This week I have written to all GP's in Haslingden and Hyndburn to gather their views on the radical shake up of the NHS that will see nearly all fundholding transfer to them away from hospitals and strategic health authorities.
These plans will mean GP's buy what services they feel necessary and that all hospitals will become private businesses competing against each other including private hospitals.
If hospitals can't pay there way or fail to make a profit from selling their services to GP's they will go bust and be closed. A wholesale marketisation of health care that will see winners and losers.
This leads to a wide variety of questions of why, what evidence is there to support these changes and what questions should be raised to ensure should changes are for the betterment.
Those questions are widely debated but I wanted to concentrate on local GP responses and I have had 7 points raised so far.
1. There is no evidence that GP's are capable of being strategic managers managing £90bn of health care and in effect managing the NHS.
2. A lot of clinical time is being lost putting managerial responsibilities on GP's
3. The government is cutting NHS management costs but it is the GP's who are expected to make work a 50% reduction in management budget.
4. The work being put on GP's is not the same for 50% less but is in fact more work.
5. The total savings thought to be achieved by the government in these proposals do not seem to add up. There is little evidence to support the governments case and the feeling is that the badly presented argument will in reality actually turn out to be higher NHS costs and greater waste.
6. The wholesale changes are demoralising staff and causing uncertainty. That the new changes will have huge up front costs in establishing.
7. That the current system could have been altered very easily that would have added greater GP and patient control such as democratising the PCT structure. Altering the current system would have far greater chance of ironing out waste and inefficiencies.