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The Government's NHS reforms will do "irreparable harm", a group of top doctors and health specialists have said.

(35 Posts)
ttosca Tue 04-Oct-11 01:12:08

Warning over 'harm' of NHS reforms

The Government's NHS reforms will do "irreparable harm", a group of top doctors and health specialists have said.


More than 400 experts sent an open letter to the House of Lords urging peers to reject the coalition's controversial Health and Social Care Bill when they vote later this month.

The letter, also sent to the Daily Telegraph, said: "The Bill will do irreparable harm to the NHS, to individual patients and to society as a whole.

"It ushers in a significantly heightened degree of commercialisation and marketisation that will fragment patient care; aggravate risks to individual patient safety; erode medical ethics and trust within the health system; widen health inequalities; waste much money on attempts to regulate and manage competition; and undermine the ability of the health system to respond effectively and efficiently to communicable disease outbreaks and other public health emergencies."

The letter includes signatories from across a wide spectrum of public health practice, including over 40 directors of public health and more than 100 leading public health academics.

Its authors added: "While we welcome the emphasis placed on establishing a closer working relationship between public health and local government, the proposed reforms as a whole will disrupt, fragment and weaken the country's public health capabilities.

"The Government claims that the reforms have the backing of the health professions. They do not. Neither do they have the general support of the public.

"It is our professional judgement that the Health and Social Care Bill will erode the NHS's ethical and co-operative foundations and that it will not deliver efficiency, quality, fairness or choice. We therefore request that you reject passage of the Health and Social Care Bill."

Professor Martin McKee from the London School of Hygiene and Tropical Medicine, a signatory of the open letter, said: "This letter demonstrates the widespread recognition within the public health community that this Bill is bad for the NHS and harmful to the overall health of the population."

Shadow health secretary John Healey said: "David Cameron is in denial, both about the damage his plans are doing to the NHS and the strength of opposition to his Health Bill."

madhattershouse Tue 04-Oct-11 01:17:04

What a surprise..NOT! This Govt is hell-bent on stealth reduction of the NHS. It does not matter whichever way they put it, they are privatising OUR health service. Soon we will be like money, no ambulance!

CogitoErgoSometimes Tue 04-Oct-11 06:49:59

The reason doctors' bodies are so negative is that they know there are a lot of extremely poor GPs practicising at the moment. They are very well aware that the weak link in the reform plans is the GP involvement and are frightened that, once their members are given real responsibility and made more accountable for the wellbeing of their patients, many will fail the test. Then the spotlight will fall on their organisations and awkward questions about competence will be asked.

Iggly Tue 04-Oct-11 15:53:18

Perhaps Cogito but why ask GPs to do something which they are not trained to do? They are health professionals not budget managers.

If they're rubbish doctors then sort them out by other means. That's no reason to ignore what concerns people have. And as for the listening exercise - it didn't result in changes other than cosmetic ones.

CogitoErgoSometimes Tue 04-Oct-11 16:21:51

Budget management will be handled by staff recruited for the purpose as happens already in larger practices. It's the clinical ability that I think is the weak link. Poor judgement and attitude. Choosing consultants because they are their mates rather than because they're the best for the job. I think the professional bodies know that the current system covers this up and that doctors will be more exposed in the new system

Jinx1906 Tue 04-Oct-11 16:24:19

Why are people so against changing the NHS. What would be so wrong with changing to a system operating in many other european countries such as Germany, Holland, France, Belgium etc... There are other alternatives than the US. I think it is normal that some people do not like change but why keep something in place which is clearly failing so many people.

Solopower Tue 04-Oct-11 18:55:12

Who is it failing, Jinx? The media might grab hold of all the horror stories - that's their job - but really? I don't know anyone who has had a bad experience with the NHS. All I have ever seen is caring, efficient, professional nursing staff and expert clinicians. What more do you want?

The NHS wasn't broken, and it didn't need fixing, imo. sad

Solopower Tue 04-Oct-11 18:59:00

It's obvious, it's so blatantly obvious that the changes this government want to bring in will seriously damage our health. They are setting up a system that will fail. And when it does, we will have no rights under the Freedom of Information Act to find out what happened in a botched operation (since it will have been a private company that carried it out) and no Legal Aid to fight court cases. So we will have to protect ourselves by taking out (private, natch) insurance. Next thing you know, like in the States, you won't get treated if you're not insured.

Why would we want a system like that?

Iggly Tue 04-Oct-11 19:55:08

I'm not sure where you got that from Cogito, can you back it up with facts?

And Jinx, give me the evidence that the NHS needs billions spent on it to reorganise it during a time of crisis. Give me the evidence that it's shit, as the Tories would have us believe. Yes people are let down by the NHS but I dont think you could argue that the majority of the people are by any stretch of the truth.

Tianc Tue 04-Oct-11 20:04:33

"Budget management will be handled by staff recruited for the purpose as happens already in larger practices."

No, large scale budget management and other admin will be handed over to private admin firms like KPMG (aka professional services firms), which unlike the Health Authorities or Primary Care Trusts have no public health remit, merely a financial one.

CogitoErgoSometimes Tue 04-Oct-11 20:48:52

Iggly the only facts I have are conversations with people who work in or with the NHS and the rest is my opinion. And Solopower my opinion is coloured by the fact that my family and friends have had a lot of problems with the NHS. Ranging from one friend that was killed by a hospital's negligence to a cousin that was told he was a hypochondriac for three years before being correctly diagnosed with cancer -a little too late. Plus far too many other serious incidents considering that I don't have that big a family. There's a thread on this board asking what are we going to do about nursing negligence. MN is full of women that have suffered terribly and been traumatised by their birth experiences. And yet nothing seems to happen. No-one apologises. There are no league tables of survival rates to help us judge whether being a particular GP's patient is a good thing or a death sentence...

I don't know if the reforms are the right thing to do or the wrong thing to do because, frankly, that's not my field of expertise But I know that for the vast amount of money we all chip in we deserve much better. I don't want to keep being told to suck up, not moan and be grateful it's free.

CogitoErgoSometimes Tue 04-Oct-11 20:57:50

I know who KPMG are and why would any accountant have a public health remit? Accountants make sure the numbers add up and there's nothing missing, that's their job. And speaking of missing money, I really hope they find a similarly professional outfit to take a bull-whip to their procurement systems. For an organisation that buys billions of pounds worth of equipment each year, it's a disgrace.

Iggly Tue 04-Oct-11 20:59:41

Oh I think the service can be improved definitely but by simpler measures instead of top down reform (which it is, however DC tries to spin it). I remember a series where a business went into a hospital and made a number of simple suggestions which made a huge difference.
As for birthing experiences - I think that's wider than the NHS - it's a problem with how, culturally childbirth has become treated as a medical event when actually it isn't in most cases.

Also league tables would be misleading - what happens in populations which have higher rates of illness? Or older people? I don't want my GP to work to perverse incentives - you can see the mess it's making in education.

spacester Tue 04-Oct-11 21:25:34

I used to live in Switzerland - had private medical insurance, it was quite a bit cheaper than the NI in the UK that I pay now, but my wages are considerably lower over here. The insurance covered the whole family, including a premium for my wife as she was of child bearing age (despite us using a long-term contraceptive solution). We got to choose our doctor in the hospital. We got to choose the hospital. We got to choose when our appointment was, we were not dictated to. The hospitals were clean with excellent facilities. The doctors in them spoke four(!) languages. So did the nurses. State of the art care, for the full family, at less than I pay now.

And those who are vulnerable in society, who can't afford the medical insurance? No problems - government pays for the same insurance that everyone else has.

Why would it be a bad thing for the UK to copy? Private medical care can work - it need not be like America. Problem is, are our politicians capable and competent enough to pull it off?

Tianc Tue 04-Oct-11 21:33:25

Given your personal interest, Cogito, I'd have thought you'd be throwing your energies into campaigning for regular re-certification for GPs, patient-oriented complaints procedures and the implementation of the post-Shipman report, as described on last night's Dispatches "Can you trust your doctor".

Rather than agitating for structural fragmentation which will reduce accountability, make "slipping through the net" mistakes more common – and not actually address the clinical problems you're rightly complaining about.

Tianc Tue 04-Oct-11 21:40:29

And who are you suggesting does public health in this new world?

Clearly not the professional services firms.

Also not the GP, who is working on the consumer model.

And not the NHS, which "will be a state insurance provider not a state deliverer," according to Mark Britnell who was the architect of the new commissioning contracts while he worked for the civil service and is now... head of Healthcare for KPMG.

Tianc Tue 04-Oct-11 21:46:02

Iggly, completely agree about the perverse incentives as seen in education.

Billed as consumer choice, it has actually become the schools competing for the "best" students and expelling those who might damage their percentages. Helps the school look good; doesn't serve the students very well.

Not hard to see how the same would happen in healthcare.

Solopower Tue 04-Oct-11 21:59:20

Cogito, sorry about your bad experiences with the NHS - but these new changes won't make anything better. At least the NHS is held to account for its mistakes (not much comfort to you, I imagine, but it could be to other victims of less serious blunders). I can't see how these private companies will be held to account for any mistakes.

Not only that but they can pay doctors and nurses what they like, staff won't have to be as well-trained as in the NHS and their working conditions could be worse. That all makes it more likely that mistakes will be made, imo.

smallwhitecat Tue 04-Oct-11 22:03:59

Message withdrawn

Solopower Tue 04-Oct-11 22:06:16

Spacester, I don't want to choose which hospital I go to! I want them all to be of the highest possible standard, whatever area they are in.

It's a very short step from so-called 'choice' to posh hospitals for posh areas and (like schools) you'll have people moving into catchment areas, putting house prices up, and 'failing' hospitals having to close or be 'rescued' by the government - at a huge cost to the tax payer.

I take your word for it that the Swiss system works in Switzerland, just as there are other perfectly good systems in other countries. No doubt we could learn from them. But you can't just lift one system and transplant it onto the situation we have here where we have completely different conditions.

Solopower Tue 04-Oct-11 22:07:30

Smallwhitecat the government is ultimately accountable for the NHS at the moment. That's why they don't want it.

smallwhitecat Tue 04-Oct-11 22:09:12

Message withdrawn

Solopower Tue 04-Oct-11 22:21:39

The government is not accountable for the failings of private companies.

How is the NHS not accountable? At the moment the NHS gets money from the government and has to conform to certain standards. If it doesn't, it's the government's responsibility to make it. When our health system is privatised, the only thing that will keep standards up is competition. And since the companies will be driven by the profit motive there will always be a tension between the quality of the service and the cost of the service. Corners will be cut and underqualified staff will be employed.

Competition is supposed to drive standards up, but that's when there is a real, informed choice for the consumer. In the government's brave new world, 'unprofitable' hospitals will go 'out of business' and close, and unless you want to travel miles across the country for your op, you won't have any choice. Also, how will we know how to judge which hospitals are 'best' for our particular complaint? And if I was needing an urgent op, the last thing I would want would be a selection of glossy brochures to leaf through that were trying to entice me into choosing their hospital!

smallwhitecat Tue 04-Oct-11 22:28:41

Message withdrawn

Solopower Tue 04-Oct-11 22:33:41

It won't be the government that chooses the providers. It'll be the GP consortia, won't it? The government is not going to be responsible for the health service at all - at least, that's its aim AFAIK.

As for monitoring it, I think there is going to be a body set up to monitor it, but I can't remember what powers it will have.

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