PubMed · 11974362
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W Caan. Working in harmony.. https://doi.org/10.7748/ns.14.49.75.s63
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The government's proposals for cross-charging could hamper the development of effective partnerships between the NHS and social services. It is regrettable that the system is being developed at a time when primary care trusts have not had a chance to influence the whole commissioning process. The problem of delayed discharges needs to be tackled from a broad approach that includes access to GP services and inappropriate use of accident and emergency departments. Reimbursements from the charging system should be given to PCTs, which then have greater influence in integrating health and social care.
The last decade has seen huge shifts away from the command and control model which dominated health policy since the foundation of the NHS. The current Labour government Initially favoured a system based on collaboration and partnership working but the incentives to achieve this were not sufficiently strong. Competition is now once again openly cited as a driver for improved performance. Political demands mean that command and control are likely to remain key features of government health policy. But this, in turn, is likely to place major limitations on the local autonomy pledged by the government.
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