I logged on for the webchat with the Secretary of State from 1.30-2.30 on Tuesday afternoon hoping to learn more about the most recent consultations on the “information revolution” and “greater choice and control”.
It was a bit of a technical pile-up really. The screen displayed loads of questions in rapid fire order (I counted over 120 over 60 minutes). Lansley’s answers were slotted in seemingly at random. People watching on screen found it hard to keep up with the rapid flow and link up the Q with the A. Note to DH IT boffins – Next time it would be better to have a live presentation and see Lansley answering questions sent in by viewers.
That aside, Mr L. didn’t really say anything we had not heard or read before. There were lots of things not “on topic” from questioners, including a determined assault from well organised ME suffers about the failure of GPs to take them seriously because NICE guidelines don’t identify a physiological cause for their condition. I felt positively sorry for Lansley at some points. All the content will remain on site here
DH has promised to supply answers to everything, which is noble of them when facing questions like:
“How are patients expected to make informed choice of medicines when even doctors can find the data confusing? ” and
“Choice is good but not at the cost of commercialisation of the NHS. The proposed reforms seem to promote a consumerist approach to healthcare which isn’t conducive to the Doctor-Patient relationship. Can the Hon’ble Secretary of State reassure GPs that there will be level playing fields if they are to compete against conglomerate giants who will cherry-pick services they offer to the public?”
There was predictably lots of cynicism about the waste of £bns on IT systems in the NHS already and wondering why the proposed “information revolution” would be any better? Lansley insisted it was about empowering patients and clinicians with information close to where patient decisions were made (“shared” of course) and it was about achieving better outcomes (effective, safe, value for money etc). He was unshakable on this.
Inevitably this discussion of information and what to do with it got shunted into the debate that never resolves about “choice” – whether people wanted it, who should enable choices, what about people who were digitally isolated, and conflicts of interest if GPs had tie ups with private providers and did not give “impartial” information. As if there was any such thing as truly “impartial” information. Some people did mention the report in today’s media that NHS Choices health information portal was getting 100m hits a year (up 10% on 2009) and “saving” some £44m a year by diverting people from attending GP surgeries. That’s what Lansley wants to see more of.
Mr Lansley did say one thing on combined patient-held budgets for health and social care that was a step forward. He wants to give people with long term conditions the money (national tariff one assumes) and let them divide it themselves. MAC has argued for this for a long time, particularly for people with long term neurological conditions.
I have said social care users should exercise more control including access to personal budgets. Once their need has been assessed, it is very predictable. This isn’t the case for health care. The scope is limited as the cost varies a great deal. But we are going to look at cases of long term conditions. The most effective way of breaking down the barriers between health and social care will be to give a combined budget and let people to divide it themselves.
Micro budget holders will need information to help them be good commissioners and consumers, that’s for sure. And there are bound to be plenty of people getting into “brokerage” for just this reason. It could be one of the government’s job creation schemes led by the 3rd sector.
This is a good reason for the charities backing the Neurological Commissioning Support (NCS) project to push on with making the Neuronavigator tool accessible and usable for individuals with the neurological conditions covered in it.