Tuesday, 24 August 2010

The End Of The NHS As We Know It?

Imagine going to your GP in a few years’ time. You’re in pain and need gall bladder surgery fast. Your GP examines you, inhales sharply and gives you that look of impending bad news. “I’m terribly sorry”, he says, “but would you mind hanging on until the new financial year, the surgery has run out of money”.
This is the new NHS planned by the ConDem government.
The policies revealed in the Coalition’s health white paper, published in July, amount to nothing less than the end of the NHS as we know it. Indeed, that’s the point. The government’s idea is to jump feet first into an American style market-based health system. So what does that mean?
As most people understand it, the NHS is the organisation that provides their healthcare – it is the hospitals, the doctors, the nurses, the high tech scanners, the prescription medicines, the ambulance drivers. The health service employs around a million people and even though it is huge and spread out, when any of us receive treatment we understand that we are in the hands of one big organisation that we trust.
The government wants to change all that. Under its plans no hospital, no clinic, no district nursing service or mental health centre will be part of that one organisation. They will all be separated, converted into independent “social enterprises” called foundation trusts.
No doctors, no nurses and no therapists will work for the NHS. They will be transferred, made into employees of their particular institution. All their hard-earned national pay deals and pensions are under threat.
Many NHS managers will lose their jobs and their roles outsourced. Primary care trusts and strategic health authorities will be abolished. Now all the unpopular decisions will be made by unaccountable “commissioning consortia” and private management consultants.
And here’s the sting in the tail. For the first time since 1948, private companies will have the same status as all these former NHS bodies, opening the door for them to make profits from illness once more. All of a sudden the NHS will be subject to laws on competition, meaning every service will have to be tendered and every bit of the health service will have to fight to survive. The admin involved will waste billions of pounds. There will be a new super-regulator called Monitor, a bit like Ofgem in the privatised utilities, whose job will be to enforce market discipline.
At the end of it there will be no one organisation called the NHS. There will just be a brand, a blue logo, and a pot of money to buy treatments with. The taxpayer will still be funding health care, but there will be no unified health service.
To achieve this the government has to do the biggest NHS reorganisation since 1948 – despite Tory health secretary Andrew Lansley promising before the election that he would do no such thing. At the centre of the change is a move to so-called “GP commissioning”. Big groups of GPs, perhaps 80 doctors, will get together to form a consortium which will then most likely employ the same managers to run things who have just been made redundant by PCTs, with outside help from huge health corporations like UnitedHealth.
£80 billion of public money will be in the hands of these ad hoc consortia with no clear accountability. What will happen if your GP’s consortium goes over-budget? The government has said it won’t be bailed out, so the prospect of turning up at a GP surgery only to be told that you have to wait until the new financial year is very real.
But it gets worse. The government has told the NHS to save £20 billion by 2014. GPs in their new role will be the ones having to make these cuts. The respect patients have for their doctor will be eroded when they learn that the latter is responsible for the local ward closure. And what if your GP’s consortium decides to simply stop offering certain treatments to save money? Who would you go to if your GP told you, for example, that they are no longer paying for hernia surgery?
The consequences of the white paper are frightening, but it is not yet law. It can be stopped, but only if NHS staff and patients come together to get the word out on what the policies mean and how they can be resisted. The NHS is the public’s most valued institution – there’s no support for the government’s dangerous plans, but there is a risk of the NHS being dismantled while the public is sleeping. NHS Supporters is a campaign you can join to make sure this doesn’t happen.

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