The middle of the line

No time to discuss the Andy Burnham meeting tonight, I need my kip. But at the end the news came through that Andrew Lansley had let slip that NHS Direct would be replaced by a cut-price service. Essentially, it seems that the decision to replace the NHS Direct number with the one currently being tested in parts of the North East.

The main difference will be that far less medical expertise will be available, which will make the service less useful. It will appear to save money, but if the new service is seen to be useless then the outcome will be more people turning up at GP’s surgeries and A&E departments who don’t need to be there.

The figures in the report say that of the people who call NHS Direct (27,000 a day), 22% were referred to their GP as urgent, and 12% were referred to A&E as urgent. What this means, however, is that 66% of callers were worried enough to call up, but were not referred on for urgent care. This suggests to me that a large number of people who were unsure got advice rather than a referral. Without NHS Direct, these people – up to 18,000 a day – would either have ended up going to A&E or to their GP unnecessarily, or potentially would have done nothing, leading to a more urgent need later on.

Here’s the bit that gets me. The Tories claimed all through that the NHS budget would be ringfenced. They also said that they’d not make any major organisational changes. In the last month or so, they’ve announced one of the most fundamental changes in organisation the NHS has ever seen – putting all the commissioning power in the hands of GPs, and now it’s clear that they are trying to find cuts.

As ever, this seems to be a partisan cut – Labour did it, so it must be a bad idea – rather than having been thought through. It could easily end up creating more cost, more delays at A&E departments and more headaches for GPs. All of which means a worse service to the public.

Each time I think that the Coalition have gone too far, they come along with a new policy that shows that they have more idiocy in the bag. Five more years of this crap?