Our health not for sale

by Daphne Liddle

THE ROYAL College of General Practitioners, which represents 42,000 family doctors, last week wrote to Prime Minister David Cameron warning that the Con-Dem Coalition’s planned changes to healthcare in Britain risk wrecking the NHS.

In particular they are concerned that introducing more commercial competition into healthcare provision will turn patients and their illnesses into commodities to be fought over by greedy businessmen.

This came just days after local elections showed a dramatic drop in support for the Liberal Democrats and saw Lib Dem leader Nick Clegg fighting for his political life — and promising his party members that in future he will be more assertive within the coalition.

In order to demonstrate this he declared he would not back the controversial NHS changes unless there were significant changes.

This promise was vague enough for Clegg and Cameron the very next day to claim they had agreed key changes on the NHS bill and that the pause in processing the bill for a “listening exercise” could be more than just a cosmetic exercise.

But the newly agreed changes turned out to be nothing more than slowing the implementation of the bill. Plans to transfer the administration of most of NHS funding to GP consortia would go ahead.

Since GPs are not accountants and have their hands full with their medical work this means they will be forced in practice to hand over this admin work to the private health companies that slavering after the profits they could make from this.

Clegg explained it: “I think what we should do now is — which is a change — is an evolutionary approach that only happens where people are willing and able to take on these new changes. If not we shouldn’t be forcing the pace according to artificial deadlines in a calendar.”

But he is going to have a hard job convincing health professionals and rank and file Lib Dems that this is a real change. Their concern is not the speed of the changes but their essential content. In particular the GPs are concerned at the role of competition into NHS commissioning, which they say “will lead to the service breaking up, drive up costs, damage patient care and mean less integration of services”.

They also warn the bill would allow GPs and hospitals to start charging for some services, undermining the basic NHS mission since its creation in 1948, to provide healthcare for all regardless of ability to pay.

The bill would also end the NHS being the “preferred provider of services” and put it on an equal status with private health companies when bidding for work.

And it would make the NHS subject to European Union competition law — meaning private companies could sue GPs if they think they are not getting their fair share of the available work.

This would destroy the current collaborative relationship between GPs and hospital doctors that benefits patients but private companies look upon as unfair bias against them.

Any concept of patient choice of course totally vanishes as private companies demand a right to their cut of the care and the profits that go with it. Our illnesses will become commodities to be traded in a private market and God help those of us who have more than one complaint or condition and different companies win contracts to treat different bits of us.

As the GPs put it: “The fear is that it will no longer be possible to deliver integrated services in practice, especially where the integration relies on close collaboration between different providers and commissioners, and could be seen as ant-competitive.”

The changes will also completely cut hospital consultants out of making decisions about patient care. They will only be able to make recommendations to the GPs — or rather their accounting and admin agencies — who will hold all the purse strings.

If Clegg had any shred of concern for the wellbeing of the people of Britain he would end this nightmare scenario by doing the responsible thing and bring this coalition down and force a general election. That might even restore the party’s credibility in the polls a little.

But he is clearly himself a closet Tory. The Lib-Dems’ best hope is to get rid of him and sink the coalition as quickly as possible.

In the meantime all of us must do everything we can to bring this government down because it is the only way to save the NHS.