What nurses say about the NHS shakeup

RCN doubts reforms will achieve aims of putting patients at the centre of care and driving up standards

The Royal College of Nursing doubts the reforms will achieve their aims of putting patients at the centre, reducing inefficiency and driving up standards. Forcing through such big changes at a time when hospitals are shedding staff, demand is rising and the NHS has to save 20bn by 2015 is highly unwise, says Dr Peter Carter, the RCN's chief executive and general secretary.

Nurses are opposed to "unjustified" plans to abolish the private income cap, the amount NHS foundation trust hospitals can earn from private patients. They fear state-funded hospitals will be tempted to put those patients ahead of NHS ones. About half of hospitals are foundation trusts; all will be by 2014.

The bill does not enshrine patients' supposedly central place in the new NHS. "There is no requirement for the NHS Commissioning Board, [GP] commissioning consortiums or HealthWatch England to have a public representative," the RCN points out.

It warns against abandoning national pay rates: "The encouragement of NHS organisations to determine their own pay and reward structures will be highly damaging to recruitment, retention and morale, and lead to unequal pay problems across the NHS".

Bonuses that the new National Commissioning Board can award to high-performing GP consortiums should be used to improve frontline care, it believes.

Department of Health responds: "The implementation of these plans is not being rushed. Some of the changes will not come into effect until 2015. This modernisation involves simply the logical extension of models tested under previous governments."


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