A 革命 in the GP's 外科:
Doctors will take over NHS 予算 from 経営者／支配人s ... but will it save any money?

By DANIEL MARTIN FOR THE DAILY MAIL
Updated: 08:27 BST, 13 July 2010

A Health Service 革命 which will put billions of 続けざまに猛撃するs of taxpayers' cash 直接／まっすぐに into the 手渡すs of GPs was 明かすd yesterday.

Health 長官 Andrew Lansley 約束d the biggest 激変 since the NHS was formed in 1948.

Fam ily doctors will take over 責任／義務 for spending £70billion from NHS 経営者／支配人s, thousands of whom could lose their 職業s as their organisations are 廃止するd.?

激変: Family doctors will have the 責任／義務 for spending £70billion rather than NHS 経営者／支配人s

Mr Lansley （人命などを）奪う，主張するs that 管理／経営 costs could be 削減（する） by 45 per cent.

But there are questions over how much money would 現実に be saved? -? with 関心s that bureaucrats will 簡単に move across to take 職業s with some 500 new GP-led organisations.

There are also 関心s that family doctors could fleece taxpayers by 需要・要求するing more 支払う／賃金 to take on their onerous new 役割s.

Mr Lansley's 計画（する）s, 明らかにする／漏らすd in a White Paper, will enrage the unions. He calls for hospitals to 始める，決める aside more of their beds for 私的な 患者s, and signals that he will 捨てる 国家の 支払う／賃金 取引ing for NHS staff.?

The 文書 also 約束s an ' （警察などへの）密告，告訴（状） 革命' so that 患者s have greater 力／強力にする to choose their 臨床の team in a hospital, or the type of 治療 they want.

It 捨てるs waiting-time 的s, 焦点（を合わせる）ing instead on 改善するing 結果s such as 癌 生き残り, and puts GPs 支援する in 告発（する），告訴（する）／料金 of out-of-hours care.

Mr Lansley said: 'The sick must not 支払う／賃金 for the 負債 危機 left by the previous 行政. But the NHS is a 優先 for 改革（する） too. 投資 has to be matched by 改革（する）.

'So we will 改革（する） the NHS to use those 資源s more 効果的に for the 利益 of 患者s.'?

He said the new structure would 'put 患者s 権利 at the heart of 決定／判定勝ち（する）s made about their care and put clinicians in the 運動ing seat on 決定／判定勝ち（する）s about services'.

影をつくる／尾行する Health 長官 and 労働 leadership 候補者 Andy Burnham said ten years of 'painstaking work' to raise 基準s in the NHS had been 'thrown in the 空気／公表する'.

'It is a 抱擁する 賭事 with an NHS that is working 井戸／弁護士席 for 患者s,' he said.

The White Paper calls on family doctors to take over 責任／義務 for buying in a whole 範囲 of services and 治療s for 患者s, from hospi tals and other organisations.

This 職業 現在／一般に belongs to 経営者／支配人s in 最初の／主要な care 信用s - organisations which will be scrapped.?

Chris Ham, 長，指導者 (n)役員／(a)執行力のある of the King's 基金 healthcare charity, said: 'This is the biggest change in the NHS since 1948. 効果的に what the 政府 is doing is turning the NHS upside 負かす／撃墜する.'

He 追加するd: 'We don't know whether there will be a 逮捕する saving as a result of all this.'

Nigel Edwards, of the NHS 連合, which 代表するs 信用s, said: 'It is hard to 強調する／ストレス just how 過激な this is. The NHS will look much more like the gas, electricity or telecoms market than it will the monolithic 明言する／公表する 官僚主義 we have come to understand.'

GPs will have to join one of about 500 consortia. They will be 許すd to buy in outside help from 私的な 会社／堅いs or charities to run their practices.

They could also 雇う 経営者／支配人s from 廃止するd 最初の／主要な care 信用s. This has led to scepticism that the 計画（する） would 現実に save money.?

Dr David Jenner, of the NHS 同盟, which supports GP-led （売買）手数料，委託（する）／委員会／権限ing, said: 'There will be 堅い 決定／判定勝ち（する）s to be made, for example, between expensive 癌 麻薬s that 申し込む／申し出 a few weeks extra life for a few and 介入s such as like smoking 停止 which 利益 a larger number of people. GPs will undoubtedly need 専門家 support from 経営者／支配人s and 資源s to be successful in their new 役割.'

David Furness, of the So cial Market 創立／基礎 think 戦車／タンク, said: 'Giving 支配（する）／統制する of NHS 基金s to GPs is like asking your waiter to manage a restaurant.

'They might know what you want to eat but they won't やむを得ず be any good at ordering 在庫／株, designing a menu or controlling the chef.

'GP consortia will need organisational support to work 効果的に. Who else could do this but 現在の PCT staff? This new NHS reorganisations will mean wasted years reinventing the system we have now.

'And with the prospect of a 基金ing squeeze that will certainly have an 衝撃 on 患者s, this is no time to introduce an ideologically driven 政策 that 軍隊s GPs to become NHS 経営者／支配人s.

'At best this will be a waste of time, at worst a waste of money.'

WHAT ARE PRIMARY CARE TRUSTS ?

They 支払う／賃金 the salaries of GPs and dentists, buy in 麻薬s, '（売買）手数料，委託（する）／委員会／権限' hospital 任命s and 操作／手術s on に代わって

They are NHS 部隊s which manage and 基金 healthcare 準備／条項 at 地元の level.

GPs, and 基金 other services such as public health and out-of-hours care. There are 現在／一般に 152 PCTs in England in 支配（する）／統制する of £80billion 年次の 基金ing.

HOW WILL THEIR POSITION CHANGE?

Andrew Lansley wants GPs to take over the entire （売買）手数料，委託（する）／委員会／権限ing 役割. Family doctors will be 推定する／予想するd to join together in 地元の 'consortia'? -? probably around 500 across the country? -? to organise healthcare and decide which services to buy from hospitals and other organisations in their areas.?

WILL GPs WANT TO TAKE ON EXTRA RESPONSIBILITIES?

Previous 労働 and Tory 政府s have tried giving GPs （売買）手数料，委託（する）／委員会／権限ing 力／強力にするs but in both 事例／患者s, 大臣s were 直面するd with a 際立った 欠如（する） of enthusiasm from the 大多数 of docto rs who want to 扱う／治療する 患者s rather than manage 予算s. The British 医療の 協会 can be 推定する／予想するd to 押し進める for more money in return for taking on the 力／強力にするs.

WHAT WILL HAPPEN TO PCTs?

They will be 廃止するd 完全に by 2013, once GPs have taken on their 責任／義務s. Some specialist services will be （売買）手数料，委託（する）／委員会／権限d at a 国家の level. The public health 機能（する）／行事 of PCTs will be passed to 地元の 会議s.?

WILL THIS SAVE MONEY ?

The 政府 says it will save millions in 減ずるd 官僚主義 as up to 20,000 管理の staff in PCTs and 戦略の health 当局 - the 現在の 地域の 行政の 部隊s - will become redundant. But most GPs have little （売買）手数料，委託（する）／委員会／権限ing experience and will need to 雇う 経営者／支配人s to do the 職業.

In practice many public health 経営者／支配人s will 簡単に move across to work for the new consortia. So although a whole tier of 官僚主義 is 存在 除去するd, it is 不明瞭な what the final saving might be.?

世界保健機構 ELSE MIGHT WANT TO TAKE ON THE? MANAGEMENT ROLE?

Several 私的な health 保険会社s and US based 'health 維持／整備' organisations might see the changes as a 商売／仕事 適切な時期. These 含む Humana, 部隊d Health, McKinsey, Bupa and Capita.?

WILL IT IMPROVE CARE?

Mr Lansley says the GP 革命 will 改善する care because doctors know better than 経営者／支配人s what is best for their 患者s. But the 恐れる is that in the short 称する，呼ぶ／期間／用語 such 抱擁する organisational 激変 could result in NHS staff spending too much time adapting to the new 手はず／準備 and not enough seeing to the needs of 患者s. Also many GPs might 簡単に not be up to the 職業 of running a healthc are 商売／仕事, which could lead to even greater 地域の postcode 宝くじs.?

WHAT IS TO STOP GPS USING THE MONEY TO PAY THEMSELVES MORE?

Mr Lansley has 約束d strict accountability 支配するs to 確実にする that GPs do not 簡単に spend their 抱擁する 基金s to aggrandise their practices.