Published: 21/07/2005, Volume II5, No. 5956 Page 7
The reform of the NHS will fail unless patients are given a range of primary care providers to choose from, one of the architects of the NHS plan will today warn.
Former ministerial special adviser Professor Paul Corrigan will argue that a range of providers must be allowed to get a foothold in primary care so there is enough capacity in the system for patients to have real choice - which will drive quality.
In a paper on reforming primary care for the Social Market Foundation, to be published today, Professor Corrigan argues that if patients are not 'empowered' to exercise choice of primary care provider, which forms the vast majority of their interactions with the NHS, the government's entire programme of creating a patient-led NHS will have failed.
Professor Corrigan says that primary care trusts in some areas - most notably London, where the Healthcare Commission reports four out of five GP lists are closed - have failed to drive up capacity using existing mechanisms, including direct PCT provision. They should not be involved in approving capacity because they 'allow existing providers to play a role in opening or closing the lock on market entry'.
GP co-ops, foundation trusts and private sector providers should all be encouraged to offer services where gaps are identified in the initial phase of reform, according to Professor Corrigan. He says the introduction of new providers offering different kinds of services could be locally or regionally driven, but requires central guidance.
'It would be wrong to assume that capacity will in some way be solved by a top-down process of capacity-building from the centre, ' he argues. 'Such a process would envisage that once the quantum of capacity-building from the centre has been solved by old-style planning, this extra capacity will then be developed by patient choice to improve quality.' Patients' views could be represented via a local councillor or directly to PCTs via petition to shape supply and delivery, he adds.
Professor Corrigan, who left the DoH in May after four years, is due to present his paper, Improving the Quality and Capacity of Primary Care: the role of choice, entry and exit, at an SMF seminar today.
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