Listen to John: the NHS needs reform
JOHN HUMPHRYS is absolutely right that the NHS needs help from the private sector (Mail). As he says, bureaucracy is a big issue, but so is its sheer size and complexity. Who really understands the relationship between the various NHS Trusts in any area? I’ve received letters and appointments from a number of Trusts. Each must have their own set of administrators and managers. They include Sussex Community Dermatology Service in Worthing, with an appointment in Haywards Heath; Surrey & Sussex Healthcare Trust (ENT), Redhill, with an appointment in Horsham; and Brighton & Sussex University Hospitals Trust. I was also sent a home testing kit from the bowel cancer screening programme in Guildford. Other Trusts in my county include Western Sussex Hospitals NHS Foundation Trust; South East Coast Ambulance Service NHS Foundation Trust, which also covers Kent, Surrey and part of Hampshire; Surrey & Sussex Healthcare NHS Trust; Sussex Partnership NHS Foundation Trust; and Sussex Community NHS Foundation Trust. Where does my GP fit into all this? Well, she is part of an independent group of GPs within the NHS West Sussex Clinical Commissioning Group. How can all these groups work effectively together to provide coordinated care? How can it make sense for patients, their family and carers to have to travel back and forth across the county to attend appointments for different ailments, not forgetting the environmental cost of doing so? Why isn’t there a single geographic NHS Trust based on the local authority area with responsibility for all healthcare? It would have a clearly defined structure, accountable to the local area. The first point of contact would be GPs or A&E and referrals would be made to whichever speciality is required. If appropriate that could be a privately provided service for a pre-agreed NHS fee. This would reduce administration while focusing on front-line care. Private enterprises needing to reorganise to save money will make layers of management redundant, but when do you hear of public bodies ever doing this?