David Cameron delivered yesterday a telling speech suggesting that the Government was ready to change their approach to the reforms. It seems that the government has indeed listened to what the professionals and the public had to say about the reforms. Cameron aimed to appease unrest both within and outside General Practice by guaranteeing that both consultants and nurses will be involved in the commission process, that commissioning consortia will be expected to be fully operational only when they are ready, and not necessarily by April 2013 as previously envisaged, and that competition will be only pursued where it may benefits patient care and choice.
However, the most significant commitment was to ensure that the new system made integration of acre a priority: "clinical senates" consisting of senior medical professionals will oversee integration of NHS services across local areas and, even more astonishing, Monitor, the NHS watchdog that had been previously commissioned with the task of ensuring fair competition, will have a duty to promote integration of care.
Although not inherently opposed, the goals of higher integration and more competition seem difficult to reconcile. It is a shame that nobody dared to ask Mr Cameron what he meant by integration, such an elusive concept. But elusive or not greater integration is good your health.
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