It was only a matter of time; after a regressive budget and numerous announcements relating to cuts affecting the poorest the ConDem coalition has finally touched Britain's rawest nerve - the NHS. After campaigning on the promise of ring-fencing the budget and no further 'top down re-organisation' the government published their NHS White Paper on Monday leaving Shadow Health Secretary Andy Burnham by his own admission, close to tears. Andrew Lansley defended the paper in the Commons on Monday, but it was left to a struggling Francis Maude to confront Burnham and the hecklers of Bexhill-on-Sea on Question Time. The public are finally beginning to question the coalition and their actions; Lansley's proposals will cost a staggering £1.7bn at a time when the NHS and the electorate would rather that all money is directed towards front line services. The proposals aim to rid the NHS of a costly bureaucracy by scrapping Primary Care Trusts (PCT's) and instead placing budgets in the care of GP's, a new NHS Commissioning Board and Local Authorities. The biggest shake up will be for GP's who will have to form consortia and will be responsible for buying services for their patients from 2013. This will add a new dimension to the role of many GP's who will, in many cases, lack the skills and expertise to perform these accounting roles. For those who fear for the long term future of the NHS itself there is an extra dimension of concern. Private health care providers will now be able to offer their services to GP's, meaning that companies could effectively undercut the NHS in order to 'win business'. Anyone fancy a Virgin branded brain scan? Its no wonder that Kingsley Manning, business development director at Tribal, welcomed moves which the firm said "could lead to the denationalisation of healthcare services in England". For those of us who have a fundamental fear of mixing healthcare with profit this is a worrying statement.
There is further muddy water surrounding the core principles of the coalition when it comes to the NHS. Whilst they are keeping their election promise to ring-fence spending there is concern that the resulting severe cuts in local government could have a detrimental effect on the NHS; without effective social services, social care and elderly care it will struggle to exist and safely discharge vulnerable patients. Furthermore their insistence that the targets put in place by Labour are ineffective and bureaucratic means that we could lose the two week cancer promise and the 48 hour GP appointment guarantee; measures which are popular with the electorate.
And let us remember, these are reforms that nobody voted for - they were not mentioned in any manifesto or the coalition agreement- and thus the government has no mandate to carry them out. NHS staff and their unions will be watching closely as the debate rages on; but we can be assured that the coalition will not be able to sneak through such radical reforms without a fight.
Some excellent points there Helen. These reforms, whilst appearing sensible are actually going to lead to more bureaucracy in the NHS, its just going to be a private one, instead of a public sector one. GP's and Hospital Trusts are all going tohave to employ lawyers, accountants and (management) consultants to help them move this money around the system. All this is going to put pressure ont he limited resources, and result in a poorer service - longer waiting times for GPs, hospital appointments etc. And money will leave the NHS which wont come back.
ReplyDeleteYou just need to look at what happened to the rail service when it was privatised in the 1990's. The same money was moved around the system, with much of it vanishing in fees to lawyers, accountants, consultants, and in profits to shareholders. As it happens, the cost of the railways has risen by 300% in real terms due solely to privatisation. We can't afford to let the same thing happen to the NHS.
By the way, did you know that Andrew Lansley received £21,000 from the wife of the man who owns www.careuk.com ? Coincidence? I think not.