The NHS: Targeted for reform
UK Prime Minister David Cameron’s emergency summit was supposed to heal rifts over planned NHS reform. Instead, the Health and Social Care bill has been plunged into fresh controversy after reports emerged that key healthcare groups had been excluded from the meeting – apparently because they don’t back the government’s stance. Shadow Health Secretary Andy Burnham slammed the decision not to invite health bodies such as the British Medical Association (BMA), the Royal College of Nursing and the Royal College of General Practitioners: “The NHS matters too much to too many people for Mr Cameron to play what is a dangerous game of divide and rule,” he said, reported The Guardian.
Key planned reforms include making GPs responsible for patient care; buying in services from public, private and charity sectors; cutting NHS management staff; and abolishing primary care trusts. Health Secretary Andrew Lansley has already taken considerable heat over the proposals, with commentators criticising his handling of the proposed legislation and GPs up in arms over the reforms. Cameron was supposed to ride to the rescue; but the latest controversy suggests the prime minister’s support may have backfired.
The PM’s aides claimed that as the point of the health summit is to discuss how to implement the bill, ”there is little point inviting those who have opposed the reform from the start”, said Samira Shackle on a New Statesman blog. However, Shackle pointed out that this is unlikely to win over a general public already suspicious of the proposed NHS reforms: “A Unite/YouGov poll found that six times as many people trust health professionals over Cameron and Andrew Lansley on NHS reorganisation.”
An e-petition calling for the bill to be scrapped has attracted 147,000 signatures, reported Sky News, with celebrity supporters including footballer Rio Ferdinand and broadcaster Stephen Fry.
NHS mess. “The health and social care bill is now a wreck,” thundered Jackie Ashley on The Guardian’s Comment is free, branding the proposed reform largely “friendless”. According to Ashley, the bill will do more harm than good in its current form: “In the service of reducing bureaucracy, it is busy creating a new, and probably eventually bigger bureaucracy. Instead of giving hospitals and GP surgeries more freedom, it is imposing a new round of top-down enforced changes on them, just at the time they are having to find big cost-savings.” Ashley argued that Cameron is backing the bill simply in order to save face – and this may come back to haunt him at the next general election.
Science writer and doctor Ben Goldacre published a round-up of the organisations excluded from David Cameron’s HNS reform summit on his blog.
Carving up the NHS. The bill is driven by a belief that “the NHS must be dismantled and the parts sold for scrap to the private sector”, wrote Max Pemberton in The Telegraph. Pemberton described amendments aimed at addressing concerns as “a precariously placed fig leaf designed to preserve the modesty of the more gross and gratuitous aspects of the Bill”, pointing out that the section that deals with the regulation of competition for NHS services is unchanged, “despite it being one of the critical elements that undermines the NHS”.
Over 150 paediatricians have written to medical journal The Lancet to condemn the proposed NHS reform on the grounds that children’s healthcare would be undermined. A Department of Health spokesperson dismissed the call for the bill to be abandoned, reported The Independent, saying: “These 150 individuals represent just over 1% of the total members of the Royal College of Paediatricians and Children’s Health and cannot be taken as an accurate representation of the College, who we continue to work with.”
Poorly introduced but potentially not so bad. “The coalition’s health and social-care bill is a textbook example of how not to introduce major reform,” said The Economist; however, the proposals may not turn out to be so terrible in practice. After all, “rising treatment prices, an aging population and ongoing fiscal austerity mean that [the NHS] will have to change if it is to keep pace with expectations,” according to The Economist.