Chris Lancelot: 'Pause for reflection' a gargantuan mistake?

We've now reached the end of the government's three-month listening exercise on the Health Bill. Will it have achieved anything, I wonder?

The GP Record, by Fran Orford
The GP Record, by Fran Orford

Politically speaking, I suspect that the 'pause for reflection' may come to be seen as a gargantuan mistake - a tacit acknowledgment by the government that they got their initial plans wrong.

It will also provide an opportunity for the Liberal Democrats to be far more aggressive now their all-important referendum on voting methods has taken place.

Will there be changes to the legislation as a result of 'the pause'? I do hope so: both supporters and opponents of the new plans agree that there are some notable omissions from the current Bill - particularly over tuition. Certain areas also need to be thought through in more detail.

What about conflicts of interest, the doctrine of 'any willing provider', rewarding practices for keeping within budget, and the danger that despite all the talk about 'GPs being in charge', consortia will end up being micromanaged from the centre?

Whatever the eventual results of these deliberations, one thing is absolutely certain - the three-month delay has increased uncertainty about the future, among PCTs and consortia. With no certainty about timescales and budgets, neither can plan properly. Before the pause, PCTs were already haemorrhaging staff. Many managers have had to decide whether to take voluntary redundancy or hope for a job within the consortia - yet if the Bill fails, so do the consortia.

As a result, many PCTs are having to make do with too few staff for the job which they have, by law, still to perform. The net result is continuing chaos with no clear end in sight, talk of a lengthening timescale and anything but an orderly transition from PCT to consortium.

This uncertainty will also affect GPs involved in consortium planning: will their busy practices still be prepared to release them for this work, knowing that the plans may never come to fruition?

But the 'pause for reflection' could also start another process that might derail the government's plans - and so far nobody seems to be aware of it. More next week.

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