JS Bamrah and Kailash Chand
As a GP and ex-Chair of a
primary care trust and as a practising consultant psychiatrist, we collectively
have a lifetime of experience with the NHS.
We have been through numerous meaningless structural changes, but never before have we witnessed such an assault on the values of the founding principles of the NHS as in last two years.
Lansley's reforms, which were universally opposed, were sold as championing three issues: patients at the centre of the NHS, changing the emphasis from targets to clinical outcomes, and empowering health professionals (in particular GPs).
In practice, this turned out to be an illusory empowerment for GPs and patients, as we had warned at the time.
If Lansley was a doctor he would have been referred to the General Medical Council for affecting patient care on such a mass scale, and if the politicians live up to owning the truth then he should be hauled in front of parliament to face some form of disciplinary action.
In what was a sham consultation on the NHS Bill, the Coalition government blatantly ignored the unequivocal and sometimes vociferous lobby of those opposed to such a massive reorganisation.
These included the BMA, the BMJ, King’s Fund, RCN, NHS Confederation, Patients’ Associations, trade unions such as Unisonand Unite, the HSJ, Nursing Times, the Community Practitioners and Health Visitors’ Association, and many others.
You would have thought that the penny might have dropped when the previous CEO to the NHS, Sir David Nicholson, said that the reforms were so wide reaching they could be seen from outer space.
The reforms were predicted to be like a slow train crash at the time, and indeed that has been proven to be the case. The "new" NHS is now more fragmented than ever before.
It has no primacy over provision, and money is squandered over lost causes such as procurement of contracts and fighting competition from within.
Outside of the NHS, trolley waits in A&E have trebled in the last three years, timely access to primary care has become difficult in many areas, and the reform itself has been a wasteful financial exercise with estimates of £3bn being very conservative indeed.
The morale of the NHS family is at rock bottom.
Their pay has been frozen for two years under the coalition, and they have been forced to accept a major downgrading of their pension benefits.
Freezing and squeezing pay is heaping financial misery on more than one million NHS workers.
One intended consequence of the reforms was to increase the plurality of provision, in particular the introduction of market philosophy, so that private providers could be enticed to take a cake of the NHS services.
This would mean public and private providers could compete against one another, not on the basis of quality, but efficiency savings, which is a euphemism now for a cut in costs.
Success in winning a contract is largely based on competitive tendering, with the unlikelihood of an organisation being successful on the basis of increasing the costs even with improved quality of care being on offer.
There has been a proliferation of small or large providers in the NHS in the last two or three years. The Coalition has undoubtedly achieved that aim, but to the detriment of the NHS as a whole.
The other winners in this revolutionary reform are change and management consultants.
We sincerely believe it will be a completely different healthcare system in five years time – one which will be much worse in terms of access, equity, health outcomes and cost.
The NHS has already simply become a logo which can be brandished on a transport vehicle or a clinic even though the incumbents might be a shareholder in a plc.
This NHS plc will increasingly draw on public funds to line the pockets of wealthy venture capitalists or multinationals.
Once the envy of the world, the NHS is already showing signs of cash fatigue, fragmentation and disintegration.with no-one accepting or being able to accept responsibility, and indeed with chaos at the top of the organisation and no ownership of who the buck should stop with.
In this train crash analogy, we are steadily being driven blindfolded to a US-style insurance-based scheme, divorced from high quality, safe care.
Jeremy Hunt is already distancing himself from the Times report. In an interview with Radio 4’s Today programme he has been justifying Lansley’s reforms and peddling untruths about how the NHS has improved as a result of the reforms, and saved over £6bn so far.
It is this schism that gives one very little confidence that the Coalition knows what its talking about or that the NHS is safe in its hands.
Dr Chand
For 30 years, a market ideology which puts competition and profit-making above providing healthcare has plagued the National Health Service.
Now, under the coalition Government, this ideology is threatening to kill the NHS.
And the outsourcing of more and more NHS services is not just bad for the patients and health workers directly affected, it also means private providers cherry-picking easy profit-making services such as safe one-off procedures, while an increasing cash-strapped NHS is left with expensive services like caring for the old, chronically ill or mentally ill long-term.
Section 75 of the Health and Social Care Act 2012 (the competition clause) and the Transatlantic Trade and Investment Partnership (TTIP) deal are about giving healthcare to the private sector lock stock and barrel.
The creation of a market ethos-led NHS and the corporate philosophy of treating health as a commodity and the patient as a target have resulted in a colossal waste of funds with little real benefit to the patient.
David Cameron and his Government are turning the health sector into a “fantastic business”. They are driving a coach and horses through public accountability.
People will be alarmed to see just how many of the people brought in to run the NHS under the coalition have loyalties to private healthcare providers.
Cameron has recklessly mixed medicine with the money motive and that could damage the bond of trust between doctors and patients on which the NHS is founded.
And, let us remind ourselves, the biggest health market on the planet, the United States, has scored the remarkable double whammy of having the most expensive system in the world and the greatest health inequalities.
The Labour Party has the opportunity to restore the NHS to its founding principles of universal healthcare – quality for all on the basis of need – in a modern setting.
Shadow Health Secretary Andy Burnham’s proposals to change the NHS from a “disease service” to a health service as part of a “whole-person care” policy integrating health and social care constitute a brilliant vision.
An integrated service that brings together mental, physical and care services delivered to where people need them, when they need them is the continuation of Nye Bevan’s dream.
Ed Miliband’s pledge to repeal the NHS act is a step in the right direction.
His promise that next Labour government will create a £2.5 billion a year NHS Time to Care Fund to save and transform our health service is music to the ears of NHS campaigners.
Labour must also pledge that it believes hospitals and community health services should be publicly owned, publicly run and publicly accountable.
We need to integrate all services to work co-operatively to keep people out of hospital. It doesn’t need a market, just leadership.
There is no need for higher taxes to increase NHS funding, because there was already enough money “floating around”.
Funding should be raised by closing tax loopholes and clamping down on corporate tax avoidance.
If Labour wants to win back power on the back of the unpopularity of the coalition’s NHS reforms, then the party at all levels must start showing real opposition to the privatisation of the NHS.
The Labour leader should promise to abolish the independent monitor – the central piece of the coalition’s health policy.
This would allow the reintegration of the health service; make it again directly accountable to Parliament; and end the culture of secrecy, corporatism, bullying and commercial confidentiality that now threatens to surround every transaction.
The only way forward is for Ed Miliband and Labour is to give this manifesto pledge for 2015:
“Our fundamental purpose is simple but hugely important: to restore the NHS as a public service working co-operatively for patients, not a commercial business driven by competition.”
Protecting and pledging to save the NHS from private vultures could be the winning strategy for the next general election.
We have been through numerous meaningless structural changes, but never before have we witnessed such an assault on the values of the founding principles of the NHS as in last two years.
Lansley's reforms, which were universally opposed, were sold as championing three issues: patients at the centre of the NHS, changing the emphasis from targets to clinical outcomes, and empowering health professionals (in particular GPs).
In practice, this turned out to be an illusory empowerment for GPs and patients, as we had warned at the time.
If Lansley was a doctor he would have been referred to the General Medical Council for affecting patient care on such a mass scale, and if the politicians live up to owning the truth then he should be hauled in front of parliament to face some form of disciplinary action.
In what was a sham consultation on the NHS Bill, the Coalition government blatantly ignored the unequivocal and sometimes vociferous lobby of those opposed to such a massive reorganisation.
These included the BMA, the BMJ, King’s Fund, RCN, NHS Confederation, Patients’ Associations, trade unions such as Unisonand Unite, the HSJ, Nursing Times, the Community Practitioners and Health Visitors’ Association, and many others.
You would have thought that the penny might have dropped when the previous CEO to the NHS, Sir David Nicholson, said that the reforms were so wide reaching they could be seen from outer space.
The reforms were predicted to be like a slow train crash at the time, and indeed that has been proven to be the case. The "new" NHS is now more fragmented than ever before.
It has no primacy over provision, and money is squandered over lost causes such as procurement of contracts and fighting competition from within.
Outside of the NHS, trolley waits in A&E have trebled in the last three years, timely access to primary care has become difficult in many areas, and the reform itself has been a wasteful financial exercise with estimates of £3bn being very conservative indeed.
The morale of the NHS family is at rock bottom.
Their pay has been frozen for two years under the coalition, and they have been forced to accept a major downgrading of their pension benefits.
Freezing and squeezing pay is heaping financial misery on more than one million NHS workers.
One intended consequence of the reforms was to increase the plurality of provision, in particular the introduction of market philosophy, so that private providers could be enticed to take a cake of the NHS services.
This would mean public and private providers could compete against one another, not on the basis of quality, but efficiency savings, which is a euphemism now for a cut in costs.
Success in winning a contract is largely based on competitive tendering, with the unlikelihood of an organisation being successful on the basis of increasing the costs even with improved quality of care being on offer.
There has been a proliferation of small or large providers in the NHS in the last two or three years. The Coalition has undoubtedly achieved that aim, but to the detriment of the NHS as a whole.
The other winners in this revolutionary reform are change and management consultants.
We sincerely believe it will be a completely different healthcare system in five years time – one which will be much worse in terms of access, equity, health outcomes and cost.
The NHS has already simply become a logo which can be brandished on a transport vehicle or a clinic even though the incumbents might be a shareholder in a plc.
This NHS plc will increasingly draw on public funds to line the pockets of wealthy venture capitalists or multinationals.
Once the envy of the world, the NHS is already showing signs of cash fatigue, fragmentation and disintegration.with no-one accepting or being able to accept responsibility, and indeed with chaos at the top of the organisation and no ownership of who the buck should stop with.
In this train crash analogy, we are steadily being driven blindfolded to a US-style insurance-based scheme, divorced from high quality, safe care.
Jeremy Hunt is already distancing himself from the Times report. In an interview with Radio 4’s Today programme he has been justifying Lansley’s reforms and peddling untruths about how the NHS has improved as a result of the reforms, and saved over £6bn so far.
It is this schism that gives one very little confidence that the Coalition knows what its talking about or that the NHS is safe in its hands.
Dr Chand
For 30 years, a market ideology which puts competition and profit-making above providing healthcare has plagued the National Health Service.
Now, under the coalition Government, this ideology is threatening to kill the NHS.
And the outsourcing of more and more NHS services is not just bad for the patients and health workers directly affected, it also means private providers cherry-picking easy profit-making services such as safe one-off procedures, while an increasing cash-strapped NHS is left with expensive services like caring for the old, chronically ill or mentally ill long-term.
Section 75 of the Health and Social Care Act 2012 (the competition clause) and the Transatlantic Trade and Investment Partnership (TTIP) deal are about giving healthcare to the private sector lock stock and barrel.
The creation of a market ethos-led NHS and the corporate philosophy of treating health as a commodity and the patient as a target have resulted in a colossal waste of funds with little real benefit to the patient.
David Cameron and his Government are turning the health sector into a “fantastic business”. They are driving a coach and horses through public accountability.
People will be alarmed to see just how many of the people brought in to run the NHS under the coalition have loyalties to private healthcare providers.
Cameron has recklessly mixed medicine with the money motive and that could damage the bond of trust between doctors and patients on which the NHS is founded.
And, let us remind ourselves, the biggest health market on the planet, the United States, has scored the remarkable double whammy of having the most expensive system in the world and the greatest health inequalities.
The Labour Party has the opportunity to restore the NHS to its founding principles of universal healthcare – quality for all on the basis of need – in a modern setting.
Shadow Health Secretary Andy Burnham’s proposals to change the NHS from a “disease service” to a health service as part of a “whole-person care” policy integrating health and social care constitute a brilliant vision.
An integrated service that brings together mental, physical and care services delivered to where people need them, when they need them is the continuation of Nye Bevan’s dream.
Ed Miliband’s pledge to repeal the NHS act is a step in the right direction.
His promise that next Labour government will create a £2.5 billion a year NHS Time to Care Fund to save and transform our health service is music to the ears of NHS campaigners.
Labour must also pledge that it believes hospitals and community health services should be publicly owned, publicly run and publicly accountable.
We need to integrate all services to work co-operatively to keep people out of hospital. It doesn’t need a market, just leadership.
There is no need for higher taxes to increase NHS funding, because there was already enough money “floating around”.
Funding should be raised by closing tax loopholes and clamping down on corporate tax avoidance.
If Labour wants to win back power on the back of the unpopularity of the coalition’s NHS reforms, then the party at all levels must start showing real opposition to the privatisation of the NHS.
The Labour leader should promise to abolish the independent monitor – the central piece of the coalition’s health policy.
This would allow the reintegration of the health service; make it again directly accountable to Parliament; and end the culture of secrecy, corporatism, bullying and commercial confidentiality that now threatens to surround every transaction.
The only way forward is for Ed Miliband and Labour is to give this manifesto pledge for 2015:
“Our fundamental purpose is simple but hugely important: to restore the NHS as a public service working co-operatively for patients, not a commercial business driven by competition.”
Protecting and pledging to save the NHS from private vultures could be the winning strategy for the next general election.
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