Vulnerable patients in Hackney and inner city areas will be hit hardest if the government’s planned changes to NHS healthcare go ahead, according to local GPs.
Doctors and organisations across the borough are mobilising opposition to the proposals, which includes putting GPs in charge of buying services for patients.
Around 30 Hackney GPs have sent an open letter to the Health Secretary Andrew Lansley criticising the changes proposed in the government’s White Paper, and the impact they will have on local communities.
They say that the restructuring of the NHS will “destroy the NHS as a public service” with an increase in waiting lists, a lack of specialist treatment and overpriced healthcare from private health providers.
As part of the radical proposals, which were published in July, GPs will be put in charge of a £80 billion budget to spend on patients. Primary Care Trusts (PCTs), which are currently in charge of the budget, will be scrapped by April 2013.
The government says that the reforms will cut bureaucracy and give patients more choice over their healthcare. However, GPs say it will result in “limited choices in urban areas” like Hackney.
Local GP Dr Jonathan Tomlinson said that vulnerable patients will suffer because of the changes. “This White Paper was not designed for sick people, but for well people who need occasional care.”
According to the Association of Public Health Observatories, the health of people in Hackney is generally poor, with life expectancy for males being worse than the England average. The area has the highest proportion of adult smokers in London, at 32%.
GPs say that the government’s plan of operating hospitals and GP practices based on profitability rather than community needs will be detrimental to their patients, many of whom have long term conditions requiring expensive and ongoing hospital and community care.
Currently, PCTs spend £33 per patient for administration costs, but under the new system GPs will be expected to spend £9 per patient. However, there have been reports that the real figure could be much lower, at £1.66 per patient. GPs will also have to cut 30% of the services that PCTs normally fund.
Many GPs feel overwhelmed by the pace of change in the NHS. Local GP Anne Solomon says that the government is using “shock and awe” tactics so that doctors are unable to react and sufficiently mobilise against the new measures.
City and Hackney PCT has already been affected by the government’s policy, with up to 99 NHS jobs currently under threat as the trust tries to implement the government’s money saving targets.
Doctors also feel uneasy about the new financial role that they will have to take once PCTs have abolished.
Dr Coral Jones of ‘Hackney Keep Our NHS Public’ said GPs lack the management skills that are needed to run an efficient health service, which will damage patients’ health. “How will we know what’s being done on a PCT level?” she asked. “If patients need wheelchairs, how do we know about wheelchair providers in Hackney?”
The task now is to get the local population to understand the impact the changes will have on their quality of care.
“People don’t realise what’s happening to NHS services”, said Dr Jones, who along with other doctors is trying to get the public involved in the debate about healthcare.
Hackney Local Involvement Network, the borough’s watchdog for health and social care, has circulated a campaign pack inviting local people to write to their GPs, MPs and councillors about the plans.
Malcolm Alexander, Chair of the organisation, said: “We believe that the proposals in the NHS White Paper are not grounded in evidence or in any clear mandate from the electorate and will cause massive damage to NHS services.”
A petition signed by 800 people in Hackney was presented to City and Hackney PCT in September by Hackney’s Keep Our NHS Public group, calling for an end to the possible “sell-offs” of health services to private companies. The group hopes to get Hackney mayor Jules Pipe involved in the healthcare debate and they are trying to get the issue debated at the next council meeting.