16 January 2013
The White Paper - big questions still to answer…
07 10 2010 | Marie Hannah, RCN Board member, Northern Region
Many of the nurses that I have spoken to say they are worried about parts of the White Paper. Most are concerned about the change to how NHS services will be commissioned. The NHS is an incredibly complex organisation, and the business of purchasing services on behalf of patients is no easy task.
The White Paper proposes that GPs will be responsible for the commissioning of key patient services. GPs, like nurses, should be patient-focussed, delivering frontline care; they are not accountants or auditors, and I believe some will struggle to manage both the health of their patients and the finances of their local area.
To me, it seems optimistic to assume that handing over commissioning to GP consortia will automatically deliver cost savings and improve patient services across the country.
Nurses who have been through so many changes know how much it all costs. We also understand that at a time when the NHS is supposed to be saving money, best estimates suggest that these structural changes will actually cost between £2-3 billion to deliver.
The NHS has experienced a wide range of structural changes over the last two decades. Some of these changes have improved the service, others have not. However, the fact is that for those providing frontline care, the endless revolutions have left nurses feeling fatigued and frustrated.
I also have to question the assumption in the White Paper that greater competition between providers is the only vehicle to deliver more choice. In reality, the push towards localism and competition may in fact just be a return to the NHS postcode lottery that thankfully we had begun to move away from.
In short, there are still some very big questions to answer…