The Royal College of Obstetricians and Gynaecologists (RCOG) welcomes the Prime Minister’s speech today on the Coalition Government’s plans for NHS reform during the pause provided by the Listening Exercise.
There are several encouraging sound bites from today such as: ‘Evolution, not revolution’ and ‘Collaboration, not competition’. Whatever the case may be, the RCOG agrees that change within the NHS is much needed in order to ensure cost-efficiencies whilst continuing to deliver high quality and safe care. However, several key issues still remain.
- In order for GP Commissioning Consortia to work, there needs to be a process involving service providers in the decision-making process since they have the front-line experience and knowledge of what services are needed in their respective specialties
- There needs to be clearer explanation of the way in which competition in the NHS will work. While competition can be a spur to drive up quality and drive out inefficiencies, the extent of the private and charity sectors’ roles in the NHS need to be far better defined and delimited
- There is real anxiety over workforce planning and the training and education of doctors in training, a critical factor in the future development of high-quality specialists. To be involved, ‘any qualified providers’ must provide training, subject to the same standards and conditions as NHS providers. These developments will have serious consequences on our medical workforce in the future
RCOG President Dr Tony Falconer said “Amidst all the uncertainty in the reform agenda, one factor for us remains – as doctors, we want the best care for the women that we serve.
“As far as we’re concerned, if the Government is serious about offering better choice in women’s health, the first step to take is to look at it as a whole, in a continuum, from cradle to the grave. At the moment, the reform proposals have the potential to split services further into silos and this could have unintended effects on services.
“We believe that competition has several benefits including rising the quality of clinical care. To achieve this aim, we want to be assured that patient care is underpinned by national clinical standards and agreed pathways of care, through the commissioning process. Then and only then can quality be ensured.”
The current plans to ensure that all GPs are involved in the Pathfinder scheme by 2014 may be too ambitious, especially since so many questions remain to be answered. It will be prudent to extend the deadline so that the early adopters have time to embed and prove that they are successful before wholesale transition from one system to another is made. At a time of evidence-based medicine, proof is needed before change is made.