Surgeons warn over NHS reforms

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Standards of patient care may be compromised if GPs focus on 'the lowest price', surgeons warned

Standards of patient care may be compromised if GPs focus on “the lowest price” rather than quality when it comes to health spending, the Royal College of Surgeons of England (RCS) has warned.

The independent body called on greater clarity from the Government on the role of doctors following sweeping health reforms that will see the introduction of a clinician-led service.

RCS President John Black said explicit minimum standards of care need to be set out by ministers to avoid GPs entering into a “race to the bottom” where price squeezes out quality.

In an analysis of the Coalition’s Health Bill ahead of its second reading before parliament on Monday, he said: “Alongside colleagues in the other Medical Royal Colleges, I am concerned that some of the aspirations for a clinician-led health service envisaged by the Health Secretary are not borne out by the legislation as currently drafted.

“We are concerned that minimum standards of care are not set out in the new arrangements to introduce greater competition. It is quite right that the government seeks the best value in health spending, but this needs greater detail if we are to avoid a ‘race to the bottom’ with price squeezing out quality.”

Under the flagship bill, published earlier this month, GPs will be handed power over commissioning treatment worth £80 billion. A new independent NHS Commissioning Board will decide the overall budget and oversee the reformed service.

Mr Black also called on the Government to give more detail on how the new board would be constituted, and criticised the fact that it “includes no formal requirements for clinician representation at the highest level.

“This new system will only fulfil the expectations invested in it if practising clinicians of all specialities are able to co-ordinate, and engagement between commissioning consortia and local hospitals needs to be included as a responsibility,” he added.

He said: “By reducing elective surgery you can immediately save money, but at the cost of pain, reduced quality of life and deterioration of health. If the NHS continues to save money in this way, we will pay later in terms of future suffering of patients.

“The immediate need to save money by going for the soft targets of elective surgery will leave a lot of people with unpleasant symptoms and build up future health problems. Medically that makes no sense.”

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