Not endangering universal coverage means nothing where there are clear signs of postcode lottery with a range of services, including IVF in today's news. With consortia at a 100,000 person level, not every one will contain a hospital, nor will all midwifery services be available. Therefore what Cameron is saying is nonsense, he cannot increase existing services on 80% of the current PCT budget therefore the gaps already in existence will stay, and new ones will form.
The same applies to improving efficient and timely care, with limited budgets, which are currently below EU average in any case, and rising costs, the timeliness of care will obviously be effected. When thrown into the mix the debate of 'concentrating hospital services', one must recognise this means closing other hospitals and services.
Cameron says there will be no sell-off, but it is prudent to observe he does not echo Clegg's announcements on potential problems with competition introductions. Therefore he is still intending to commission services to private contractors, which amounts to the same thing.
As well as this, such reform will create an opaque layer of bureacracy which will mean reviewing performance will be virtually impossible with commercial sensitivity, something we already see with Council service contracts.
The only solace in Cameron's rhetoric is he will maintain that services will be free at the point of delivery. But even this silver lining has a cloud, one can still receive retrospective invoices.
I have little faith in the report published next week, and remain as ever cynical.
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