ONFIDENTI
CONFIDENTIAL
Page 40
ignorance among doctors as well as the general public about precisely what those reforms entailed, and much of the opposition to them stemmed simply from a resistance to change.
C. The case for the reforms had been reinforced by recently published research which drew attention to the wide variations in standards between different GPS' services. Unfortunately the researchers had drawn the perverse nclusion that the proposed new contract would worsen the Misparity in standards: in fact, their research illustrated he need for the incentives for which the new contract would ovide as a means of ensuring that disparities were reduced. It would be helpful if the Secretary of State for Health were to make available to his colleagues a note on this point
d. The
arguably a case for doing more to promote to the public the benefits of the proposed reforms. The case for change
needed to be made out. In view of the public's tr
the medical profession, there was no advantage incising the doctors themselves, although the BMA itself waspen to criticism. It was possible that the opponents Meanwhile there achievements in tac
times or in
M
medtroll Government's approach
hange would overplay their hand. case for demonstrating by practical specific problems such as waiting pre-defined targets, that the the problems of the NHS was bringing results. onepful approach might be, for example, to remind those whiticised the reforms that the Government was not proposing move away from a publicly funded National Health Serviceather it was a question of good stewardship in using the lic funds entrusted to the olic funds entrusted to the Service to best effect. It was resistance to change from those stewardship of resources was in the
ural that there should be in the Service, but better
interests of all.
e. The most convincing argument for the reforms would be the successful adoption of self-ove hing status at particular hospitals. Such statu
d give local hospitals and their staff much greater freedom in managing their own affairs for the benefit of patieom the local community. Self-governing status could not be introduced ahead of the necessary legislation, but a great was already under way to encourage volunteers governing status to come forward; to
of work
self-
enthusiasm in the face of criticism of opponents
bargaining arrangements for the profession; and to
the volunteers successfully to achieve the new status.
reforms in the medical profession and from the Bich feared the reforms' impact on the
existing
6
CONFIDENTIAL
Page 40
FIDENTIAL
their
the
Page 40