Government treating NHS like failing bank, says Lancet
Medical journal says coalition trying to abdicate all responsibilities for running effective healthcare system
The NHS is on a path to becoming a "market commodity" with the coalition treating it more like a failing bank than a public service, one of Britain's most influential medical journals has said.
An editorial in the Lancet criticised the government for expecting NHS hospitals to be financially successful and deeming them failing enterprises if they did not meet targets on efficiency and cost-saving.
In particular the journal took issue with a Tory minister's suggestion that NHS managers should take inspiration from the television show Bargain Hunt when procuring medical supplies.
"Reading headlines last week, such as 'Struggling A&E units to get £500m bailout' and 'NHS managers to get price comparison website', one might be forgiven for thinking that the current coalition government views the NHS as a failing bank or business," it said.
"This stance is one of the most cynical, and at the same time cunning, ways by which the government abdicates all responsibilities for running a healthcare system that has patient care and safety at its heart."
The journal, which has been publishing on medical matters for almost 200 years, said the coalition's NHS reforms meant the health secretary "no longer has a duty to provide comprehensive health services", having handed over responsibility to a "complex system of organisations".
"The exact responsibilities are at best complex, not easily understood, and at worst deliberately obfuscated. Who exactly is leading and to what end is even less clear," it said.
However, the journal had praise for Don Berwick, the health former adviser to Barack Obama commissioned by David Cameron to review patient safety.
It suggested someone with his skills and wisdom should take over as chief executive of NHS England on the retirement of Sir David Nicholson next year. It expressed concern that the government did not currently require candidates to have knowledge of healthcare systems.
"The role of chief executive [of] NHS England was advertised last week with a deadline of 6 September for applications," it said. "Astonishingly, the candidate does not have to have experience in, or knowledge of, healthcare systems.
"However, only someone with the calibre, passion, experience, and wisdom of Don Berwick will have the slightest chance of turning around the NHS from its current path to a market commodity to its true purpose of a compassionate, free, equitable and effective health system with patients' health, wellbeing and dignity as its goal and top priority."
Labour said the Lancet's intervention was a "serious warning that the NHS is being put through a process of dismantling".
"Sadly, the Lancet is right in saying ministers treat the NHS like an arms-length failing bank that they have little responsibility to help," said Andrew Gwynne, a shadow health minister. "David Cameron points the finger, but he must accept what's happened on his watch ? an NHS reorganisation that's damaged patient care, a crisis in England's A&Es and understaffed hospitals as 5,000 nursing jobs are axed. He must accept that the buck stops with him."
Anna Soubry, a Conservative health minister, defended the government's twin goals of creating an efficient NHS that puts patient care at its heart. "That is why we are introducing a chief inspector of hospitals who will ensure patient care is a priority throughout the NHS and are encouraging hospitals to become more efficient with their resources so more money can be spent on the frontline," she said.
www.theguardian.com/society/2013/aug/16/government-nhs-failing-bank-lancet