Nick de Bois is Wrong

Nick de Bois is Wrong

The arguments in the article by Nick de Bois MP in Conservativehome are seriously flawed and there are many inaccuracies.

1.     It is true that two layers of management are being removed, but we are going from three layers to five. This is an increase in bureaucracy. We also go from around 50 PCT Clusters to well over 100 Clinical Commissioning Groups, each with its Board and officers. This is a huge increase and will cost a fortune, just when the NHS is facing very difficult financial times.

2.     Clinicians will not be doing the actual commissioning – GPs, in the main, have neither the time not the skills. Clinical commissioning skills lie within Public Health, and this aspect of PH is being side-lined completely.

3.     Your statements about PH in the LAs are wrong

a.     Because most Directors of Public Health were already joint appointments and working with LA colleagues

b.     There was no need to transfer money – the only thing this achieves is that LAs will be able to means test things that were previously provided free by the NHS e.g. sexual health services and smoking cessation services

c.      Although there is much talk of PH, the only bit of PH really being discussed is Health Improvement (or health promotion), which is a tiny bit of the whole. The rest is being totally fragmented.

4.     The statement that if GPs are opposed to the Bill they could simply commission what is already in place is, at best, disingenuous. If this Bill is enacted, the NHS will become subject to EU competition law. As the Dutch recently found, this can lay commissioners open to huge fines, in this case of €7million.

5.     There is no evidence AT ALL that patients are not happy with the NHS – quite the contrary. And there is already choice – it is called Choose and Book and means we can refer patients anywhere in the country. Choice will be more not less restricted.

This country, in five years time, will have an NHS that is no more than a brand name and I do not believe that the country will ever forgive the Tory party for that. What we need now is strong leadership to admit a mistake and get us out of this mess.