"The NHS will last as long as there are folk left with the faith to fight for it"
- Nye Bevan
“No bill is better than a bad one”
- Nick Clegg
The NHS is fighting for its life.
Before the last election, David Cameron promised that there would be “no top-down reorganisation of the NHS”. He did everything he could to make us think the NHS was safe in his hands. Then – not long after the removal vans had pulled away from Downing Street – along came Andrew Lansley’s white paper on the NHS, swiftly followed by the Health and Social Care Bill. It is a top-down reorganisation of the NHS.
In fact, it’s a lot more than that. It will undermine – irreversibly – the central principle of the NHS: that it is free at the point of contact, for everyone, regardless of wealth or status. The Bill’s central idea is to let market forces run our health service – despite the huge amount of evidence that this has a negative effect on results. It will also change the Secretary of State for Health’s role from providing to promoting healthcare. It’s hard to overstate how crucial this change is – at a stroke, it removes the government’s responsibility for the nation’s health. Remember the PIP breast implant scandal? Southern Cross care homes? That’s what deregulation brings. And that’s how the whole of the NHS will be run – competing private companies winning contracts by forcing down costs, and the devil take the hindmost. As Andrew Lansley himself puts it, “the first guiding principle is this: maximise competition”.
Cameron and Lansley aim to give the world’s biggest private health companies what they’ve spent years lobbying for: access to the UK healthcare budget. In other words, to our money. Have a look at this chilling short film.
To do this, the Bill will create a market. Healthcare in the UK will become a battleground for private companies to slog it out for profits – and your local NHS hospital will be obliged, by law, to compete with them. It will also create a two-tier NHS: ‘topping up’ with insurance and personal payments will become the norm – for those who can afford it. Noticed an increase in TV ads for private health recently?
Try and find support for this Bill in the medical profession and you will be looking for a long time. 76% of NHS staff think patient care will suffer. When the Royal College of GPs surveyed their members on the Bill a few weeks ago, 98% were against it. And they’re the ones Lansley reckons will be grateful for this chance to run the NHS. Do you want your GP to spend half their time running the NHS? I doubt it. Neither do they. They know that what ‘GP commissioning’ really means is huge firms of management consultants, like McKinsey, running it for them. And taking another slice of our NHS budget for their trouble.
These are some of the groups that oppose the Bill:
- The British Medical Association
- The Royal College of GPs
- The Royal College of Nursing
- The Royal College of Midwives
- The Royal College of Radiologists
- The Royal College of Psychiatrists
- The NHS Support Federation
- The Chartered Society of Physiotherapists
- The British Medical Journal
- Nursing Times
- The Lancet
- The Health Service Journal
- Unison
- Unite
And so on – the list is growing daily.
What they all see is that the Bill means the end of the NHS as we know it – the best in the world, available equally for everyone – and that in their desperate rush to ram the Bill through, Cameron and Lansley have created an administrative and financial muddle of gigantic proportions. The BMJ, Nursing Times and HSJ this week ran a damning joint editorial calling it an “unholy mess”. Basically, almost the entire medical profession has tuned its back on Lansley’s ‘reforms’. They see it leading to a disastrous failure in patient care.
But there is one vital group who haven’t made their voices heard. The people who rely on the NHS: the patients. Us.
The most frequently-used phrase to justify the Bill is “patient choice”: the idea that you, the NHS patient, will be offered a range of medical services in your local area from which to choose. It sounds great – choice! For me! Well, I’ll choose the best provider, obviously. Right? Well, amazingly enough, this is one of the many ways in which – despite being over 400 pages long – the Bill is obscure. The chances are that your “choice” will be any provider - so long as it’s the cheapest one your local Commissioning Group has been able to find. Any colour you like, so long as it’s black. In all likelihood, it’s they who will make the choice – not you.
And how will these providers – hospitals, clinics, GP surgeries – make themselves so competitive? In healthcare, there’s only one real way to make profits – by cutting staff. A private company’s primary responsibility is to its shareholders, not its patients. Staff are expensive. But good healthcare needs people: it needs nurses, surgeons, porters, anaesthetists, administrators, cleaners. It needs staff.
The NHS is currently shedding 53,000 jobs. And that’s before it becomes a source of profits for the private sector. Again – remember Southern Cross care homes?
The Coalition also like to claim their reforms will ‘cut bureaucracy’. Hooray! We all hate bureaucrats, don’t we? Down with wasteful bureaucrats! Well, guess what. After Lansley’s ‘reforms’, administrative costs in healthcare are predicted to rise. Massively. Naturally, with competing providers all needing their own admin – which will include accountants, lawyers, managers, all the bureaucracy of a corporation. And a doubling in number of organisations running or regulating the NHS. All paid for by you.
The NHS isn’t perfect. No system on that scale is, ever has been or ever will be. But it is – in terms of results, as well as cost – the best in the world (as this survey by US thinktank the Commonwealth Fund revealed). You may not think that when you’re sitting in a crowded waiting room for an appointment that was meant to happen an hour ago – but would you rather the appointment never happened? Your GP – who under Lansley’s proposed system will be responsible for deciding how the budget is spent – might not refer you at all. Already GP groups are limiting referrals. If you’re the third person with that condition through his door that week, and their ration is two referrals a week – tough shit. Unless you have deep pockets, or your insurer is feeling generous.
When Nye Bevan founded the NHS in 1948, one of its guiding principles was ‘freedom from fear’. Fear of being unable to pay the doctor, a fear that was very real for millions of people. We don’t have to let that fear come back. We can act.
The NHS is ours. And it’s time we – the patients – were heard. It’s time we added our voices to the professional bodies and health workers’ unions who oppose the privatisation of our healthcare – who oppose the fear.
This ePetition was submitted by Dr Kailash Chand, a Derbyshire GP and committed believer in public healthcare. To his and everyone else’s surprise, it was accepted.
Over 44,000 people have signed it already. If it gets over 100,000 signatures, David Cameron will be forced to pay attention to us – the public. Sure, he may try and brush it aside; he may just ignore us and carry on. But he may not. He is terrified that the NHS will become this government’s poll tax – that the Tories will never be trusted on healthcare again. Andrew Lansley’s disastrous Bill is under fire from all sides – except ours. Let’s open up a new front in the battle to save our NHS.
Use the hashtag #ourNHS – raise your voices, share your stories, tweet the link to the petition: http://epetitions.direct.gov.uk/petitions/22670. Send it to everyone you know. Ask them to do the same. Come to the rally on the 7 March.
Above all – make sure our voice, the voice of the patients, is as loud as the voice of the medical professionals. Tell Cameron and Lansley the NHS is ours – and if they take it away from us, they will never be forgiven.
#ourNHS
This FAQ on the Bill is a great resource if you have questions:
http://abetternhs.wordpress.com/faq/
And if you’re looking for an alternative proposal to Lansley’s Bill, this ‘plan B’ by Kieran Walshe is a good place to start:
http://www.guardian.co.uk/commentisfree/2012/feb/01/nhs-reform-plan-b