The progress through parliament of the coalition government’s Bill for root and branch reform of the NHS has been put on hold while alterations are agreed between the coalition partners.
This highly unusual hiatus comes in the face of serious opposition from within the health care professions, from the cross-party Health Select Committee, among a few Tory backbenchers and some LibDem MPs, and above all in the House of Lords where the Bill might have been voted down.
If the Bill maintains its main features, it looks as though most of the NHS budget for Wiltshire will be divided between three GP consortiums centred on the area’s three main hospitals – Bath, Salisbury and Swindon.
But negotiations among GPs have been slower than expected. Consortiums were supposed to begin shadowing NHS Wiltshire (the Primary Care Trust or PCT) from this week.
The Chair of NHS Wiltshire, Tony Barron, has welcomed the pause: “It seems as though there is going to be a delay in process which will give us time to sort out anomalies – what we don’t want is chaos.”
NHS Wiltshire is currently having to do its normal commissioning and contracting work, assist the reform process, identify huge savings over the next three years to allow for inflation – and make a major cut to its management costs, as ordered by Secretary of State, Andrew Lansley.
One of the largest holes in Mr Lansley’s proposed system is said to be a lack of democratic accountability. The LibDems’ demand for directly elected members of PCTs was part of the coalition agreement in May last year. But two months later the White paper simply abolished PCTs from April 2013.
At present the Bill makes GP consortiums all powerful – free from any democratic checks and balances. On the other hand, if consortiums are organisationally weak, it’s thought effective control of the NHS in some areas could pass back to hospitals.
The consortium covering Marlborough is not yet ready to go public. Its make-up and policy will be watched very keenly after the long controversy over the closure of the minor injuries unit at Savernake Hospital.
Mr Barron told Marlborough News Online: “The GPs in Marlborough were offered the opportunity to provide minor injury services for Marlborough, but declined.
“I don’t envisage that the first priority for any GP consortium will be the re-commissioning of a service which was deemed to be both clinically and financially unviable.”