by Amanda Ramsay
U-turn Dave, along with his Tory and new Lib Dem colleagues, made many an empty promise during last year’s general election campaign: VAT would not rise, frontline services would not be cut, the educational maintenance allowance would be safe.
And the Fib Dems promised the abolition of tuition fees, subsequently voting to triple them. The latest non-mandated policy is the health and social care bill, introduced to the Commons this week, heralding the largest reorganisation of the NHS since 1948.
This is despite the coalition agreement committing to quite the opposite, clearly stating: “We will stop the top-down reorganisations of the NHS that have got in the way of patient care”. In addition, the government’s health reforms feature in neither Conservative nor Liberal Democrat election manifestos, prompting Andrew Neil to ask on the BBC’s Daily Politics: “Are manifestos worth the paper they’re written on”? It is an alarming precedent.
Yet Tory health secretary, Andrew Lansley’s, bill effectively takes a political sledge hammer to the nation’s beloved NHS. It dismantles the 151 English primary care trusts (PCTs) and abolishes all strategic health authorities, replacing these public bodies with private consortia which will meet behind closed doors, despite managing a huge £80 billion budget – an eye-wateringly huge amount of taxpayers’ money.
Ever since the health reforms white paper was published last summer, there has been mounting concern over the disbanding of two tiers of public governance. Not only losing the associated checks and balances, but seeing them replaced by an opaque, unaccountable alternative. GPs are due to take control of multi-millions of pounds of the NHS budget by 2013. Yet no one voted for any of this last May. I wonder if the public even know what is about to happen to their primary healthcare?
Labour created PCTs to be transparent bodies that hold meetings in public; members of the press can attend and, crucially, minutes of all meetings are published. In contrast, these new consortia will meet behind closed doors, despite managing a huge portion of the public purse. Information will only surface through carefully honed and stage-managed press releases.
The NHS as we now know it will cease to be an organisation with a management structure. Instead, a free market of competing health service providers will be introduced, bringing with it associated economic risks, with healthcare decisions being based on price rather than clinical need. Market-led competition, under this Tory-led government, will be at the new heart of our treasured NHS.
This bill certainly poses more questions than it answers. Shouldn’t GPs, having spent years of training in medical school, be focusing on doctoring rather than management, procurement and budgets? Many certainly think so. Indeed, one GP commissioner at the coalface, Dr Clive Henderson, has spoken of the dangers of a populist approach to pharmaceutical rationing creeping in. Even Sir David Nicholson, chief executive of the NHS, considers the reforms too fast and too extensive, as do a host of healthcare specialists.
Damningly, a survey by the King’s fund – the independent healthcare charity – claims that less than one in four doctors believe these reforms will improve the quality of patient care. Equally significantly, GP consortia proposals are opposed by the British medical association and royal college of nursing.
Another worry is the nature of competition, which could see GPs at risk of being offered financial incentives to choose certain pharmaceutical companies and prescribe specific drugs.
And what of complaints – to whom are these consortia going to be accountable? What of local rationing?
There is also the issue of cost. Such an enormous reorganisation may end up costing a startling £3 billion, particularly ill-timed and inappropriate expenditure during a time of austerity and huge public sector cuts.
This is not some partisan rant. Mine is far from a lone voice. Nor should it be. Those of us who think alike must take action. Write to your MP and launch letter campaigns to local and national papers. Make some noise and oppose these changes before they become law.
Amanda Ramsay is a former Labour councillor and cabinet member.
Tags: Amanda Ramsay, Andrew Lansley, health and social care bill, NHS reorganisation
We are getting use to change as Blair and new labour came in and took a lump hammer to change and the market. Every hospital I know went for private companies , private hospital BUPA was allowed to run hospitals, so now people are just saying look it’s just progression, 40 years ago you would have had people on the street, now people just say ah well.
Labour removed the NHS dental profession, in my town we have a small one off dentist that does the NHS stuff, and it comes from America, America for god sake.
This article is thoroughly deceptive. The reforms were clearly listed in the conservative manifesto (p 46 since you’re asking), over half of the UK is currently operating under consortia because of the enthusiasm for these reforms (contrary to your claim that GPs are hostile) and the reorganisation cost is half of what you have suggested (see the impact assessment). Opposition to reforms is one thing, but you have a responsibility to at least tell the truth.
For my own part, I very much like the idea of my GP being involved in purchasing care rather than a PCT I have absolutely no access to.
@Robert
Sorry, didn’t really understand your rather incoherent comment.
@Stranded
The conservatives said repeatedly that they would *not* re-organise the NHS.
“over half of the UK is currently operating under consortia because of the enthusiasm for these reforms (contrary to your claim that GPs are hostile)”
ROFL! What utter nonsense, the consortia aren’t even operating in shadow yet.
“the reorganisation cost is half of what you have suggested (see the impact assessment).”
The NHS has budgeted £3bn this year for the re-organisation.
“Opposition to reforms is one thing, but you have a responsibility to at least tell the truth.”
The above article is the truth.
“For my own part, I very much like the idea of my GP being involved in purchasing care rather than a PCT I have absolutely no access to.”
LOL!!! I don’t think you really understand how these reforms will work in practice, GPs won’t be making “commissioning” decisions while you’re in their room. The most likely outcome is that GPs will outsource their commissioning powers to the private sector, a healthcare service company will then be making decisions in secret with no direct accountability to voters or patients. You try getting access to the minutes of their meetings.
Lets be straight , Stranded on pg 46 they say they will ” Back the NHS and reform education” no mention of reforming the NHS anywhere in the manifesto so dont start trying to peddle lies on behalf of the tories which you support. Over half the country is not operating under consortia , they are still all responsoible to PCT’s It is true that the vast majority of GPs are hostile to the reforms but not hostile to improvements. The facts about the NHS are there in the MAnifesto and all they say is that they will strengthen GP’s ability to comission services, which they already do anyway, butb again under the PCT’s . At least lets have honest debate.
The tories DO NOT HAVE ANY MANDATE TO CARRY THEIR PROPOSALS and this will be the downfall of the tory party, of that there is no doubt.
You currently have access to the PCT at anytime of the day or night and inaddition you have the right to attend their meetings all this will be taken away from you under the tories proposals