This week the controversial and unwanted Health and Social Care Bill returns to the House of Lords. Despite David Cameron’s pre-election promise to end top-down reorganisations, the NHS is set for its biggest structural reform since it was created. Organisations representing 1.2 million NHS workers are now in outright opposition to the bill. The Royal College of Nursing, Royal College of Midwives, British Medical Association, Faculty of Public Health. I could go on. Perhaps opposition from vested interests might seem inevitable, but even the Royal College of GPs regard the changes as expensive, bureaucratic and think they should be dropped. GPs are the very people who would be handed greater power and money if the bill passes and even they don’t want it. They know that the bill undermines the relationship of trust doctors have with their patients, where financial incentives could override medical decisions. In removing the cap on private patients, NHS patients may end up waiting longer. This is coupled with the watering down of guarantees on NHS waiting times. Already in Sunderland we’ve seen a 23% increase in the number of patients waiting more than 18 weeks for treatment.
The NHS is under massive financial strain. As Age UK’s campaign has highlighted there is a growing crisis in care for older people. This is the wrong time to be embarking on a reorganisation that will cost £3.5billion. The government claims its reforms are about reducing NHS bureaucracy. It’s hard to see how that is the case. We will see a National Commissioning Board, 50 or so Primary Care Trust clusters, clinical commissioning groups, clinical senates, and health and well being boards. Doctors’ time is being taken up with these structural changes, rather than on patient care. GPs may be left with no choice but to use large, private companies to carry out commissioning work. I support greater involvement of doctors and other health professionals in decision making, but this can be achieved without the wholesale structural change that has seen Sunderland Teaching Primary Care Trust alone set aside over £21m to fund the government’s plans.
There is significant risk involved in all of this, not least to patient care. However, the government won’t share with us how dangerous it could prove. Despite a ruling from the Information Commissioner, the government has decided to appeal and not publish the risk register where it sets out the impact the bill could have. What exactly are they trying to hide?
Health Secretary Andrew Lansley has tried, he really has. But despite all the effort on his part, he has failed to convince the very people who are central to his reforms that they are right for the NHS. The changes are reckless and damaging, at a time when the focus should be on improving standards and care for patients in the face of growing financial pressures. The time has come for the government to accept defeat and drop the bill.
This post was originally published on 8th February 2012 in the Sunderland Echo