CCGs – still a chance to protest NHS changes

October 16, 2012 by
UPDATED: Read the update >   Blog, Health   No Comments Yet

CCGs are one one of the planks of the NHS reforms instigated by Andrew Lansley, and now due to be implemented by his successor Jeremy Hunt. In essence, they will be the local bodies deciding how NHS money is spent and prioritised. While  – until Labour make it clear that the whole party supports Andy Burnham’s stated intent to repeal the Health and Social Care Act – the juggernaut of change seems unstoppable, there are still a few individuals pulling apart the jargon and highlighting the real problems the new NHS system presents.

Lord Hunt: motion of regret

Later today, Lord Hunt (no relation to Jeremy, the Minister for Magic) will move a regret motion in the Lords pointing to just one small – but significant – detail in the new CCG regulations which exemplifies the disintegration and potential chaos the changes may lead to – despite the best will of the GPs involved.

His motion reads:

to move that this House deplores the fact that the National Health  Service (Clinical Commissioning Groups) Regulations 2012 (SI 2012/1631)  involve the exclusion from membership of a Clinical Commissioning Group  of (1) a member of a local authority, and (2) a registered nurse or a  secondary care specialist if employed by a body which provides any  relevant service to a person for whom the Clinical Commissioning Group  has responsibilities.

Watch it here later today (after the Local Government Finance Bill Report).

So is it just a shout of protest?  Regret motions do not lead directly to legislative change though they can be voted on (if the proposer feels the House’s feelings on such a motion should go on record. If you want to support him, you may want to let Lord Hunt know how you feel via his Twitter @LordPhilofBrum).

Tthe legislation which Lord Hunt is criticising is secondary legislation (an SI or Statutory Instrument), regulation resulting from the passing of the Health and Social Care Bill which could destroy links between CCGs and local councils; and between CCGs and hospital consultants/specialist nurses.

Why do you need those links?

Because regarding local councils, it is absurd that in cases of significant health and social care overlap (which are destined to increase thanks to our ageing population), local government officers are unable to work closely with the GPs who will be seeking to find holistic community-based care for patients. The prevention of promotion of close ties between expert practitioners (consultants/nurses) and GPs worries me even more. Hospitals and GP surgeries need to be hand-in-glove if truly effective modern health care is to be achieved. Sometimes, a specialist diabetes nurse (to think of one chronic and widespread problem)  – or her endocrinologist at the local hospital may have much more idea of what the local community of diabetes patients need that the GPs for whom – by necessity – knowledge of every condition is diverse not so precise.

This disintegration of links will only worsen of course if more GP practices become privately owned or backed.

This is not the joined up thinking we should aspire to – it is the opposite. Divisive, destined to lead to arguments, lack of shared knowledge or experience, it will set GPs against hospital doctors and councillors. What a short-sighted regulation.

Lord Hunt spent his career in the Health Service as a manager. He was Chief Executive of the NHS Confederation, and previously Director of the National Association of Health Authorities and Trusts (NAHAT) from its formation in 1990. Before that he was Director of its predecessor organisation, the National Association of Health Authorities (NAHA) from 1984 to 1990. He became President of the Royal Society for Public Health in 2010. He is currently Chair of Heart of England NHS Foundation Trust.

But obviously he is political too – as Labour’s spokesman on Home Affairs, and Labour’s Shadow Deputy leader of the House of Lords.  So while I absolutely support and applaud this motion of regret, I hope he will soon go further and assure those of us still hoping for reversal of the whole Act itself that – in 2015, if Ed Miliband becomes PM – the privatisation of the NHS will be stopped altogether. I think the public needs to hear this more from Labour and specifically from Miliband – and to learn how privatisation will directly affect their health.

UPDATE: Read the Hansard debate here

About the Author

Victoria Lambert has been a journalist for more than 20 years, and specialises in health and medical matters. She writes for the Telegraph, the Times, the Sunday Times, the Guardian, the Mail and the Mail on Sunday. She contributes to Saga, Geographical and First Eleven magazines – where she is the agony aunt.

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