After being criticised by GPs, doctors, nurses, trade unions, the lap-dog Lib-Dems and Labour, David Cameron today unveiled sweeping changes to NHS reforms. Is this a significant political moment as it shows that the coalition isn't quite steaming ahead with its agenda as it would have liked?
I'm not sure the changes are as big as Cameron makes out. The fundamental changes to the NHS will still happen, even if a bit later than planned. GPs will still take over the commissioning of services from primary care trusts. Greater competition will still take place with private sector providers. I accept that the plans have been watered down but the fundamentals remain.
The reform process is ill thought out and suggests a dogmatic wish to return to the John Major days of GP fund-holding. I don't really understand on what basis the Tories decided that GP commissioning would be the answer to the NHS ills. There is no reason at all for this form of service delivery to be more efficient. On the contrary, spending swathes of scarce cash on a major reorganisation at a time when funds are so scarce seems completely foolhardy. For a Tory party that is so bent on cutting public spending to do this now shows how committed they are to the changes and demonstrates an ideological commitment to them.
The delays and changes show how hard Cameron is finding it to run his party and get his legislation through. I expect him to overcome these obstacles and press ahead with an unnecessary and costly reorganisation of the NHS just when it needed it least.
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