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Two-tier NHS: Doctors benefit from informed choice, not given to their patients

March 13, 2012

A quarter of GPs would not choose their local hospital. Think about what that says about today’s NHS. Imagine if it was an airline, and only a quarter of pilots said they’d fly with their employer – would you trust that airline with the safety of yourself and your family?

But worse that that, it is also a fact that even those who would choose their local hospital to care for themselves or their families – would be selective about which doctor they insisted on seeing.

And it also works the other way around – every hospital specialist will have clear ideas about which of their local GPs give great care, and which should be avoided at all costs. Every doctor knows that when you move to a new area the best way to find a good GP is to ask the senior consultants in the hospital.

With all the noise and confused argument about the NHS and the need for change, this is something that should be kept very clear: 100% of doctors would choose carefully where their children are looked after in the NHS, and the reason is very simple – there is ”shocking”, significant variation in safety, quality and outcomes across the NHS.

Unlike the public (their patients) doctors do have inside knowledge and use this daily to make an informed choice of who looks after them, their children or their parents. And one of the most important aspects of the changes proposed by the Health Secretary is to give such open, transparent information to everyone: to individuals, to the media, to charities, and to all those responsible for ensuring a great NHS which delivers great care not just in some cases, but across the whole system.

The fact that so many GPs would not choose their local hospital for themselves or their family is why Andrew Lansley is absolutely right to put GPs at the heart of deciding on who treats their patients, making decisions and offering advice on the very best care, the best outcomes and ensuring scarce resource is spent in the most cost-effective way. As GPs gain the ability (and information needed)  to help patients make the choices that they have made for themselves for decades we will see increased competition between a range of  NHS providers as well as independent providers of care. Competition between NHS hospitals is a good thing according to the London School of Economics, “Clearly competition between NHS hospitals improves productivity, quality and efficiency.”.

Of course the scare-mongers deliberately try to confuse competition with privatisation – they are not the same thing. Rather competition in the NHS is about letting patients and GPs choose the organisation that is delivering the very best, the safest and the highest quality care with a superb patient experience. Competition in the NHS is about highlighting and applauding fantastic care, given by fantastic people day after day, and which does not need artificially protecting from alternative providers. The best NHS providers need fear nothing from increased competition – but those that are not doing a good enough job – those that doctors avoid – will be forced to improve.

In essence, what is at the heart of the proposed improvements to the NHS is to give the public what doctors choose for themselves and their families every day.


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