Uncertainty over reorganisation is destabilising primary care
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《英国医生杂志》
Primary care staff are leaving their jobs or are becoming increasingly distracted from their day to day work because of uncertainty caused by government plans to reorganise primary care, MPs have been told.
The reconfiguration of primary care organisations is taking its toll, witnesses said at last week's hearing of the House of Commons health select committee's inquiry into changes to primary care trusts.
The finance director at one primary care trust, giving evidence to the committee, said some staff were already "voting with their feet" and leaving to go and work in the acute sector—which is seen as more stable—because of the uncertainties in primary care.
Phillip Barrett, director of finance at High Peak and Dales Primary Care Trust, said: "I was talking last week to one of my matrons in a community hospital. She has lost four qualified nurses in the last few weeks to the local foundation trust, and they have gone because of uncertainty about their future and fear of effectively being privatised."
Karen Rhodes, director of primary and community care at North Lincolnshire Primary Care Trust, said: "I think there's a very serious risk in destabilising some essential community services. Where I come from we haven't yet seen a drift of staff, but they are so uncomfortable about their futures that it's only a matter of time."
A committee member, the Conservative MP Anne Milton, said: "I am left in no doubt the fact that is going to cause a huge distraction, a huge loss of focus, a decrease of service delivery, and some extraordinarily unhappy staff."
Lord Warner: "No one likes organisational change"
Credit: RUI VIEIRA/PA/EMPICS
The health minister Norman Warner, giving evidence, said: "No one likes organisational change. In a nutshell, this is about strengthening the commissioning function."
The effect of these changes was not as deep as was interpreted by some people, Lord Warner argued. He said that some of the proposals that had been received from strategic health authorities to reconfigure primary care had opted to make no change to the current organisation of primary care trusts.
"It isn't all change, and the variety of change is variable in the proposals that have come from the health authorities," he said.
Timing had been tight, Lord Warner said, but the government had talked about change in March in its Creating a PatientLed NHS document, which had said that organisational change would be needed.
Lord Warner then discussed the letter sent out by the NHS chief executive, Nigel Crisp, at the end of July that had sparked a furore. The letter, which out-lined his vision for primary care over the next two years, set out his expectation that primary care trusts would become commissioners rather than providers of services and that many of them would merge. It also contained a tight timetable for this process, with the first deadline being mid-October for strategic health authorities to submit their proposals to reconfigure services in their area.
Lord Warner said: "The timing was not impeccable, but we were where we were, and if we had just let things drift for three months until Parliament came back we would have had more speculation and more unease about where the direction of travel was."
The Royal College of Nursing has subsequently requested leave for a judicial review of the letter, questioning the Department of Health's right to issue such a statement without proper consultation first. (See p 1156.)(Adrian O'Dowd)
The reconfiguration of primary care organisations is taking its toll, witnesses said at last week's hearing of the House of Commons health select committee's inquiry into changes to primary care trusts.
The finance director at one primary care trust, giving evidence to the committee, said some staff were already "voting with their feet" and leaving to go and work in the acute sector—which is seen as more stable—because of the uncertainties in primary care.
Phillip Barrett, director of finance at High Peak and Dales Primary Care Trust, said: "I was talking last week to one of my matrons in a community hospital. She has lost four qualified nurses in the last few weeks to the local foundation trust, and they have gone because of uncertainty about their future and fear of effectively being privatised."
Karen Rhodes, director of primary and community care at North Lincolnshire Primary Care Trust, said: "I think there's a very serious risk in destabilising some essential community services. Where I come from we haven't yet seen a drift of staff, but they are so uncomfortable about their futures that it's only a matter of time."
A committee member, the Conservative MP Anne Milton, said: "I am left in no doubt the fact that is going to cause a huge distraction, a huge loss of focus, a decrease of service delivery, and some extraordinarily unhappy staff."
Lord Warner: "No one likes organisational change"
Credit: RUI VIEIRA/PA/EMPICS
The health minister Norman Warner, giving evidence, said: "No one likes organisational change. In a nutshell, this is about strengthening the commissioning function."
The effect of these changes was not as deep as was interpreted by some people, Lord Warner argued. He said that some of the proposals that had been received from strategic health authorities to reconfigure primary care had opted to make no change to the current organisation of primary care trusts.
"It isn't all change, and the variety of change is variable in the proposals that have come from the health authorities," he said.
Timing had been tight, Lord Warner said, but the government had talked about change in March in its Creating a PatientLed NHS document, which had said that organisational change would be needed.
Lord Warner then discussed the letter sent out by the NHS chief executive, Nigel Crisp, at the end of July that had sparked a furore. The letter, which out-lined his vision for primary care over the next two years, set out his expectation that primary care trusts would become commissioners rather than providers of services and that many of them would merge. It also contained a tight timetable for this process, with the first deadline being mid-October for strategic health authorities to submit their proposals to reconfigure services in their area.
Lord Warner said: "The timing was not impeccable, but we were where we were, and if we had just let things drift for three months until Parliament came back we would have had more speculation and more unease about where the direction of travel was."
The Royal College of Nursing has subsequently requested leave for a judicial review of the letter, questioning the Department of Health's right to issue such a statement without proper consultation first. (See p 1156.)(Adrian O'Dowd)