|All Purpose Clinics With Directly Employed NHS Staff|
In announcing a series of pledges to create a more integrated National Health Service, Burnham forecasts that the coming general election would be a "battle for the soul of the NHS".
Integrated care with GPs, mental health nurses, occupational therapists and physios, home care workers, midwives would all form part new local NHS teams for the “whole person – physical, mental and social”.
But here’s a thing: the first reaction to Burnham’s speech came from the Royal College of General Practitioners who are said to have “grave concerns” about Burnham’s plans to create hospital-led integrated care organisations.
Yet in Reading, as elsewhere, we see increasing struggles to maintain GP surgeries as they are – one threatened, then saved in Caversham, another giving notice of closure in Southcote – with repeated failures to recruit new GPs.
At the same time we see our great Royal Berkshire Hospital under particular financial strain for, amongst a number of reasons, loss of income from a fall in referrals by the GP-led commissioning groups and increased costs of people turning up at Accident & Emergency because they have no GP or else can’t wait two weeks for an appointment.
Would it not be better to have a network of “polyclinics” or “super surgeries” around the town where the new integrated teams could work, which could act as both a shield and referral point for the RBH, perhaps even sharing or swapping staff? Perhaps that’s what we should have had down the Oxford Road after the closure of Battle Hospital.
The trouble is, for all the talk of new waves of privatisation in the NHS, GP surgeries are for the most account, small, private business partnerships, which already control around two-thirds of all NHS spending. New GPs may not want or be able to afford to “buy in” to these established near local monopoly enterprises.
Remember when Nye Bevan established the NHS in 1948 he took the pragmatic decision in order to get the private medical professions on board, to “stuff their mouths with gold”. So, Andy, if you really want to complete Nye Bevan’s vision of the NHS, let’s not pander any more to the vested interests of the Royal College of GPs and their like, but directly employ salaried GPs in NHS hospitals and polyclinics in a real cradle to grave, whole person, integrated NHS.