NHS reforms: what do doctors think?

After disastrous results in the local elections, Deputy Prime Minister Nick Clegg has chosen the NHS to be the Liberal Democrat battleground in his party’s coalition with the Conservative Party.

Over the weekend Mr Clegg said his key priority now was protecting the NHS, and threatened to veto the NHS reforms if he did not think they would improve the health service.

The renewed political battle comes after the reforms have already been “paused” in the face of vociferous criticism from many sides – including GPs, nurses and surgeons.

The Royal College of GPs warned on Monday that, if the reforms went ahead: “The NHS will be in essence a brand name only and it will not be a national health service.”

But what do those working in the NHS think about the reform – particularly as, in many cases, they are already putting preparations in place to implement them? Channel 4 News has asked two GPs on different sides of the debate to blog about their experiences.

NHS reforms – let’s try and make them work

Dr Richard Withers is the chair of one of the first-ever GP consortia to be set up. Handing power over to GPs to commission health services – as well as the majority of the NHS budget – is at the centre of the controversial reforms.

He writes: “Despite the increasingly adverse or critical coverage of the healthcare reforms from either within the profession or from political parties opposed to the reforms, we generally have been content to plough our own furrow…

Despite the adverse coverage of the healthcare reforms, we have been content to plough our own furrow. GP Richard Withers

“Over the recent months we spent quite a lot of time formulating our strategy and setting up the organisation…More or less at every level now GPs are involved in the major decision-making processes carried out by NHS Cambridgeshire or NHS Peterborough.”

He said that the new system means better organisation and better sharing of information between different areas of the health service. But he remains concerned over NHS debt.

“Despite all of these good things, however, I’m still left with a sense of foreboding about how we’re going to make the numbers add up and run a balanced budget. Despite all the co-operation and teamwork that has already taken place, I remain sceptical – if not a little nervous – of how we are going to live within our means.”

Read more from Dr Richard Withers on the NHS reforms: let's try and make them work

NHS reforms – ‘this way will harm those who need help’

Dr Jonathon Tomlinson is a GP in east London, who is on the steering committee of the Keep Our NHS Public campaign.

He is extremely worried that the NHS reforms undermine the fundamental principles of the NHS, to provide health care for all.

All of this goes completely against the founding principles of the NHS. Dr Jonathan Tomlinson

“Just as NHS hospitals are unprepared, GPs have had no training for this and the management that we depend on has disappeared almost overnight with the abolition of Primary Care Trusts, without Parliamentary approval on 1 April,” he writes.

“All of this goes completely against the founding principles of the NHS, which is to provide an integrated, comprehensive health service for the nation. The Health Bill will create a dis-integrated, postcode-lottery of competing healthcare markets.”

He said the future was worrying.

“In a few years’ time, assuming the Bill is passed, I can imagine the future for my patients. Because of the cuts, several unprofitable departments in the local hospital will have closed. The services will hopefully be available elsewhere, but my patients will be forced to travel to unfamiliar and inconvenient places…

“Those services that remain free will have long waiting lists and will be severely restricted, for example physiotherapy or psychotherapy will be limited to a handful of sessions with a junior practitioner…Care for the elderly, home care, psychiatry, and treatment for addiction will be hit hardest because market incentives will divert resources towards the most profitable work. My job as co-ordinator of my patient’s care will be made impossible because of the huge array of different companies involved in looking after my patients.”

Read more from Dr Jonathon Tomlinson on the NHS reforms: yes, but this way will harm those who need it