RARELY has a piece of Government legislation faced such opposition.
The Coalition wants to completely change the way the NHS is run, putting control of its budget in the hands of GPs rather than bureaucrats, and opening up services to be run by private companies.
But opposition to the reforms has escalated to the point where Health Secretary Andrew Lansley was last week forced to make 136 changes to the legislation, and an unnamed Downing Street source was quoted as saying the veteran Tory should be ‘taken out and shot’ over his handling of the matter.
Despite the national furore over the proposal a group of eight Sheffield GPs, a nurse, four advisers and three officials are preparing the ground for the policy to become reality.
If the reforms pass through Parliament, the new Clinical Commissioning Group will take responsibility for the Sheffield’s £1 billion health budget in April 2013, little over a year away.
The group is already running in ‘shadow’ form and has taken over 71 per cent - £709 million - of the city’s health commissioning budget from the Primary Care Trust, which will be abolished next year.
Dr Tim Moorhead, a GP from Oughtibridge and elected chairman of the group, told The Star the new system offers family doctors a chance to control the way the system is run.
“This makes it much more driven by the doctors, rather than us just being consulted,” he said.
“That’s the big difference in our approach. We are trying to get the best out of the new arrangements for Sheffield patients.”
Dr Moorhead - a member of the British Medical Association, which vehemently opposes the proposals - admitted the plan has its flaws.
“The concerns of the professional bodies are noted and we share many of those concerns,” he said.
“But we have an unparalleled opportunity to really change the health system for the better.”
And he was scathing about Labour MPs’ demands that the whole reforming process simply be abandoned.
“No change is not an option. The way the health economy in Sheffield was going, it was becoming unaffordable, mainly because of the way health payments were organised.
“We were doing too many procedures in hospital, and it doesn’t have to be done that way.”
Ian Atkinson, interim chief executive of the Primary Care Trust, has been appointed chief operating officer of the new clinical commissioning group.
He agrees with Dr Moorhead’s vision for the future of the service - and thinks they can achieve it despite having to make around £19m of savings this year.
“The test is making the efficiency while delivering better services,” he said.
“Not everyone who goes to A&E needs to. Not every patient needs to be sent to diagnostics.
“Hospital costs a tremendous amount of money. We want to treat as many people as possible elsewhere.”
Mr Atkinson added: “This reform is about trying to bring some really good GPs and doctors around a table with consultants, to break down the divide between the hospitals and the GPs.
“The real test of the reform is whether we can deliver that.”
Dr Moorhead said: “We need to keep our hands on the tiller, to be engaged and have the debate.
“The top-down approach has been tried time and time again. The bottom-up approach takes the redesign lead from the doctors and hopefully from patients and the public as well.
“Provided we have freedom to do that I think we can have a great deal of benefit.”
Dr Moorhead admitted opening the provision of health services to ‘any qualified provider’ - which includes private companies - is the sticking point for many people.
“The emotive issue is the risk of privatisation in the NHS.
“Yes, the policy opens up a possibility of privatisation, but I think we are in a strong place already in Sheffield.
“We don’t want to start breaking things up that work. Privatisation would only be a last resort.”
Much opposition to the reforms has been based on a view that doctors should focus on treating patients, and leave financial matters to managers.
Dr Moorhead said: “We aren’t going to become financial experts overnight.
“But we are experts in dealing with patients’ health - doing it wrong costs more.
“If we can get patients’ experience right it costs less. You do it once and you do it right.
“We have a lot of expertise in Sheffield in health service management, these people are there to advise us.”
And he pledged to oppose outsourcing the administrative side of the commissioning service to management consultants.
“I am hoping we will change the administrative side really quite quickly - it won’t look the same as the PCT.
“That’s where privatisation is potentially on the cards, but that’s something I wouldn’t be supportive of.”