“NHS Alliance is very concerned by statements made at the Labour Party Conference that seem to undermine the role of GPs as commissioners and the right of Clinical Commissioning Groups to make decisions as to the best use of public resources and healthcare.
“We are equally concerned by reports that the Labour Policy Review Group is to consider “ditching the GP gatekeeper’s role”. Both reports imply a lack of understanding of the NHS in terms of its strength and its potential, especially with regard to primary care. Numerous research (eg, from Barbara Starfield and WHO) has shown that a health service predicated on primary care delivers better mortality statistics, improved health, and is more cost effective. This has traditionally been the strength of general practice and its siblings in primary care in the UK. We should be strengthening the role of GP as gatekeeper not threatening to demolish it.
“The importance was illustrated to me only a few weeks ago, when one of my elderly patients fell asleep over supper in France. Instead of a primary care clinician calling and seeing the situation for what it was, she was transferred immediately to a hospital and only after three days as an inpatient, and thousands of pounds of investigations, declared to be fit and well. Other countries look to us with awe and admiration because they don’t have a strong primary care system, meaning technological care and specialist resources are wasted when often patients could have been better looked after closer to home. It seems odd that Labour is challenging both evidence and common sense in this respect, and we would urge all political parties to heed our message.”
“When it comes to commissioning, of course it is important that CCGs and Health and Wellbeing Boards are agreed on the way forward and that local democratic accountability and clinical leadership are ‘in tandem’. After all GPs have surgeries and so do local councillors. Clinicians are close to patients and also have a grasp of what local services and health initiatives are required and an understanding of the sciences that underlie them.
“For many years frontline clinicians have been frustrated by services that do not respond to their patients and the physical and social environments that seem too often to damage their health rather than aim to improve it. Only since 1st April 2013 have clinicians been offered the baton to lead on the planning of local services and health initiatives. It is odd that Labour (having supported Practice based Commissioning) should want to undermine the authority of clinical commissioners and CCGs after they have been in action for only six months – and to pit them against local councillors and local democracy.
Surely the right way is for both to work together to avoid any further reorganisation and to allow clinical commissioners and Health & Wellbeing Boards to forge their own future in an organic way, and unhampered by the dictates of politics and political pragmatism?”
