Memorandum submitted by Maldon and South
Chelmsford PCT (PCT 26)
I am Chair of Maldon and South Chelmsford PCT
and have been asked by my non-executive colleagues to prepare
evidence for this inquiry
LIKELY IMPACT
ON COMMISSIONING
OF SERVICES
There is a significant risk that the emphasis
on Health Improvement and Public Health will be reduced. Our Trust
has introduced approximately 800 service changes in the past four
years. The PEC (clinicians) has enthusiastically engaged in introducing
new and improved services to treat patients locally. However they
have not been the force behind changes to improve health and prevent
illness. The latter have been achieved as a result of strong local
partnerships with patient groups, business, the voluntary sector,
local government, the executive and non-executive directors. Resources
may well be directed away from what is after all the traditional
role of GPs—the treatment of sick patients. The danger is
that we will concentrate on Illth rather than Wellth (apologies
to Wm Morris).
LIKELY IMPACT
ON PROVISION
OF SERVICES
This is potentially the most damaging area.
At present deprived areas such as Hastings—Yarmouth—Tendring
receive significant support which they did not receive when they
were part of larger health authorities covering predominantly
wealthy counties. Under the new proposals every one of these Trust
areas will join other richer areas which have large debts. The
new Trusts will have to take resources from the most deprived
in order to balance financially. Patient choice will most probably
be exercised most effectively by those wealthier areas of the
new Trusts and less so by the patients of deprived and socially
isolated communities. There will therefore be a real risk that
inequalities will increase.
CONSULTATION ABOUT
PROPOSED CHANGES
This has been dreadful. Conflicting advice has
left my staff bewildered and demoralised. The public do not understand
how the process of setting up new bodies can begin before the
consultation process is complete. The process is creating deep
cynicism following as it does after a campaign to promote "patient
choice" which coincided with the decision not to require
GPs to work in the evenings and weekends which was taken with
no public consultation and clearly would not have been agreed
by the patients.
LIKELY COSTS
AND SAVINGS
My personal experience of working in large organisations
has been that increasing size does not reduce costs. The whole
process of revolutionary change is destructive as it breaks up
effective networks and creates uncertainty. Evolutionary change
has worked well in the past four years and the huge gains made
under the present system should be recognised.
Tony Plumridge, Chair
Maldon and South Chelmsford PCT
7 November 2005
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