This week: The NHS reforms and Clinical Commissioning Groups
Dear Bridget, I’m worried about my painful cluster
When I became a CCG I was told I could buy commissioning support wherever I liked. Now I’ve been told I’ll have to buy it from a PCT cluster. What’s going on?
Brian, CCG manager
Oh dear, Brian. I can see you’re a bit confused. There is a big difference between being able to buy what you like and actually being able to procure it. The government has always said there would be a wide choice of commissioning support available from April 2013, but as a statutory body you will have to go through a long and complicated procurement process. These things can take years, but it’s best not to rush into an important purchase, particularly when times are hard.
We were told that the reforms would cut bureaucracy, but it doesn’t feel that way to me!
Rosie M, practice manager
Rome wasn’t built in a day, Rosie, and if the appropriate building regs had been enforced it probably wouldn’t have been built at all. Have you seen those crumbling ruins? Of course in the long run the idea is to speed things up and cut down on paperwork, but we’ll need a lot of people to make sure that the transition to the new system is well planned, orderly and safe for everyone concerned – not least all the bureaucrats who don’t want to be looking for new jobs in a recession.
How will you stop CCGs from reinventing PCTs?
It’s only natural to worry about this, Rashid. A lot of clever people have been working on the same problem, but the solution is really very simple. It you don’t really get rid of PCTs, reinventing them becomes unnecessary.
Can I have my top down and my bottom up at the same time, revolution-wise?
David, NHS manager
I know where you’re coming from, David. You can’t have a grass roots revolution unless you manage it properly, otherwise you end up with a lot of out-of-control weeds. To stick with the gardening theme, you wouldn’t dream of planting a new lawn without a few hundred managers to oversee the watering and application of fertiliser, would you?. It just wouldn’t make sense.
I’m a patient and I’m worried about the future of the NHS. By the way, what’s commissioning?
There’s always one, isn’t there! We’re trying to have a serious debate here, we’re putting you at the heart of everything we do, making sure your voice is heard, and taking no decisions about you without running it past the CQC, Monitor, the clinical senate, the BMA, the CCG, the commissioning board, the cluster, the SHA, HealthWatch, the health and wellbeing board, the private sector and the district nurse. Obviously you haven’t read the white paper.
Next week Bridget takes questions on the Italian debt crisis and the collapse of the eurozone.