A misdiagnosis of GP finances

0
Have your say

THE LAW of unintended consequences, a phrase first coined by the 18th century philosopher Adam Smith, probably lies behind reports that up to 100 GP practices, including surgeries in Sheffield, could close because of changes to their funding arrangements.

THE LAW of unintended consequences, a phrase first coined by the 18th century philosopher Adam Smith, probably lies behind reports that up to 100 GP practices, including surgeries in Sheffield, could close because of changes to their funding arrangements.

The reason is this. In a bid to switch NHS money to the larger clinics with the most patients, the Department of Health no longer guarantees funding over a seven-year cycle to smaller surgeries, predominantly in rural areas, which serve a modest number of people.

Yet, if the Royal College of GPs is to be believed, insufficient thought has been given to the transition arrangements – after all the amount of public money allocated to general practice has not been cut.

And it is a health warning that the Government needs to heed as Ministers, headed by Jeremy Hunt, prepare the ground for the next phase of surgery to make the National Health Service more fit for purpose in the medium to long term.

As Mr Hunt said at the weekend, the onus needs to be on treating more patients in their home, or in their local community, if the burden on the major hospitals is to be eased.

It is a noble aspiration – most people with minor ailments would prefer not to go to hospital for treatment – but it does require a major overhaul in the quality, and efficiency, of GP services.

If Mr Hunt’s vision is to work, and it certainly does from a financial perspective, then not only do local doctors need to provide a more robust out-of-hours care service. Furthermore, the expertise of doctors needs to be backed up by far more occupational therapists and physiotherapists who can offer tailor-made help to those people, like the elderly, with mobility problems. This will only happen if general practice has the financial flexibility and scope to respond to the consequences of the necessary changes now envisaged by Ministers – the Smith doctrine.

Miliband’s move

Intervention will define Labour

NOW that Ed Miliband has two policies to his name, a cap on rent rises for tenants to complement his proposed freeze on energy prices, a clearer picture emerges of the direction of travel that will be undertaken by a future Labour government.

Even though these are populist measures that will chime with those who have seen their income squeezed by the rise in the cost of living, it suggests that a Miliband government will be the most interventionist since the 1970s and compromise investment by taking an over-zealous approach to regulation.

Take housing and the Labour leader’s desire to make three-year tenancies the norm. This appears to be an over-reaction to the approach undertaken by a relatively small number of rogue landlords whose cavalier attitude besmirches the whole industry.

Most people who buy property to let out do so because of the investment opportunity afforded to them, and with the knowledge that a flexible approach is in the best interests of their tenants. They certainly do not need Labour interfering with arrangements that revolved around basic common sense.

As such, it would have been more beneficial if Mr Miliband could have explored ways of protecting the rights of those people who are mistreated by their landlords. At the same time, he could have done far more to explain how his government would provide sufficient affordable housing to meet current demand and assist those aspirational individuals who are struggling to obtain a foothold on the property ladder.

The billionaires

Debt of gratitude to volunteers

ONE FIGURE stands out from the crowd in today’s “state of the nation” report about the Yorkshire voluntary sector, and it is the value placed on the benevolence of those public-spirited people who give up time to help the less fortunate or to give something back to their local community.

This figure equates to a staggering £100bn and is testament to the extent to which David Cameron’s Big Society is alive and well in Yorkshire, even though the Prime Minister now seems embarrassed to champion a policy notion that was once intended to define his premiership.

He shouldn’t be. This army of people, ranging from hospital volunteers to the Grand Départ’s Tour Makers, epitomises the goodwill that goes to the core of this county’s DNA.

Without these sacrifices, Yorkshire life would be much the poorer, hence why Ministers – and charities – should never take these community stalwarts for granted and, in fact, do more to acknowledge the positive contribution that such people make to everyday life.