My submission to the NHS “listening exercise”

Thanks to 38 Degrees, I was able to have my say: http://blog.38degrees.org.uk/2011/05/26/nhs-listening-exercise-submission-resources/ with only 1 day left.

I want to make a contribution to the NHS listening exercise. I am deeply concerned that the changes that Andrew Lansley wants to make will end up damaging our health service irrevocably.

The government’s “duty to provide” a comprehensive health service must be kept. Dropping this duty would erode the foundations of the NHS.

GPs don’t know mental health: I know this from personal experience.  Mental health services have been among the first to suffer under successive “cost-cutting” exercises; this will get worse if GPs are commissioning Mental Health services.  Patients are referred by GPs to Mental Health service teams, and GPs then have very little to do with ongoing treatment; GPs therefore don’t understand mental health treatment or appreciate the value of these services.  The commissioning of Mental Health services should be undertaken by experts in the field – the Mental Health Service teams themselves.  The same applies for many other specialist areas of health care, which GPs have no hope of ever understanding well enough to effectively commission.

The NHS has been under constant reform for decades – David Cameron promised in the General Election, “no top-down re-organisation” but the new policy is a total re-organisation.  Constant reform hurts performance and morale, and any benefits of a particular reform take time to emerge, time that the NHS has never been given.  Any new reforms should be developed on an evolutionary not revolutionary basis, with clinical judgement at the centre, and with trials undertaken and reviewed.

Doctors and Nurses should be able to avoid the impression that decisions will be taken for financial rather than medical reasons – even the impression itself will lead to a loss of trust in the Doctors and Nurses (even if it’s a false impression).  Involving the private sector in the NHS will only add to this impression; that we’re getting the “best value” health care that puts profits in other pockets, rather than getting the “best” health care possible regardless of any other considerations.

I note that these proposed reforms have not been put on hold during this “listening exercise” – this indicates that the Government is not prepared to change their reforms, regardless of what people say.  I also note that I have not been given an opportunity to have my say; I have not been made aware of any events, surveys, publicity, letters, or articles in the press, until the 38degrees campaign.  This all shows it to be an “exercise” rather than true “listening” – where someone is prepared to discuss their case and have their mind changed by another.

Please cancel all these reforms, and instead begin a long process of trials and expert reviews, before making any changes which emerge from the trials as necessary on an evolutionary basis.

Please listen.

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