Money to primary care is shrinking by the minute. A PMS contract overhaul set out by NHS England could further strip more than £200m from general practice.
At a time when practices are being crushed by massive workload, and GP recruitment and retention is reaching a crisis point, this will further sink the morale of the profession. Therefore it is unsurprising that the diminishing funding for the NHS, combined with increased pressure and demand on services, has led to speculation that certain services might in reality face rationing in certain circumstances.
Whilst clinical commissioning could potentially lead to an NHS that is more responsive to the needs of the local community and empower doctors to get more involved in shaping services, the current financial squeeze is going to make this progressively more difficult.
A worrying number of GPs have told me that rather than being able to focus entirely on their patients’ care, the government’s healthcare reforms mean they have become administrators of the NHS cuts.
The NHS Act 2012 gave CCGs the authority to decide to whom they will provide a service and what service they will provide, leaving GPs feeling that they have been handed the responsibility for decimated budgets.
NHS England aims to achieve £20bn efficiency savings by 2015, but this, quite frankly, is an incredibly difficult target against a backdrop of rising patient demand especially from an ageing population with complicated health needs.
In this environment, there is a real danger that some CCGs will become rationing committees, choosing which services should be cut and which groups of patients should lose out. I am gravely concerned that increasingly the health service and those that work in it will come under pressure to put financial imperatives before the clinical needs of local populations.
The traditional role of doctors is as the true advocates of patients and this is how it should remain. At the moment, GP practices are under such pressure that this role is under threat as they find it increasingly difficult to deal with the difficult news financial reality facing the NHS.