An ordinary meeting of the Society was held on 6th February 2008. The President was in the chair. He introduced the speaker, Professor Jonathan Montgomery who spoke to the title: Future Directions for Hampshire’s NHS.
He informed us that he was Chairman of Hampshire PCT as well as having a Chair in Healthcare Law at Southampton University. He is also on the National Advisory Committee on Distinction Awards. He wanted to raise issues concerning all three.
He wondered how fair and transparent clinical excellence awards were and were they value for money? He considered they should be more objective. The Committee were taking care to see that the localities were getting it right and that there was more transparency. But he asked, do all the deserving people get them? He also considered them to be good value as “we do need something to reward people for devotion.”
He then discussed the place of law in the clinical environment and its ability to make good decisions. In many areas its influence was vague and unhelpful. Concerning responsibility, accountability and liability the law was good but under threat from politicians who were reducing self regulation in response to Shipman and imposing restrictions. Some judgements reflected this now. Furthermore if an individual made a mistake is it the individual or the organisation that has the liability now the NHS indemnifies their staff? He feels that this has diffused the personal responsibility.
Forty per cent of his week is spent with Hampshire PCT. Hampshire has good health, low infant mortality, and people are living longer. There is lower smoking, higher physical activity and lower death rates from heart disease, cancer and stroke. He was pleased to report that the debts incurred through profligacy up to 2005 are being paid off from current surpluses He was concerned not to squander the achievements and plan for sustainable health resources even though the projected demand will outstrip a reducing income over the next 9 years.
The challenges of the future were, he considered, to commission for quality, rather than the activity which satisfies government; resisting learned helplessness, and local responsiveness rather than national. He was critical of the way that the NHS stifled ideas and innovation.
About Practice Based Commissioning he said “it is not practice based and not about commissioning.” He said GPs who want to be innovative find PBC no help. He was critical of the way the NHS has made it difficult to get clinicians into planning.
In a Mori survey people were concerned about the risks of going into hospital. We have, he said, “to devise a big stick or a way of encouraging hospitals to sort out their own problems.” He also discussed dental provision.
The talk was followed by a number of questions which he answered at length and he finished by saying that he wanted to see a return to clinical leadership again and clinicians having support to put ideas into practice.
There being no other business the meeting closed at 10.15 pm