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

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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.

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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."

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It also coincidences nicely with a whole range of targets being dropped, so there won't be much visibility about variation either.

I'm not saying that the NHS didn't have failings, or that there wasn't room for improvement, but this is a wholesale, ill-conceived, unwanted change, with no electoral mandate.

Smallwhitecat, this is turning into a yes it is, no it isn't type of argument. I can't prove anything - maybe you can?

I am just deeply worried about how our cherished NHS is being thrown out with the bathwater. What you describe, Nooka, is not reassuring!

Accountability is not about some grand theoretical argument where the govt is or is not in ultimate control.

It's about the practical issues of working out who actually has responsibility for what when you have the level of fragmentation we got on the railways, with prime contractors, subcontractors, companies dissolved or bought out after incidents, overlapping or not-quite-butting bailiwicks, where responsibility falls through the many, many gaps.

Small example. A hospital contracted an external firm to provide porterage, T&C very tightly written. So tightly written, that when new building opened (or maybe just because wording was ambiguous or omitted something), the porters' area did not cover the whole hospital site. Medical staff were reduced to phoning 999 ambulances to move patients across the site.

This is like the worst pastiche of trade union "Demarcation, Squire," reborn in the guise of follow-to-the-letter outsourcing contracts. It is not efficient, not good for patient-care and shouldn't be happening.

The current restructuring and fragmentation will be the porterage story writ large, across many, many elements of the service. The only people who make money from this sort of thing are the lawyers, who multiply with the number of parties involved and must be rubbing their hands in glee at these proposals.

What I believe is wrong with the NHS is the following:

Long waiting times to see the GP, if one feels unwell it should be possible to see a doctor on the same day. (A doctor one feels comfortable with, not an emergeny doctor).

Long waiting times for referral to specialists. People are often refered too late. Forget the media, doesn't anyone know of someone who died of cancer because they were diagnosed at a very late stage, despite banging on the GP's door for weeks, months if not years... Also when a GP refers someone, often one of the first questions they will ask is "do you have private cover ??"

Hospitals are dirty, people are not fed properly and there are so many people crammed on to wards that it is almost impossible to rest.

People who have contributed their whole life are told that they can not get certain medicines because they are too expensive.

People have to die in agony because it happens to be weekend (how inconvenient) and there is no consultant to prescribe drugs like morphine etc...

Add to this the endless waitingtimes in A&E, the fact that this is probably the only country in Europe where it is faster to order a pizza than get an ambulance etc...

And before someone gets the handbags out, I did not get this from the daily mail, the mirror, sun, any other paper or the telly. This is based purely on my personal experience as well as what happened to my friends and family and my experiences abroad.

I'm genuinely frightened to be treated by the NHS. Based on experience, not hearsay and would much prefer to be treated on the continent or simular system if it was at all possible. Ideally I would like to see the whole system binned tomorrow.

I appreciate that a lot of people feel protective over the NHS, and I'm not out here to often or upset anyone. Do those who believe that the NHS is good have experience with being treated abroad other then what they read in the paper about the American system?

The question as do I think there is enough evidence to spent millions on changing the system = Yes. Do I believe one more penny should be spent in a system that is failing, absolutely not.

Jinx, I simply don't recognise your experiences - except for one long wait in A&E on a Saturday night. My own experiences are the opposite of almost everything you have written.

So what this proves, imo, is that when it's something as important as the NHS, it's just not enough to go on anecdotal evidence or personal experience! You (not you personally but everyone) need to have an overview and a long term perspective.

I have personal experience of hospitals/health systems in Africa, France, Spain, and second-hand experience of the US, Thailand and Australia - but no way do I think that makes me an expert!

It's like the 6 blind men describing an elephant: according to which part they can feel, one says it's wide and flappy, another that it's shaped like a bendy pipe, another like a column, etc.

National data showed that last year, public satisfaction with the NHS was at an all-time-high. Excellent achievement for Britain, our NHS is truly the envy of the world.

Our NHS has been declared one of the best in terms of healthcare, and financially, it is also one of the most cost effective in the world.

Solopoer - ditto Perhaps we have different expectations as to what good health service is. Perhaps you are lucky enough to have a clean hospital, with private rooms and onsuite facilities, nutritional food, access to the newest cancer drugs regardless of the cost etc... but if this is definitely not the case for most users of the service.

ChickenLickn - I would describe the NHS rather as the "sick patient of Europe" rather than the envy of the world other than perhaps in the 3rd world countries. ..