A senior GP's radical plan for the NHS - while the health system's tectonic plates are moving with unaccustomed speed

Written by Tony Millett on .

The NHS in Wiltshire is changing.  We have hinted at this over the past months, but now there are real signs that change is coming - and fast.  They do not do waiting list queues when it comes to changing the NHS itself.

These changes will at first be mainly structural - and not all very revolutionary.  So GPs and managers on Wiltshire Clinical Commissioning Group (WCCG) had a bit of shock when they were treated at their board meeting on Tuesday (March 26) to a pretty revolutionary call-to-arms.

It came from Dr Simon Burrell, a long serving GP in Corsham and a very senior member of WCCG when it came to life in 2012.  This was his last board meeting in the official capacity as Chair of WCCG's North & East locality - and he gave it both barrels.

He said that 95 per cent of those working for the NHS are 'totally dedicated' to quality and care - and that included the managers at this CCG.  But he singled out the problems inherent in "The uncertainty and oscillation of government...they build up expectations but don't supply the resources."

Then he turned to the shortage of staff that is currently crippling the NHS:   "We're running out of people.  There are very few people left who want to work in care."

He had a radical suggestion for the NHS budget for England: cut it by 20 per cent  and put the money into education.   

That's not just education as in training NHS staff.  It is mostly about teaching children and young people about health - it is after all their health - and about how to stay healthy and especially about the vital importance of diet.

From his long experience as a GP, Dr Burrell believes that the current generation of those achieving previously unseen levels of longevity, are surviving into greater old age not so much because of advances in medicine and health care, but more because as children after the Second World War their diet was so good.  And from that he drew his important lesson about teaching the necessity of good diets.

Unfortunately the board had a full agenda - and a private session to follow - so there was no discussion of Dr Burrell's fascinating intervention.  Some of that agenda concerned the restructuring that will affect Wiltshire a great deal.

The people at the very top of the NHS in England seem to have an obsession with structure and organisation.  Perhaps it is on the principle that anything Lansley could do badly in his £3billion Health and Social Care Act 2012, can be done well now.


The more structures change, the better the NHS is expected to do as regards value for money and patient satisfaction - and patient safety.  Or so they say.  Now the structures are shifting again - and this time with no Parliamentary input and scrutiny and so far without much publicity.  And, be it noted, with many closed meetings and private sessions.

Right now these changes are uppermost in the minds of many NHS managers - some of whom might, when the music stops for a while, find they have to re-apply for their own jobs or even lose those jobs. 

There is a Titanic flurry of chair moving.  And it may all fail when it finally hits the unmoving iceberg that is the dire shortage of trained NHS staff.

So we are sorry to have tell you that we will be publishing - over the next months - a series of short reports on the forthcoming changes and how they may affect Wiltshire and so you too.  They will be as short as NHS complexity allows. 

In no particular order these will cover:  the introduction of Primary Care Networks (or grouping GP practices), the future of the CCG, what's happening with our overarching Sustainability and Transformation Partnership (STP), what other parts of the structure could fall off, social care, hospitals, and finally the iceberg itself - the staff shortage. 

Interestingly, on the latter issue, the Labour Party have just announced a policy for  'green lighting' all visas for NHS staff coming from overseas - and they may stretch that to social care as well.

All the above topics will be in the firing line of the new round of NHS changes.

In the meantime you can tell NHS managers what you think should happen to the NHS.  At Healthwatch England, which was set up under the Lansley restructuring of the NHS in 2012, they have an unambiguous and crisp tweeted message:  "The NHS is changing and it needs your help. What do you think needs to be improved to services where you live? Talk to your local Healthwatch".

...and on cue its local ‘branch’, Healthwatch Wiltshire, are up and running with their survey.