Tuesday, 1 February 2011

Health and social care bill | Mind

Health and social care bill

Posted: Tuesday 1 February 2011

Since it was elected the Coalition Government has wasted no time in implementing sweeping changes to raft of policy areas.  Like it or not, change is coming to education, welfare, spending, crime and justice and almost everything else you can think of - and at a remarkable pace. 

The changes to health and social care policy — as set out in the mammoth 367-page Health and Social Care Bill — are perhaps the most radical of all.

This week the Bill was debated at length in the House of Commons, and Secretary of State for Health Andrew Lansley set about explaining the principles behind his Bill.  In short, he intends to put patients at the heart of decision-making, to integrate the health and social care, and to improve the nations health across the board.

Pretty much everyone, regardless of their political colours, would agree that those are sensible and good principles. But agreement on how we get there is much harder to come by.

Perhaps the most contentious of the Bill’s proposals is to hand the lions’ share of the NHS budget — some £80billion — to groups of GPs, enabling them to commission the hospital and secondary care services that they think patients need.

This job is currently done by our 151 Primary Care Trusts (PCTs) but the government believes local GP consortia will have a better understanding of local need and patient priorities.  

All sorts of concerns have been raised: will the plans result in different postcode lotteries to the ones we currently experience, with services in one area being entirely different from services in the neighbouring region? Will patients be forced to lobby GPs for the treatments they want?  Will GPs avoid buying expensive treatments such as hip replacements? Do GPs actually want to move into this type of management, or would they prefer to focus on treating patients?

GPs are the first port of call for most people when they’re feeling unwell, so there is some intuitive merit to the plans.  But as many readers will know from first-hand experience, not all GPs ‘get’ mental health. 

Mental health is complicated, and as our work on talking therapies demonstrated, some (but certainly not all) fail to understand which treatment is the most appropriate for which condition.

GPs themselves recognise their lack of expertise in this area, with only 31% expressing confidence in their mental health commissioning abilities.  The Government will need to address this or else risk compromising the quality and quantity of our already stretched mental health services. 

Mind is working with a number of other mental health charities and organisations to ensure none of the proposed changes to health and social care adversely affect mental health services, and service users themselves. This week we sent a briefing to MPs setting out our concerns, and a good number of MPs raised our issues with the Secretary of State during the Bill’s second reading debate. 

We’ll continue to push for safeguards in the coming months — what do you think about the proposals? Tell us in the comments below.

Louise Kirsh, Parliamentary Manager

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