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Monday, July 26, 1999 Published at 11:45 GMT 12:45 UK


NHS reform: The grassroots verdict

Many doctors are still unconvinced about Labour's NHS reforms

Ordinary doctors and nurses have given a mixed reaction to the government's assessment of its second year in office.

Launching the second "end of year report" on Monday, UK Prime minister Tony Blair said this year's NHS reforms were part of a 10-year strategy to modernise the health service.

He admitted that targets on reductions of waiting lists were not yet being met, despite an expensive initiative.

Earlier this year, the government trumpeted that it was on target to meet its waiting list times a year ahead of schedule, but in the last two months the figures have crept back up.

Mr Blair conceded that reforms of the NHS might take a decade to complete: "To turn round a big public service is a 10-year project and it will take time to do it.

"I understand the frustration that people feel."

The British Medical Association has already expressed its concerns about the scale and speed of the NHS reforms, but ordinary doctors also reveal their morale has been hit.

Doctors re-grouped

One of the main reforms is the setting-up of primary care groups, which will plan for the health needs of entire communities.

Their creation was part of an election promise to scrap fundholding, in which some practices had their own budgets to buy healthcare services for their patients.

[ image: Junior doctors are threatening to strike over pay]
Junior doctors are threatening to strike over pay
The government also plans to set up a modern, secure, computer network spanning the entire NHS, although critics say this is unworkable.

Dr Keith Edgar, a GP who practises near Rugby, is supportive of the aims behind many of the government's proposals, particularly those aimed at making sure patients get the highest possible standard of clinical care from doctors.

But he says progress has been stunted because of a lack of information, and proper investment, from the government.

And many doctors, he said, are suspicious of some of the innovations like telephone helplines and walk-in centres.

Several consider these "gimmicks" and say they could worsen the overall standard of patient care.

In addition, they fail to address important issues such as the shortage of GPs, say doctors.

[ image: Nurses pay has been revamped]
Nurses pay has been revamped
Dr Edgar has not noticed any reduction in waiting times for his patients waiting to see consultants at hospital - in fact, in some specialisms, the wait has got longer.

"A lot of doctors are slightly cynical about what the government is doing," he said.

Although a white paper on public health set ambitious targets for the reduction of heart disease, stroke and cancer over the next decade, he is concerned that the medical profession is not being given the necessary tools to complete the task.

Information on heart care missing

In particular, a vital document which will tell doctors the minimum standard of care a heart disease patient should get - due out earlier this year - will not arrive until much nearer the millennium.

"Morale amongst doctors is now lower than under the last government because of all the uncertainty," said Dr Edgar.

Nurses are generally thought to have fared better than doctors in terms of pay over the last two years.

There has already been a pay boost for novice nurses, and last month the government announced a new nursing strategy which included the creation of a new grade experienced "supernurses" who can earn up to £40,000.

This has been welcomed by the Royal College of Nursing and grassroots nurses, including those who have retired from the profession but are being tempted back by a recruitment drive launched earlier this year.

Mr Blair said: "Nurses are underpaid and often overworked. We are trying to recruit more and changing pay structures."

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