How about a little crystal ball gazing? What will the NHS under the coalition be like in the future years? How will the changes impact upon the lives of the people of North Staffs? I have looked at the manifesto pledges of both Lib dems and Tories and here are my hunches for the future of local health care.
1. The abolition of the Strategic Health Authority and its replacement with locally elected health boards. I am convinced that the coalition will act fairly swiftly on a pledge that they both made on the management of the NHS and the need to cut bureaucracy. I therefore see no future for the arm of the Department of Health in Staffordshire the SHA. What will it be replaced with? I sense the Lib Dem policy of elected boards will come through and also replace the Primary Care Trusts. I would say a Health Board covering North Staffs possibly covering some of the functions of the Local Authorities at Stoke and Stafford. The boards will also be able to set their own targets with national targets being of less prominence. They will be able to commission services from local providers.
2. More power devolved to Primary Services and with it funding decisions made by GPs. I would also see an aim of both Tories and Lib Dems the abolition of GP boundaries allowing people to register with whatever GP they wish. I can also see a return to the principle of GP Fundholding which was one of the planks of Primary care in the last Tory Government.
3. An increasing market approach to health care with patients to choose whatever health provider they wish as long as the provided meets NHS standards. Patients’ rights and the ability to access information will be a driver of this with the prospect of those who lack the information or knowledge finding it more difficult to access services.
4. There will be greater emphasis on the private and voluntary sector to provide services. Both Tory and Lib Dem manifesto’s stress the need to develop “talking treatments” which will be delivered by private and voluntary providers. I also see the possibility of NHS staff being allowed to form co-operatives to deliver services although this is already happening. The Voluntary Sector will also be more involved in services for vulnerable people to ensure that people remain independent and living in their own homes.
5. An acceleration of the closure of smaller hospitals and community services which is again already happening but I can see some of the more geological peripheral community hospitals being placed under threat.
6. A greater effort on using the power of Government to address some of the public health issues in the country although there will be a clash on the minimum price for alcohol which the Lib Dems support and the Tories oppose. The Tories also want to link GP pay to results in reducing health inequalities in deprived areas. Nationally there will be a move to rebrand the Department of Health to a Department of Public Health.
7. More controversially I can see a break down of the nationally agreed wage and service agreement made between the Union and the management and in some ways the concept of a National Health Service will be replaced by a Local Health Service with wages and conditions meeting local circumstances.
8. Greater use of means testing in the provision of care for the elderly and again the Lib Dems suggest yet another Commission on the future of services for an ageing population.
9. There will also be pressures to reduce the drug budget so expect the stories which we have been getting in the local press such as the Dot Griffiths and access to Herceptin.
10. More hotel costs being implemented in local hospitals for meals and servcies during hospitals stays