have all been shortlisted for the three year contract by NHS Devon and Devon County Council. A source close to the process told The Guardian that the NHS bid – in partnership with Barnado’s – is not likely to win.
If the £130m contract goes to a private company it will be seen by critics as evidence that the NHS will rapidly be broken up among private companies. The winner will run sensitive frontline services including child protection, treatment for mentally ill children and adolescents, therapy and respite care for those with disabilities, health visiting, and palliative nursing.
Final bids will be evaluated in May with the contract going to ‘the most economically advantageous’. Neither of the private companies has experience of specialist children’s health services for the NHS. Serco plans to run the services with Cornwall Partnership NHS Trust, but the extent of the trust’s role is unclear. Serco’s past NHS involvements have sometimes been controversial. Virgin Care has a major dispute with the NHS in Yorkshire.
John Ashton, director of public health for Cumbria, said: ‘What on earth are they doing taking risks with our children like this? Children’s services such as these are very complex and involve working with lots of agencies over long periods. How a private company can function in that area when it needs to identify ways of making money is really hard to see’.
A government spokesman said: ‘We support patient choices and whoever is best getting the contracts. We reject the idea that because a private company might get it, it is privatisation’. He added that services would remain free to use and publically funded.
London IT deal not a cert for Cerner
Cerner says it is not certain that its Millennium product will be chosen by all nine London trusts which have joined forces for a huge, collaborative tender. EHI reports that they could each choose different suppliers.
Matthew Swindells, managing director of Cerner Global Consulting, said he expected ‘most’ trusts to stick with Millennium. However, he added it was not a foregone conclusion and it was up to trusts to encourage other suppliers to bid for the work.
Suppliers can bid independently, or as a consortium. The estimated value of the tender is between £250m and £400m.
Meanwhile CCGs are showing increasing signs of wanting a powerful influence over the IT used in their areas. Three clinical commissioning groups in North Mersey have set up a joint board to provide strategic overview of IM&T programmes in the region. The group is writing to IT and medical directors at local trusts and providers to let them know about the role of the IM&T board.
In a further major development, Sussex Partnership NHS Foundation Trust (subscription required) has named a specialist provider 2e2 as its preferred bidder for a contract to provide information technology infrastructure and support. The work will include everything from computers to phones and support for all applications including the website, intranet and clinical information systems.
Tackling child healthcare variations
The DH has launched a drive to tackle variations in child healthcare. In a separate development the watchdog, Monitor, is to publish an annual blacklist of health services that must be reconfigured. Both moves are designed to ensure uniformly high standards across England.
GP online says the new NHS Atlas for the Variation in Healthcare for Children and Young People is aimed at spurring commissioners to review their care pathways and take firm action to end a postcode lottery in care. The document reveals that the number of emergency admissions for asthma among young children varies five-fold across PCTs. There were also wide variations in admissions for epilepsy and diabetic ketoacidosis.
Dr Sheila Shribman, national clinical director for children, young people and maternity services, said: ‘Tackling unwarranted variation can help the NHS to provide better care, reduce waste and make sure that all children and young people get the best possible results from their care’.
The Monitor blacklist, according to HSJ (subscription required), is intended to establish a ‘pre-failure regime’. This means that central authorities will be able to force healthcare providers to take action before they are deemed to have failed and are taken into administration. Providers that ask for subsidies above standard payment rates – as they are allowed to do under the bill – will automatically be considered for the list.
News in brief
- NHS trusts seek IT consultancy, project management for eHospital plan: Cambridge University Hospitals NHS Foundation Trust and Papworth Hospital NHS Foundation Trust are seeking suppliers to provide project management and IT consultancy services for the pair’s eHospital programme, reports The Guardian.
- Online GP booking through 111: Pulse claims that patients using an online version of the NHS 111 urgent care service will be able to directly book appointments with their own GP, or another practice within 10 miles. Some GPs are angry that their control over their appointments systems might be overruled.
- PCT managers get most top commissioning jobs: HSJ (subscription required) reports that 60% of CCGs have chosen primary care trust managers as their leaders. However, in most cases the role of chair will be taken by a GP.
- NHS Constitution update: The NHS Future Forum is to update the NHS Constitution – and a new section has just been included on whistleblowing. For details on this and all the latest DH news see the latest issue of The Week.
- Cancer and Alzheimer’s study: Research which followed nearly 1,300 older people has found that cancer survivors have a lower risk of Alzheimer’s, and that people who develop Alzheimer’s have a lower risk of cancer. BMJ reports that the risk of Alzheimer’s disease was lowest in survivors of smoking related cancers.
Opinion
Central versus local – it’s one of the biggest questions to haunt the NHS. Mike Farrar, chief executive of the NHS Confederation, has written an essay for the think tank Reform in which he argues that the pendulum has swung too far towards diktat from the centre and claims that it is a mistake that will come back to haunt us.
‘People in the UK fundamentally believe in the idea that access to healthcare is a universal right. But in recent years the use of choice and competition to move away from a universally available average system to a higher quality more personalised individually tailored system has begun to challenge these assumptions.
‘In light of this, the issue of centralist versus localist has often and misleadingly been equated with the view that centralism reflects the predominant desire for equity, whilst the non-centralist view has been equated to a less managed, deregulated world, in which a market philosophy sits more comfortably.
‘In this respect, it has led to the decentralisation policy question becoming a political question. Unhelpfully, this has turned what should have been an evidence-based debate about policy into a hotly-contested political debate.’
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Jeremy Nettle calls for people to smile a little more to improve their health.
