In the run-up to the general election, all the political parties trying to win your vote using the NHS card. They make all these wild promises, but what is going on behind the scenes?
Labour -- Gordon Brown's health team is promising something for everyone: the public can have whatever they want – if they drink themselves nearly to death the NHS will put them right; speaking of rights, they will have the right to be waited on hand and foot. The NHS will find £20 billion worth of savings. And any manager who cuts services will be named and shamed.
Conservatives -- David Cameron promises a better NHS. His health team is busy flirting with private companies, to great effect (Andrew Lansley’s electioneering pot is £20,000 richer!). The United States experience of private healthcare is that 40% of all spend goes on administration. This means; 40% less money available for patient care -- how can they maintain standards of patient care if the money is being used up on administration?
Liberal Democrats -- lots of worthy talk, very little sign of realism and implementation – but then they don’t think they will actually have to do anything.
BNP – apart from wanting to paint everyone white and sterilise anyone who isn’t a member of the party, I haven’t read anything interesting yet.
But what do we gain from all of this navel gazing?
It's as well to be prepared. If an incoming government is going to do what's necessary, that is, empower the people and organisations who can have the most impact, then those very same people need to be ready with ideas of what to do and plans to do it.
If, on the other hand, an incoming government plans to continue the current policy of promising everything and funding nothing, then we -- the people who can make a difference -- need to reconcile ourselves and continue doing the best we can.
I've worked a long time understanding health in UK - on the outside looking in (selling into the health service and NHS); I worked at a national level developing and supporting policy; I've worked regionally, implementing policy and strategy; I've worked in NHS organisations; and I work in a GP practice at the moment. The biggest difference that can be made is where the patient first touches the health service. Most of the time, nine times out of 10, that's with the GP.
The right resources in the right hands
GPs make the first decision following a diagnosis: they can make the biggest difference to the quality of service the patient receives (by referring to the best pathways), and the amount of resources (cost) that a patient consumes (by using appropriate healthcare close to the patient's home). It really does make sense to empower the GPs and support them to care for their patients.
So how can primary care trusts engage with their GPs?
The first thing to do is to listen; understand the concerns they raise; understand their ability to implement (or inability); and understand whether they are looking for more money for themselves, or more money to support their patients.
It's important not to get precious. If someone comes up with a good idea for a service, that doesn't mean that you'd steal the idea and give it to your PCT provider arm. NHS as preferred provider was old-fashioned before Andy Burnham said it – competition has created some inefficiencies, but it has also created an enormous amount of good.
Making it happen
Minney.org Ltd works with many health and social care service providers and commissioners: we promote engagement, we are realistic about the provider's ability to implement the good ideas they come forward with, and we support Commissioners to get the best for their population. It would be pleased to talk to you about what we can do for you. Contact me on the contact details below.