Report
to the People
3rd
March 2003
Radical Shake-up Must Deliver Results
I know the phrase "radical shake-up" is probably overused when it comes to describing government plans. But it’s about the most appropriate phrase I can think of to describe the proposals for root and branch reform of the NHS outlined last week by Health Minister, Malcolm Chisholm.
Just to pick a couple of examples, there are plans to widen the range of services delivered in communities; extend treatment time guarantees; introduce vigorous independent monitoring, backed up by tough sanctions, to ensure the highest standards of care and cleanliness; and increase staff training and professional development. A new Scottish health council is also suggested to promote the involvement of patients in the planning and delivery of better services.
As I have argued, however, the real key to improving the service we receive from the NHS is getting as much of the extra investment to the frontline as quickly as possible. Of course, in an organisation as large and as complex as the NHS, this is easier said than done. But two of the proposals in this NHS plan – the new requirements to devolve authority to frontline units and the scrapping of NHS trusts – have the potential to make it happen.
Take the abolition of the trusts, for example. As the Health Minister himself said, having separate NHS trusts covering the same areas as NHS boards "has not yielded clear benefits, but has confused accountability and obstructed the integration of services."
The idea, then, is to replace them with a single management structure which will drastically reduce the scope for the sort of bickering, empire building and red tape which stops new funds hitting their target and, hence, impacts on patient care.
This new structure should also reduce bureaucracy and increase efficiency savings.
Inverclyde, of course, is already moving towards this. As you will recall, at the end of last year the old NHS board and three trusts in the Argyll and Clyde area were dissolved and work began to replace them with a single-tier management structure. As I said to the Health Minister in the Chamber, I am looking to this new system not only to tackle bureaucracy, but to give patients in Greenock and Inverclyde a real say in the NHS and to help resist the pressure to centralise services.
These are ambitious plans. And implementing them will be a huge challenge. But, with the support of both NHS professionals and of patients, I am confident we can do it.
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