From a list of eight possibilities suggested by the Department of Health (covering about £1 billion of NHS expenditure nationally), NHS Sheffield has selected two: Diagnostic Tests (such as ultrasound, MRI and CT Scans) closer to home; and Physiotherapy Services to treat back and neck pain. The short list is completed with the addition of three others: services to help with the self-management of Long Term Conditions; Community Chemotherapy, including home chemotherapy; Dementia Care/ Memory Services.
Although some of the services selected could be provided or differently or are new approaches, the money will be going out of the public purse often to large profit making companies who can offer the best economies. The government claims that there will be cost savings, but these will be achieved through poorer working conditions or sometimes even because regulations are biased towards the private sector.
The whole scheme is fraught with dangers. By and large patients want a good service, not a lot of complicated choices. For most of us it is hard enough to decide whether to have a particular treatment, let alone who is going to provide it. There is also an increasing risk that doctors will have conflicts of interest because they have financial interests in local providers or may even want to offer services from their own surgeries for a fee. If Lansley’s reforms weren’t looming over everyone, it might be easier to do some limited experiments especially around home-based services, but this is the thin end of the wedge. We must write in now with our protests.