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The health white paper in full - Equity and excellence: liberating the NHS

The full text of the health white paper

Read the white paper here

Readers' comments (11)

  • There is no mandate for this reckless, ill thought through, non-evidence based GP-centric faraggo. It's ideologically led and not about quality or finance. Privatisartion and the American nightmare are just around the corner....

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  • This will destroy the NHS and the quality of public services will diminish. GP's are proven to not be equipped to manage, they should be left to focus on patient care. GP's now have no choice but to take on a role they are ill eqipped for and don't have the time to do and there will be little equity as lead GP's in an area will be nominated for them. Where will accountability lie? This is awful.

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  • I suspect, like many others, I have some doubts and wouldn't need much encouragement to do a little carping.

    However, this is where we are, and I wish the White Paper God's speed. It could just change things for the better.

    My main interest is in mental health services. The commitments to put the patient front and centre encourages me enormously, as does the adoption of 'no decisions about me without me'. Something similar was first the credo of patients and carers in learning disability services, I think. It didn't take mental health long to spot a good thing, and take it up with passion.

    The commitment of MH services to the call was universal, but too often tokenistic.

    Although the NSF for adult mental health brought many improvements, users and carers can still encounter serious, and seemingly intractable problems. The most serious can involve access, even at times of crisis. The possibility of patients, families and wider carers identifying those services that perform well and choosing to be cared for by them if and when the need arises, would bring huge peace of mind to many.

    It goes without saying that the 'inormation revolution' to support this empowerment will need to be just that, and that, in mental health means, patient orgaisation validated and 'kite marked'.


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  • Return of fund holding but this time no more Mr. Nice Guy! Many GP's are little more than part of a cottage industry sometimes struggling to make sense of their own 'business' so commissioning will be a breeze? FT's compulsory? a few short steps from de facto privatisation. Pay off trough is being filled again.

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  • Its quite simple: Lansley has lost the plot on the NHS! The NHS will loose talent, GPs don't have a clue of what they are doing they cant get PBC right never mind commissioning for the whole population.

    They talk about management cost savings, what about all the workforce in SHAs and PCT, what are you going to do with them?

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  • Today marks a turning point in the history of NHS commissioning and paves the way to the abolition of some of the most wasteful NHS bodies ever - what on earth have PCTs actually achieved, let's be honest? Have of them are full of people who don't know what they are doing, the other half are full of people meddling and creating paper chases. Your average GP cares deeply about practice list patients and is sick and tired of bureaucracy and small minded, bullying PCT managers. Comments from Terence Lewis at 5.44 today are completely accurate and all I would add is that Mental Health Commissioning as delivered by PCTs has been a complete and utter failure of policy implementation. GPs working in locality commissioning consortia can only improve on dismal leadership shown by PCTs up and down the country.

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  • Well the proof is in the pudding - talk about wasting tax payers money. Cast your mind back 10 years to the creation of PCTs when management cost increased in some areas by 150% and over the years granted this has been reduced but still in some areas today its still above the levels of the 1990's. The Labour Government gave the NHS billions and what have we done with it - are things better for patients or do we have just more bureacracy, I think the latter. Whilst I don't agree with Mr Lansley's latest actions neither do a agree with the massive waste of resources that the NHS has had access to over the last 10 years. I'm one of the many that stands to lose their job through this mess but hey perhaps I might get another job with the private sector when they start to take over!!

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  • Can't wait to see services being managed by GPs - reaching for the Bupa application forms now.

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  • We are going to be watching a slow-motion train wreck over the next three years as the NHS turns inwards on itself and neglects patients. My solution is not to devolve budgets to GPs - let's go further and give patients their own health service budgets. We can then hire our preferred clinician as we need them - after all GPs (average salary £250k) are in it mainly for the money..

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  • The last thing I want if I am ill and in need of care - very likely since I am only just recovering from 19 years severe mental illness which may well return - is to have to work out my own budget. I rely on my GP - who has always, long before these awful commercialisation reforms, been able to refer me to any specialist in any hospital he feels fit to refer me - to direct me to the best consultant, as my GP in 1989 most certainly did.
    I seem to remember the government having tried this experiment of GP funding before. By all means allow GP's to go on referring their patients to the hospital and specialist they feel best, but I don't see any sense in burdening the many GP's who believe they are doing all that they went into general practice to be doing, to continue doing that without un-looked for financial responsibilities.
    As a patient I no more want the burden of my own budget than most parents want the burden of having to run their children's schools.

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  • Surely burdening those who are supposed to be delivering the services (GPs) with more responsibility will only slow the process down further and reduce efficiency?

    I'm not sure about the diffusion of responsibility from the Government to the GP and patient either; passing the buck much?

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