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Health service reconfiguration requires “sensible thinking”


10 October 2012

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Major reconfiguration in the health service requires “sensible thinking” from senior politicians and an understanding the agenda is bigger than votes, Health Minister Dr Dan Poulter has said.

Major reconfiguration in the health service requires “sensible thinking” from senior politicians and an understanding the agenda is bigger than votes, Health Minister Dr Dan Poulter has said.

Speaking at a fringe event run by think tank 2020Health at the Conservative party conference in Birmingham, Dr Poulter said he hoped Shadow Health Secretary Andy Burnham’s speech at last week’s Labour conference  – when he said he  would support hospital reconfiguration if it saved lives but oppose those that are driven by cost cutting – signifies a break from “irresponsible” MPs on the campaign trail.

“If we have clinical leaderships and patients telling the public that the reorganisation is about improving care for patients, which then will hopefully neutralise those politicians who do choose to jump on the bandwagon for votes, but that initial push has to come from doctors, nurses and other health professionals,” he said.

Jeremy Taylor, Chief Executive of National Voices, said the public could be “won over” to support hospital closures with “basic communication skills and nous” from MPs and clinical commissioning groups (CCGs) alike.

Dr Poulter also revealed the tariff payment mechanism will be “reviewed and improved” to drive through the reorganisation in the health service.

“Putting most of the budget into primary care is going to be a good way of focusing resources much more effectively on community based care rather than reactive secondary care,” he said.

“The tariff reinforces isolated working in the NHS. The payment system in hospital – payment by results – incentives and encourages hospitals to concentrate on their activity. It doesn’t incentivise them look at how patients are cared for after their hospital episode or preventing activity.

“We need to review and improve the tariff system to extend care beyond the hospital gates.“

However, Mike Farrar, Chief Executive of the NHS Confederation, said it “remains to be seen” whether CCGs will be more or less revolutionary than primary care trusts (PCTs) in reshaping care.

“We need to encourage [CCGs] to be quite bold,” he said.

“The risk for them is the geographies that they cover. I think they will be very good at micro commissioning, but I do not think they are particularly well placed to look at the consequences of how individual CCGs want to change the shape of hospital provision.

“CCGs are a good thing, they will command more credibility, but they have a big challenge in working out how they collectively work together to help the provider side reshape for where we want to spend our money.”

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