By Dr. Kailash Chand
publicservice.co.uk, May 2, 2012
The NHS will now become ‘just a logo’ – a US style insurance scheme that is divorced from care delivery and dishes out public money to private companies, now that the government’s NHS reforms have passed into law, writes one leading clinician
The NHS bill is now an act. It was a bad bill and now is a bad act. It is a mess. That is my straight forward view of it. I think it is confused and confusing and I think it is unfortunately setting the NHS back.
The implications will betray not only the people who rely on today’s NHS but also generations to come. It will strike at the heart of Britain’s proudest institution. Nobody is opposed to NHS reforms, but the question is what kind of reforms are these and whether it makes our NHS better or worse.
The government has won the parliamentary battle, but no one is quite sure what kind of a victory it has achieved, or at what price. A lot of staff on the ground lack confidence in the bill, or say they don’t like it, at a time when we need massive energy and commitment from the NHS staff. Go to any hospital or GP surgery just now and you will hear the continual opposition from doctors and nurses about this act, their worry about how much harder it will make their jobs. I think they’re right.
Remember, the NHS has to save £20bn by 2015. What it means is managing the NHS with less money and dealing with the consequences on priorities and quality of patient care. The entire NHS workforce could become preoccupied with the changes rather than concentrating on efficiency and innovation the NHS so desperately needs. The reforms would be demoralising, not just for professionals but for patients too, who would begin to see fewer treatments available to fewer people as the NHS cuts start to bite – with wealthier people able to “top up” treatments. The rich really will be able to have much more. It’s not just a postcode lottery, it’s a taxcode lottery.
The NHS is clearly under huge threat, it will be a completely different healthcare system in five-10 years time. A system, which I believe will signal the end of the National Health Service, and a system that will be much worse in terms of access, equity, health outcomes, and cost. The NHS will just be a logo, most cherished institution reduced from being the main provider of heath services in England with one of the biggest workforces in the world, to a US style insurance scheme, divorced from the actual delivery of any care. It will become a bureaucratic governing body dishing out public money to private companies.
My response to the discredited NHS reforms hasn’t just been writing letters and articles about why it is seriously flawed. I also started my own e-petition because I was concerned about the lack of democratic accountability of the coalition government and I wanted the bill to have its ‘day in court’.
The e-petition broadened the debate amongst all sections of society securing around 180,000 signatures. It has inspired other activists and spread knowledge about the reforms. It has stimulated Liberal Democrat factions within the coalition to question their own beliefs and forced the Labour Party to raise its game.
Opposition to the bill has come from a wide spectrum including organisations such as the BMA, most royal colleges, as well as trade unions and patient groups. The e-petition did have its day in court despite attempts by some MPs on the Business Backbench Committee to block it, salvaging a few strands for the democratic rights of those who use e-petitions to force parliamentary debate over an issue that evokes public outrage.
Now that I have been elected to the BMA national council, I’ll do my best to ensure the main priority of BMA is to minimise damage to NHS caused by Health and Social Care Act. I’ll continue my efforts to defend NHS, medical professionalism, and the doctor -patient relationship. And I hope to safeguard patients’ interests in these difficult times.
For me the entire campaign against the Health and Social Care Bill is about saving a service to which I have devoted all my life. I came to this country over 30 years ago to work in what I believe to be the best healthcare system in the world. During those thirty years I have worked in many aspects of the health service and have also campaigned to ensure that the key principles of the NHS, including free universal healthcare for all, are maintained. I work in Tameside which is a deprived borough where the threat of privatisation raises the risks to those who need the NHS the most; elderly people, those with chronic disease, and the mentally ill are the most vulnerable from the coalition reforms under the bill.
The bill may have become law, but those like me who cherish the NHS will continue to fight for the right to universal healthcare as a basic human right regardless of whether they live in flourishing suburbs or inner city deprived areas.
Dr. Kailash Chand OBE is a GP, chairman of Tameside and Glossop NHS and was recently elected to the British Medical Association national council.