The Muscular Dystrophy Campaign are one of a number of health groups that have expressed serious concerns about the impact of these changes. The Muscular Dystrophy Campaign have particular concerns (which they term potentially 'devastating') about the scrapping of Primary Care Trusts, and the potential loss of co-ordination that these bodies bring:
"It's shocking that the future role of essential, specialised services for people living with very rare conditions has been almost completely absent from the debate following the publication of the White Paper. At the moment, Primary Care Trusts collaborate regionally to commission specialised services for people with rare conditions. Will the new NHS Commissioning Board have its own budget for these particular services, or will the new GP consortia contribute part of their budgets towards specialised services?"
Meanwhile, it is clear that private companies are going to have a major role in the commissioning of services - potentially opening up massive conflicts of interest and driving commissioning (and therefore ultimately service provision) decisions out of the public sector altogether.
Now Unison has decided to go to court to attempt to put the brakes on a reform that, as well as potentially meaning the end of the National Health Service in its current form was, incredibly, not even mentioned before the election by either the Conservatives or
• strategic health authorities;
• primary care trusts;
• NHS trusts; and
• NHS foundation trusts.
Section 242 explicitly states that:
“Each relevant English body must make arrangements, as respects health services for which it is responsible, which secure that users of those services are, whether directly or through representatives, involved (whether by being consulted or provided with information, or in other ways) in –
a) the planning of the provision of those services
b) the development and consideration of proposals for changes in the way those services are provided, and
c) decisions to be made by that body affecting the operation of those services. “
The duty applies if implementation of the proposal, or a decision (if made), would have impact on -
a) the manner in which the services are delivered to users of those services, or
b) the range of health services available to those users.