NHS SHAKE-UP: DEATH KNELL OR A REVIVAL?

THE Government’s plans to shake up the health service are a recipe for disaster that will destroy the NHS as we know it.

As a nation, we are justifiably proud of our National Health Service. The idea medical treatment should be provided on the basis of need rather than the ability to pay has been popular with the British people for more than 60 years.

We are proud of the fact that, unlike some other nations, we do not have to take out costly health insurance, sell our homes, or get into debt to pay for treatment.

I know there are problems with the NHS. But we do not have the worry of how we would pay for care if we or a loved one fell gravely ill. Nor do we have to make a grim choice between buying food for our family and paying for medication.

Now our health service is under the greatest threat in its 63-year history. Under the guise of reform, the Government is pushing ahead with plans to bring the biggest shift in power and accountability in the NHS’s history.

It is doing so in the teeth of widespread opposition within the health service, at a time of enormous financial difficulty for the NHS and at alarming speed – so fast, in fact, that it risks destabilising the service.

This reorganisation will cost up to £3 billion. This is madness at a time when the NHS is being asked to cut 45 per cent of management posts and make £20bn of “efficiency savings” in the next four years.

Worst of all, the changes will mean the end of the NHS in its present form. Services will be broken up, patient care undermined, and large areas of the NHS could end up being privatised through the back door. This is not what Aneurin Bevan had in mind when he founded the NHS in 1948 – and it is not what most people want for the NHS today.

Dr Clare Gerada, newly elected leader of the Royal College of GPs, which represents Britain’s 40,000 family doctors – the very people the Government wants to take over from strategic health authorities and primary care trusts in managing the NHS’s £80bn budget – is alarmed.

She told a national newspaper: “I think it is the end of the NHS as we know it, which is a national, unified health service, with central policies and central planning, in the way that Bevan imagined.”

The British Medical Association says the reforms are rushed, ill-conceived and potentially disastrous: “We urge the Government and NHS organisations (not to) adopt a slash-and-burn approach to healthcare with arbitrary cuts and poorly-considered policies.”

And just two weeks ago, more than 100 leading doctors, including 20 professors, wrote to the

So far the public has been relatively quiet on this issue. All most of us care about is that we receive the treatment we need, when we need it.

But, fundamentally, the Government wants to abolish ten strategic health authorities by 2012 and 152 primary care trusts by 2013 – the backbone of the NHS – and hand responsibility for commissioning services (that’s treatments and drugs in laymen’s terms) to England’s 35,000 family doctors.

GPs will be forced to band together into 500-600 GP “consortia” and while some have welcomed the move to take more control, a great many more are gravely worried about the responsibility of managing the NHS’s budget. Many feel they do not have the expertise or interest to do so; they want to treat patients, not be accountants.

Most people are not familiar with the language of PCTs, strategic health authorities and commissioning services and may think they would be better off if things were managed by their GP.

In fact, PCTs free doctors to concentrate on doing what they do best – caring for their patients. And the introduction of PCTs, together with extra funding and other improvements helped to nearly double patient satisfaction with the NHS from 34 per cent in 1997 to 64 per cent in 2009.

Dr Clare Gerada fears that if GPs control the purse strings as well as dish out the treatments, patients may think their financial self-interest will come first, and this will damage trust.

The Government also wants to allow hospitals to leave public ownership to become “not-for-profit” companies, and for public and private hospitals to compete on price for the treatment of NHS patients – something the respected independent health policy body the Nuffield Trust describes as “a retrograde step”.

Many predict the plans will lead to a much greater role for private healthcare companies, resulting in England’s health system looking more and more like America’s. Do we really want that kind of health service?

What is outrageous is the Government has no mandate for these changes. Nothing of this radical restructuring was mentioned in either the Conservative or the Liberal Democrat manifestos.

Quite the opposite, in fact. Prime Minister David Cameron pledged to protect the NHS – a pledge he is breaking now – saying: “I do not want another upheaval in the NHS… We have a duty not to subject the NHS to further radical reorganisation.”

He even wrote it into the coalition agreement, saying: “We will stop top-down reorganisations of the NHS”, and promised not to undermine “the spirit and ethos of our vital public services”.

Yet Health Secretary Andrew Lansley’s changes are so massive that the King’s Fund health thinktank has called them “the most radical restructuring of the NHS since its inception”.

What is equally alarming is the Government wants to rush through these changes at incredible speed and without testing out their ideas to see if they will work, despite pleas to launch pilot projects first.

The terrible truth is that people may well die as a result of this hasty and ill-judged restructuring. Only this month, cancer charities warned that cancer patients could die earlier because the NHS shake-up would abolish teams of experts.

And last month Dr Peter Carter, general secretary of the Royal College of Nursing, said the Government’s planned £20bn of NHS efficiency savings over the next four years could lead to patient deaths.

It is outrageous that the Government is willing to risk people’s lives simply to push though an ideological change that strikes at the heart of British principles of fairness and public service.

The NHS is something that concerns us all. It’s time for people to wake up to the disaster facing our health care. I certainly want to do all I can to stop it happening and I urge you to do so too.

Write to your MP and local newspaper, lobby the Government, join the many protest groups that have started up. But whatever you do, don’t stand quietly by while they kill off our NHS.

I ’VE grown up around the NHS in our local area: my mother was a nurse at the BRI, my grandmother a cleaner at the Kingswood GP surgery.

I also know how important the NHS is for thousands of my constituents. In our local area, under the previous government, there was the awful threat that Cossham Hospital might be closed — saved only by the fantastic work of the Save Cossham Hospital campaign and the Cossham League of Friends. And over 50,000 local people signed a petition to keep Frenchay Hospital’s accident and emergency facilities open, sadly with little success.

I still believe that it was a tragedy the closure was given the go-ahead. One of the first things I did when I entered Parliament was to call an urgent debate on the future of Frenchay— it was clear that by then, however, with contracts already signed and plans long down the track, things had gone too far to turn back. The decision to downgrade Frenchay by the previous government will always remain a dark day in Kingswood’s history.

The initial decision to downgrade Frenchay was ultimately taken not by local people, but by NHS middle-managers. These managers are not doctors, or nurses, or those at the front line of care who intimately understand what patients need and want. Over the past 13 years their number has mushroomed so that now there are over 45,000 managers in the NHS in organisations such as primary care trusts (PCTs) and strategic health authorities (SHAs). Of these, 320 are paid more than the Prime Minister. Management and administration costs have sucked the lifeblood out of the NHS – according to a report by MPs, including Dr Naysmith himself, in March 2010, these costs were estimated to be as high as 14 per cent of the total NHS budget. Despite these high costs, Dr Naysmith and MPs stated in their report that “weaknesses are due in large part to PCTs’ lack of skills, notably poor analysis of data, lack of clinical knowledge and the poor quality of much PCT management”. It is confusing why Dr Naysmith has suddenly changed his tune – his original report was correct in highlighting many of the current failings that must be dealt with.

David Cameron stood for election stating that his priority could be summed up in three letters: “NHS”. This is why the new Government was determined to protect health spending, so that there would be more money than ever before invested in health care. We need to do this, because demand is always rising: the population is living longer, and needs greater levels of care than ever before.

We also need to tackle the rising health inequalities that remain just as stark as in the Victorian period. Internationally, we do not perform as well as our neighbours: cancer survival rates are lower than in Europe, and in Denmark, Sweden, Norway, Austria and Poland, you are less likely to die once admitted into hospital after a heart attack.

We can only do this if we look to reinvest money that currently isn’t being spent effectively. This is why we want to cut the number of NHS managers by 45 per cent, so money that should be used for treating patients gets to them. We also want to ensure that those people who treat patients, their doctors, have the money available to ensure patients get the best possible treatment.

Sitting on the Health Select Committee, a non-party political group of MPs, I have been struck by how many doctors want to move away from having managers tell them what to do, and get on with treating their patients effectively. We can see this in South Gloucester- shire where 28 GP practices are ready to take on this responsibility. I believe that we should not hold professionals back from getting on with their job. And I believe that in consultation with their doctors, local people should have a greater say about what treatment they get.

So, yes, this may be the end of the reign of the middle managers running primary care trusts and the strategic health authorities, but we are giving the NHS back to its patients. After all, it is your money, taxpayers’ money, which in times like this must be spent wisely. We simply can’t afford to throw it away on managers’ salaries and to carry on spending like there’s no tomorrow.