Patient Choice in NHS Healthcare - after PCTs

Thanks to Timothy McCaw for this blog on the subject of 'patient choice'.

I may be behind the curve, as they say, but in case I am not, the following may be of interest.

This week I represented our local Rural Parish Council at a talk given by South Somerset Together to maybe 60 RPC reps to update us on the so-called Sustainable Community Strategy for South Somerset - “to lead and and improve the delivery of services…" - that will meet the social, economic, environmental, educational, health and safety needs of all the communities in S. Somerset.

Two interesting things: 

1. The plans for setting up a Local Enterprise Partnership (LEP) combining Somerset and Devon, Plymouth and Torbay to bring together local businesses to jump start greater job creation, productivity, and improve infrastructure – eg broadband, road, rail, housing – across this new “mega county”. LEPs are being pushed by the Coalition Govt right across the UK I understand.

2. The changes to the administration of the NHS at local level.

Dr Harry Yoxall, Secretary of the Local Medical Committee for Somerset gave a talk 

“Working together to make us Healthier” 

in place of Dr Ian Phillips of Wincanton (whom I believe is a 'homeopathophobe' - see later)

Dr Yoxall said he was involved in something called 'Interim GP Commissioning Consultation'. He reminded us of the recent scrapping of 2 layers of NHS management – the Strategic Health Authorities and the PCTs. In their place would come the NHS Commissioning Boards.

Within each county there will be a number of Doctors “Federations”, each of which will have on it representatives from the Drs practices in part of the county. Each Federation will have a delegated budget from which NHS services will be provided for their particular patch. The Federation would be able to say, for example, in respect of some aspect of care “Is there a charity in my patch which would have the resources to be able deliver (a certain service)”.

He felt that there would be “huge opportunities for the voluntary sector”. 

Dr Yoxall was only giving a broad brush outline, and not saying anything contentious, but what was implicit was that The Commissioning Board (made up entirely by doctors?), influenced by the Drs Federations, would be the gatekeepers over what medical services were available under the NHS in the future. Given the views of the Dr for whom Dr Yoxall substituted, this could mean that homeopathy under the NHS in Somerset is going to struggle. 

The reason I say this is that Dr Iain Phillips’s son went public in May this year in the local website, 'The Wincanton Window', just before I gave a free talk on 'Homeopathy for the Family', stating 

“No, no, no, no. Please do not spend your precious money on homeopathy. It has no mainstream scientific evidence supporting it at all and it has never passed a legitimate double blind trial…….the objection to homeopathy …. is that homeopathy is complete rubbish.” 

When I responded with a lengthy putdown to Dr Phillips’s son, his father waded in with 

“Where is the statistically significant, placebo controlled, peer reviewed evidence in reputable journals?” followed by his son again, “Quite. I do wish Mr MacCaw would name even a single such piece of peer-reviewed journal evidence instead of giving a myriad of links and assertions about how effective it is. ….Shame on you for offering a first aid course which proposes using water to cure ailments. I really hope no one is taken in by this".

I prefaced my second reply with the comment ... "with advance apologies for the length of this comment... necessitated by the need to encourage the Phillips's not to make untrue assertions, and to learn to integrate their approach to medical healthcare with with those of other historically effective therapies". 

I am not giving that response here, suffice to say that it effectively silenced the yabbering of the Phillips' clan. (The exchange can be seen at http://www.wincantonwindow.co.uk/is-there-a-place-for-homeopathy-in-the-21st-century-home.htm?jn4d342919=3#jotnav4d3429193d27e30ebf41f52281208975).

It is this person, with his views, who may well become one of the new gatekeepers to the healthcare options to which the public have access under the NHS!

This all points up how important it is for complementary therapists to get to understand how the new system will work and work out how the new gatekeepers can be challenged where appropriate.

One obvious way is that complementary therapists, as patients themselves of their local GP practice, should think about getting a place on that practice’s Patients Participation Group (or keep in close communication with and brief a sympathetic contact on such a group) in order to try and ensure that local GPs do not arbitrarily veto certain elements of complementary healthcare even though their patients are requesting it. If the GPs persist in their veto, then this could be publicised in local magazines and websites, such as the one I mentioned, to bring sufficient pressure to force a change of such a practice, or at least make it the subject of public debate to the possible embarrassment of the practice. As my exchange showed, GPs sometimes don’t know what they are talking about!

If pressure from patients doesn’t work, then our associations could consider asking Government for an Ombudsman to scrutinize the Commissioning Boards’ and Federations’ (monopolising) practices.