RCGP urges DoH to slow down Health Bill

In an exclusive interview, RCGP chairwoman Dr Clare Gerada tells Susie Sell the NHS reform battle is not over.

Dr Gerada: NHS urgently needs more GPs on the ground
Dr Gerada: NHS urgently needs more GPs on the ground

As the Health Bill pause came to an end last month, it quickly became clear that the government had not just hit 'play', but 'fast forward'.

Just one week after the Future Forum set out how the NHS reform plans should change, the government revealed how it intended to update its beleaguered Bill.

Four days later, 160 amendments were announced, 63 of which have been sent back to the House of Commons and are already being debated by MPs.

The speed at which the DoH is progressing has left RCGP chairwoman Dr Clare Gerada frustrated and fearful that proper scrutiny of changes to the Bill will be impossible.

Proper consultation
By the time the RCGP has gone through a proper consultation with its members, it could be too late to further fine tune the Bill, she warns. 'It's now illegal if a door-to-door salesman comes with an insurance policy and asked you to sign a 20-page document,' she says. 'We should make sure politics works to the same system.'

Dr Gerada says the whole Bill should be scrutinised again in parliament to ensure MPs, GP organisations and the public can properly debate the changes.

From an initial reading of the amendments, Dr Gerada says some of GPs' concerns have been addressed, particularly around the role of Monitor and wider professional input into commissioning.

But many concerns remain, she says, and we have ended up with an 'incoherent Bill'.

Many of Dr Gerada's concerns focus on the 'enormous bureaucracy' that will be introduced into the NHS, with plans for health and wellbeing boards, clinical networks and senates as well as the NHS Commissioning Board.

She points out that this will see the NHS move from a system of 160 statutory bodies to more than 500, which will leave clinical commissioning groups operating in a 'very complicated' environment.

'The lines of accountability look like Spaghetti Junction when you see them drawn on paper,' she says. 'Far from liberating the NHS, the Bill appears to be putting an enormous straitjacket on it.'

She adds that the changes to the Bill add weight to the argument for large clinical commissioning groups. With more health professionals and organisations feeding into the commissioning process than previously envisaged, groups need to be large enough to ensure the GP voice is not diluted, she says.

Forefront of discussions
It's hard to believe that Dr Gerada is only seven months into her three-year tenure as RCGP chairwoman - as the debate around the NHS reforms raged on, she has been at the forefront of discussions.

But with the first of her three years chairing the RCGP dominated by reform battles, what will she be concentrating on in the months ahead? A key focus, she says, will be workforce education and training issues, particularly around reversing the trend of dwindling GP numbers.

'We absolutely have to get more GPs on the ground,' she says. 'We cannot continue to deliver what we want to deliver plus run the NHS with the numbers that we have.'

She will also continue to call for an extension of GP training to five years, while keeping a watchful eye on proposed education and training reforms that will see deaneries abolished.

Dr Gerada hasn't been satisfied with the DoH response to the NHS Future Forum report around its education plans, warning that there 'don't appear to be significant changes'.

The DoH may be unwise not to heed her advice and allow time for the profession to fully digest the revised Health Bill.

Without clinical support for its amendments, the government could quickly find itself back to square one and forced to press 'pause' once again.

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