The latest craziness in Brtain's socialized medicine

Nurses to take charge of surgeries

The government will take on the medical profession this week by pressing ahead with reforms that will see greater power being transferred from doctors to nurses. Alan Johnson, the health secretary, is expected to follow up plans to introduce at least 150 large health centres, known as polyclinics, by announcing an expansion of surgeries run by nurses. The centres will replace lone GPs, many of whom the government believes are unable to provide evening surgeries or other modern patient services.

This is likely to escalate a row between the government and doctors over reform. Lord Darzi, the health minister in charge of a review of the National Health Service, has accused some doctors of being “laggards” and protecting their “professional boundaries”. Darzi has already said he wants to see nurses doing minor surgery in hospitals. This week he is expected to lay out proposals for more nurses to set up surgeries. They will be encouraged to establish not-for-profit firms to run the practices by being allowed to opt out of the NHS without losing pension rights.

Darzi will also outline plans to publish the death rates of hospital doctors so patients can compare their chance of survival according to who treats them. Death rates at NHS hospitals are available for heart surgery. Success rates for about 50 other conditions are expected to be published on the internet to allow patients to shop around.

Patients are also expected to be given personal health budgets and will decide how the money is spent on treating long-term conditions, such as diabetes and heart disease.

An “NHS constitution” will set out patients’ rights and responsibilities, including the right to be told why they have been denied a drug a doctor recommends.

Johnson has admitted that access to NHS drugs is a lottery and will order the National Institute for Health and Clinical Excellence (Nice), the government’s rationing watchdog, to assess drugs more quickly. He said: “What we have heard from patients is that one of their major concerns is the perceived ‘postcode lottery’ in access to drugs. “The draft constitution will address this by making it explicit that patients have the right to Nice-approved drugs and treatment if clinically appropriate. “We will also speed up the national process for appraising new drugs. If a decision is then taken not to fund a drug then your local NHS will have to explain that decision to you.”

Hamish Meldrum, chair of the British Medical Association, suggested the government’s plans for nurses to run surgeries would have limited impact because patients would choose to be treated by doctors. Meldrum said: “There are obviously certain things that only doctors can do. “It is all very well saying patients should have choice about where they are treated but there are certain treatments nurses cannot do, so there will be a limited choice. Patients usually prefer to see doctors.”

Peter Carter, general secretary of the Royal College of Nursing, said increasing numbers of nurses would run local surgeries in future. Carter added: “We never want to get into confrontations over territory. However, good progressive doctors recognise there are roles for nurses who do highly complex work.”

Source