One of the surprises of recent months has been the emergence of proposals for substantial change in the way the NHS is managed. They emerged gradually and quietly in Opposition, in contrast to the Education changes which were well heralded.
They contain two principal elements. The first is part of the general policy of cutting back the central overhead. Health, like eveything else, will have to demonstrate it is reducing the numbers of central executives, and curbing the amount of central and regional interference with the local surgeries and hospitals. That makes sense, and can be done.
The second is to transfer responsibility for “commissioning”, for selecting hospital or other treatment, from Health Authorities to GPs. This is the ultimate empowerment of the professionals, the ultimate localist move. Out will go the PCTs, Trusts of officials and part time unelected members, and in will come the budget holding GP.
I would be interested to hear your thoughts on this. Will GPs want to do this? What back up will they need to do it? Will it lead to higher quality of treatment and more patient choice?