White Paper for Health Competition ideology Is a main feature Local public health directors moved out of INS and Into local government. Remove targets and bureaucracy, Gobo. Creates outcomes framework for what INS should achieve and professionals work out how. Personal health budgets for those with long- term Illness. Local authorities will be given power to agree local health strategies and control over local health improvement budgets. GAP commissioning creates management of services for bottom up design of services.

Patients given choice over treatment options, their consultant-led team, GAP practice and control over their medical notes. INS trusts become foundation trust to increase employee power. Allow any provider to give services to INS patients as long as can offer high quality care expected. Aim to create the largest social enterprise sector in the world. ‘Monitor will be made a stronger economic regulator to ensure effectiveness and efficiency and that every area has INS services It needs to provide comprehensive service.

New system to be fully in place by April 2013. 500 consortia with some Gaps taking a backseat others run finances. Gaps point of view: FOR: INS Debt reductions – Gaps write prescriptions/referrals to hospital which is a large part of INS expenditure. Better placed to decide how and where money Is to be spent for patients. Logical decisions from patient perspective and bring clinical perspective to the table to increase ability to foster innovation. Best and cheapest drugs to prescribe, the most effective way to treat conditions (e. G. Aviates) and how to manage and prevent particular health problems in area. New Gaps must conform to their guidelines work in that area. Create initiatives for less hospital referral. Put INS in touch with patients and Gaps on frontline. Gaps able to tap into patient feedback and so able to make changes needed. AGAINST: Gaps are supposed to be patient advocates. Previously care denied because it may not be available but now it will be due to the Gaps financial interest. Will patients wonder is my GAP balancing their budget or acting in my best interest?

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Gaps don’t want to take on the role with little background in finance and such decision making and feel it is a gamble with clinical outcomes and taxpayer’s money with no background of running businesses. Healthcare budget had been ring-fenced but this Just means no increase. Gaps fear massive budget cuts around the corner. Inflation in healthcare is higher than the standard rate which makes it even more difficult to spend budget effectively. Gaps feel the government is distancing themselves from responsibility for cuts that insertion will have to make e. G. Leisure of A and E dept. And less district nurses. Http://news. BBC. Co. UK/today/hi/today/newsier_9189000/9189213. Stem anything linked to appropriation that you find interesting, It may cause a rush of patients to hospitals deemed the ‘best’. New economic regulator ‘Monitor’ to work alongside new independent commissioning board to divide money between consortia and monitor what they do. Gaps concerned they will control the budget but won’t have freedom to do what they want as have to ensure competition between providers of services. Competition ideology permeates INS.

A new body, whose role is to enforce competition in the INS and intervene if anti-competitive behavior occurs, will be created. E. G. GAP wants to commission and work with local hospital to develop services that can be shared between Gaps and hospital consultants. Will that be deemed against competition? Gaps will feel they have to refer to private and independent sector, undermining the effort GAP may make to serve patients in local community in local hospital. Unison fear big business will become involved – that Gaps will set their criteria but contract out their commissioning.


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