Primary Care Trusts (PCTs) and strategic health authorities will be abolished, as control of the NHS budget transfers to GPs. Hospitals will also be fined if they continue to use mixed-sex wards.
The plans are seen as a major structural shake-up of the health system. The Department of Health’s Operating Framework sets out the health service’s priorities. Along with the framework, PCTs will learn how much they will have to spend in the coming year.
Sources have suggested that the framework will also see one of the targets for the time ambulances take to respond to calls scrapped. Union leaders said they were ‘shocked’ when they heard of plans to remove the 19-minute target for ambulances attending less serious cases. It is thought that ministers will say that only an eight-minute target will have to be met for the most serious cases.
Justin Bowden, the GMB‘s national officer for the ambulance service said: “This is an absolute disgrace. When people dial 999 for medical help, they should have some guarantees they will get it.”
The plans have been defended by a Department of Health spokesman, who said that proposals to toughen up standards in response times will be announced. “We have been clear that only targets that get in the way of improving care will be abolished,” he added.
Health Secretary Andrew Lansley insisted that fining hospitals for using mixed-sex wards will tackle the long-running issue. Hospitals will lose part of the funding for a patient if they have to share with the opposite sex, unless they have consented to it.
Sharing bathrooms and toilets will also be deemed unacceptable, as well as the need to pass through areas occupied by the opposite sex, according to the Daily Telegraph. In August, Mr Lansley said the practice would be ended in all but accident and emergency and intensive care units by the end of the year. However, the sanctions will only come into force in April. He said today that patients had the right to dignity and privacy.
“We are not going to pay hospitals for providing a sub-standard service,” he said. “We will make it clear in the new year that every hospital will report on their compliance with the new standards on single-sex accommodation.
“Patients have a right to expect that they have dignity and privacy. If there is a breach of that, that too will be published, so everybody will be held to account for this.”
Criticism of the plans
However, two separate reports criticise the proposals. Think tank Civitas warns that patient care could be damaged if PCTs are all abolished at the same time. It warns that it could lead to delays in treatment which would undermine hopes of making efficiency savings worth up to £20bn by 2015.
The report ‘A Risky Business‘ calls for incremental reform, and suggests that patients could suffer delays in getting treatment while the changes are carried out.
Meanwhile, a report by the NHS Confederation outlines suggestions from doctors, surgeons and consultants on how the health service could save money.
The report, ‘Clinical Responses to the Downturn‘ was written after a series of meetings hosted by the NHS Confederation, which says it represents more than 95 per cent of the organisations that make up the NHS, also attended by other professional organisations.
Many clinicians highlighted the number of unnecessary procedures which are carried out, the waste of expensive surgical equipment, and the need for improvements to the way referrals from GPs are managed.
The report criticises policies for surgical instruments being thrown away after one use because of the scare over CJD as well as variations in discharge rules in different hospitals. In neonatal care, this is described as “myths and outdated rules around only discharging babies above a certain weight or certain age.”