As increasing numbers of health professionals oppose Lansley’s Health and Social Care Bill the government’s credibility is at stake argues Peter Stauber
Health Secretary Andrew Lansley's Health and Social care bill is sinking ever deeper into chaos.
Of all the serious miscalculations of the government - and there are many - the NHS reforms are surely the worst. As the bill returns to the House of Lords even former supporters are speaking out against Lansley. On Monday two GPs, who up until now had been advocates of the shake-up and so given the Health Secretary much-needed credibility among doctors, warned that the plans would end up suffocating GPs.
Their criticism comes a few days after another two professional groups added themselves to the long list of health reform opponents: the Chartered Society of Physiotherapy, with 50,000 members, and the Royal College of General Practitioners, which represents 34,000 GPs. They demand that the whole bill be withdrawn - a call that is also supported by the British Medical Association, the Royal College of Nursing, and the Royal College of Midwives. In a joint editorial last week, three leading health publications described the government's plans as an “unholy mess”. The upheaval, they write, “has been unnecessary, poorly conceived, badly communicated and a dangerous distraction”. In short, pretty much everybody who knows anything about health calls for the Bill to be scrapped.
From the very beginning, Lansley's plans have faced massive opposition. No wonder after an election campaign that included the Tory slogan "I'll cut the deficit, not the NHS"! It soon became clear that the health service was to be chopped up beyond recognition. Since then, there has been a "listening exercise" (which was nothing but a PR exercise) and various amendments to the proposed Bill. But the fundamental flaw remains: the Bill is nonsense.
In essence, Lansley wants to turn health care into a market. After all the re-thinks and “concessions”, nothing has changed about this ultimate motive. The aim is to introduce more competition and to give GPs the power to commission services from various providers - public or private. Primary care trusts would be abolished and replaced by "care consortia". Strengthening the profit motive in health care would give private health companies like Circle Health, which has already taken over Hitchingbrooke hospital, and management consultants magnificent opportunities to fill their pockets. Two of the biggest consultancies have already won contracts worth £7 million to train GPs how to manage their budgets.
The motivation behind the NHS shakeup is purely ideological. Health care cannot work as a market because the patient is not a consumer who chooses between different products. A patient is in need of treatment, and it has to be given to him as efficiently as possible. A public health service is the most efficient way of doing this (at around 8 per cent of GDP, the cost of the NHS is below the OECD average). When Labour increased NHS spending in the early 2000s, waiting lists went down and the health service improved dramatically. What the government lacks is not money (there seems to be millions of pounds available for all sorts of things, from nuclear weapons to military interventions abroad), but a serious commitment to health care as a public service.
The chaotic bill is a huge headache for the government. Should they decide to bottle it - which is a distinct possibility, even though some changes have already put in place - it would be the biggest government u-turn yet, and a massive blow to the coalition. Andrew Lansley would probably have to resign, and the Lib-Dems would have to face questions as to why they decided to agree to the “listening exercise” last year, when they could have killed the bill straight away. Abandoning the Bill would be a huge win for a health care system that puts the interests of the patients first, rather than the interests of profit-making businesses.
Peter Stäuber is a freelance journalist and translator. He writes for English and German language publications and is a member of the NUJ.
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