Author: Tony Davis
Describe your idea:
A retired doctor. We had to account for every act; something I thought only fair.
Recently involved in enquiry on surgery closure in a small village where sheltered housing was built on the promise that there would be a surgery in the village. The surgery was closed. The Chairman and Officers of the local PCT misrepresented their position to the enquiry.
I enquiried about the accountability and governance of the PCT and its staff. It appears that there is none and one senior Audit Commission person I discussed it with stated that concerns exist about the non accountability of the NHS.
Like the planning site I would like to help construct a site which would monitor PCT accountability.
What problem does it solve?:
The lack of accountability in the NHS.
Type of idea: A brand new project
Correct me if I am wrong, but, if a GP wishes to open a surgery in an area of their choosing, what is to stop them.
Obviously it would be financial suicide to open a surgery on top of a mountain or other sparsely populated area, unless of course there are incentives to do so.
Problem is, those incentives are coming from an ever dwindling budget, with ever spiralling costs.
When asked to vote on keeping a surgery for elderly people open using NHS funds the answer would be yes, of course.
The same question with the additional information that the renal unit in the local hospital would have to be closed and centralised 40 miles away in order to pay for this and the answer gets more complicated.
Most people don’t want to know there is an opportunity cost to every decision, they just want what is front of their eyes.
I strongly believe, on this point alone, the NHS should not have to be accountable for these decisions, otherwise the politics of life and death would be in the hands of people who have little conception of the world outside their own.
To the author.
Contrary to my opinion, I do sympathise with the circumstances surrounding your plight and I would hope a visiting GP service has been arranged for the elderly occupants, in a attempt to alleviate the stress of travel.
And yes I agree a form of accountability is always necessary, sadly in this instance it is the balance sheet.
Colin
I am sorry but you are wrong. To receive NHS funding for the staff and premises of a surgery a GP must receive consent from the PCT.
In fact, the surgeries I am talking about are in a sparsely populated area – the Salisbury plain. You can see it on maps which demonstrate urban light pollution – it is the large dark area in the SW of England.
The NHS does not take decisions in the way that you suggest. Shutting this surgery had no impact on other services. It merely made life more difficult for the elderly visitors who needed to use the once an hour bus journey at a cost of £2.50 per single trip. For a dressing change this cost the patient £5.00 and needing a journey time of at least 2 hr 30 min.
The decision was taken on the basis of a presentation made to the PCT Board which differed materially from the detail promised in writing to the village’s representative group.
The accountability which worried tbe NAO and which I would like to make open to public gaze is the degree to which PCT’s behave in this dishonest way. It will simply be a variation of public feedback regulation.
I cannot give many details but from some work I have done I am aware that this is a widespread problem. Some 150 instances in the financial year 2008/2009