Cameron dithers over NHS reforms

by Daphne Liddle

HEALTH Secretary Andrew Lansley last Monday announced a two-month delay to “pause, listen, reflect and improve” in the progress of his controversial NHS reforms through Parliament.

Many suspect this is a device to put this highly unpopular measure on hold during the run-up to the local elections in May and that any changes are likely to be merely cosmetic.

The changes, that will give almost total control over the whole NHS budget to general practitioners, have come under heavy criticism from many directions, including the British Medical Association, health unions and patient organisations.

Even right-wing economic advisers have warned the Con-Dem coalition that they were bringing in the changes far too fast risked a total collapse of the system — especially as they are to be linked to serious cuts in the total funding of the NHS.

And earlier this year a Liberal Democrat conference emphatically rejected the changes. Lib Dem leader Nick Clegg was forced to beg Lansley to consider some amendments to the changes or his party would face a total wipe-out at the coming elections.

The delay is most probably a part of that exercise. Prime Minister Cameron has said the reforms will go ahead whatever and that the delay is needed only to convince doubters of the need for the changes.

The Coalition is expected to back-track from insisting that the April 2013 would be the cut-off point for GPs to form consortia and take on the budget.

Instead, GP consortia that are not ready will be given support by a national board, led by NHS chief executive Sir David Nicholson.

other experts

Another measure being given serious consideration is the idea of inviting other experts to get involved in the consortia, something which has been proposed by the House of Commons Health Committee.

The cross-party group of MPs said involving the likes of hospital doctors, public health chiefs and councillors would improve accountability and decision-making.

But the opponents of the changes remain adamant that at whatever speed the changes are introduced they are not acceptable. And one or two others involved in the consortia will make little difference to the outcome — privatisation.

Even the general practitioners, who will gain immense power over the NHS budget and could make themselves even richer by spending less on patients, are opposed to the Bill.

in addition

They do not want to take on the role of full-time accountants and administrators in addition to their medical work. They will be forced to hand it over straight away to the dozens of private sector health companies that are champing at the bit to get their hands on administering so much money.

The BMA last Friday issued a rejection of the reforms and another Government White Paper on radically restructuring medical education and training, and public health services in England, warning they are flawed and could damage the NHS beyond repair.

The giant union Unite, which represents many health workers, was very sceptical about the Government’s promise to listen to health workers’ concerns about the reforms.

The union asked: “Is the same Government that shunned 100 amendments to health bill really ready to listen?” And added that the Bill must be scrapped.

Rachael Maskell, Unite national officer representing health professionals ranging from mental health nurses to GPs, paramedics and pharmacists, said that no amount of Government listening can disguise the reality, which is that the bill is bad news for the NHS.

“At every stage and on every day of the bill committee,” she said, “both parties of government were implored to not go ahead with this destructive bill. One hundred times they were asked to improve this bill and one hundred times they said no. Are they really going to hear and act, as well as listen, now?

“As health professionals, we need to see some sign that this Government can be trusted with our health service. Our advice must matter more than the costly counsel of accountancy firms who know nothing of patients’ needs...

“Quite simply, this Bill cannot be saved. In the weeks to come, all sorts of fudges will be proposed, but if the government is truly listening it will understand that they only way forward is to ditch this bill and start again.”

There is no doubt that after the May elections the Coalition will press on with the Bill, with a few cosmetic changes but this pause shows their current weakness and internal division.

They are rushing like mad to do as much damage to our whole state welfare system as fast as they can because they know their government is not stable and could collapse at any time.

We must strive all the harder to make that happen sooner rather than later.