20th January 2006

 
The Gloucestershire Green Party believes in the principle of subsidiarity which suggests that decision making should be made at the most local area possible. We are also generally in favour of both regional and unitary authorities, and suggest that this model should in the long-term form the basis for NHS reconfigurations. We believe that the NHS should mirror the boundaries of social services as the two require close partnership working.

Whilst we are not, generally, in favour of county councils, where social services are run by them it makes sense to organize the NHS on the same boundaries if county councils are to remain in place. However it would seem that more unitary authorities are likely to appear. In this case we would expect the PCTs to adjust in size and shape to conform to these new authorities when they appear rather than now.

We believe that the role of the SHA is limited and should be phased out over time. Many of the functions of the SHA detailed in the consultation document are already covered by PCTs and SHAs seem to provide a level of administration that is no longer required. Until this comes about, we would suggest the SHA functions be provided using the minimal amount of administration possible, i.e. over the largest area.

We suggest that control of the health service should be under local (or unitary) authorities rather than national government; we however recognize that this is unlikely to happen in the near future. We hope that if reorganisation goes ahead then the option that is finally chosen should increase the accountability of the NHS to local people through their elected representatives on local government. We also do not agree with the market economy within healthcare, and feel direct provision is fundamental to ensuring the best quality and provision of services.

The Gloucestershire Green Party are keen to learn how the SHA’s are intending to address the criticisms leveled by the Health Select Committee, specifically how savings in management costs will be demonstrated, how the SHA will be protecting valuable community services, how the SHA’s will prevent destabalisation among managers, what measures SHA’s will put in place to protect and enhance the role of public health departments and how commissioning will be more effective.

Conclusions:

It is quoted that those carrying out these consultations: "have a very open mind and are keen to hear as many people’s views as possible." We therefore hope they will reconsider the necessity for reorganisation at this time.

On the evidence so far, confirmed by the select committee, the Gloucestershire Green party along with many others, does not believe any of the options on the table should proceed. The suggested savings will be lost in the reorganisation process and damage morale. The previous changes have hardly had time to bed in and already other policies introducing more of the private sector are being introduced.

The current obsession with artificial internal market accountancy and provision being distorted by targets and incentives, has led to increasing layers of unnecessary management and internal budget manipulation. When you add to this profiteering by private sector activity - such as PFI schemes and contracted-out surgery - promoted for ideological purposes, the vast scale of waste becomes apparent.

This is not the time for this sort of reorganisation. What we need now is investment in NHS services for patients not distractions or policies that lead to more paperwork. Far more important would be changes like:
- an end to the private sector involvement where charges can be on average 40% more for the same services.
- reducing drug costs: over 12% of the NHS budget goes to pharmaceutical companies yet we are paying 20% more than most European countries for branded drugs.
- an end to the waiting list obsession: yes waiting lists are important but safety and quality also matter.
- more focus on prevention and the causes of ill-health

These changes would have a much greater impact than this reorganisation.

Philip Booth, Press Officer, Gloucestershire Green Party.