The British NHS as a Model of Public Health System

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The British NHS as a Model of Public Health
System

• Present and Future of the NHS.
• Will GPs have their say?

Dr Jordi Jimeno Mollet The Firs Medical
Centre Stephenson Rd London E17
7JT www.thefirs.org.uk
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Flow Chart
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GP Responsibilities
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GP Practice Multi-skill Team
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Management of Local Health Resources
pRactice based commissioning
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PBC

• Decision Taking from Primary Care is the most
  cost-effective
• GPs are better positioned than anyone else to
  decide on what resources are needed to treat
  their patients.
• Most Outpatient appointments could take place in
  a Primary Care Setting to a lower cost
• PBC can improve the quality of care and cut down
  costs at the same time.

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PBC Consortia

• Independent associations of GP surgeries
• Decision Making on use of Local Health Budgets
• Budget given based on historical activity data -
  Top sliced
• Share of 70 of savings achieved

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PBC
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The future
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Revalidation of GPs
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NHS Today
GP
GP
GP
GP
GP
GP
GP
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Future of the NHS
polyclinic
polyclinic
polyclinic
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Independent Sector

• Profitable organisations.
• Could run initially GP surgeries at a loss to
  take over the market from current GPs
• Will use Doctors on the cheap
• Profit of the Company is the target NOT patients
  best interest

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Independent Sector Providers
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Foreseeable Problems

• For patients
• Patient care not the main focus
• Loss of continuity of care due to turnover of
  doctors
• Loss of efficacy due to financial pressures
• GPs will take corporative decisions
• For GPs
• Unlevelled ground GPs do not have equal
  resources to compete
• Loss of activity and influence
• Worsening GP terms of employment Doctors on the
  cheap poor working conditions
• High turnover of doctors -Importing doctors from
  abroad

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Local Medical Committees

• Independent Statutory Body NOT a trade union
  (BMA)
• Represents the interests of GPs in a particular
  region / PCT
• Functions
• Representative
• Statutory
• Pastoral

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Representative Functions LMC

• Represents views of GPs to PCTs, NHS Trusts,
  Government
• Matters covered
• GPs as providers of NHS services
• GPs as commissioners of NHS services
• GPs as professionals

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Statutory Functions LMC

• The Health Authority must consult the LMC on any
  decisions that involve GPs interests
• Changes in GP contracts
• Introduction of Independent Providers
• Premises inspections
• Fitness to practice

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Pastoral Responsibilities LMC

• Assisting GPs on complaints
• Advice on employment matters
• Assisting sick doctors
• Helping with premises
• Advicing on pensions and remunerations
• Conciliation of disputes

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Thank you