The Council for Disabled Children January 18, 2013 Subject – All together now? Why service integration for disabled children is a key challenge for the new health system
I posted my concerns about health commissioning on this CDC blog as I am extremely concerned about a general conflict of interests now that GPs have been given local budget constraints to work within.
I have so many worries about the new commissioning of Health services, how on earth are we going to ensure that patients are going to be treated on the basis of clinical need and not on whether the CCG can afford it?
How will we ensure that appropriate drugs will be used rather than the cheapest ones (very important with epilepsy)? How will conflicts of interest be managed, do all CCG and GP Staff have to declare their pecuniary interests as I have to do as a school governor? How will we be sure that treatment offered is appropriate for the need and not just because some medic wants to do some private funded research which he has as personal interest in?
Will patents be able to specify a public provider under the AQP framework, I don’t wish to be treated by a private Company as standards are not as good given the profit motive and if something goes wrong they can hide behind commercial sensitivity (and there is no freedom of information requirement)?
Where will we find the complaints and appeals policy? Most important of all what are the patients’ rights and where are the safeguards. What are the legal responsibilities of the CCG. I am in my local GP patients group and I don’t know any of these answers.
Doctors can play God with this new system, how can patients challenge decisions on their treatment which may have been made on the grounds of cost rather than clinical need, they can’t and the fact that GPs and CCGs are closer to the budget will mean they can ride roughshod over people in order to try and make their budget go as far as possible instead of focussing just on the clinical need.
I can see disabled people suffering neglect and discrimination on a wider scale with this new commissioning system. I have come across plenty of medical staff who treat my son with suspicion even now due to his range of complex disabilities and challenging behaviour. I am sure many of these CCGS will make an art out of treating disabled people as second class citizens as there will no longer be a common code across the Health profession and local decisions will ultimately determine practice.
I discovered recently that my son had been given a laxative that is known to cause stomach irritation even though he has a long-term bowel problem and the correct and more expensive Movicol was only prescribed when he was seen by a locum having no ties to the GP practice. This happened just a few weeks ago under the present system, what will it be like in the future. God only knows.
Ian Penfold
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