DANGER: Our NHS is under threat

I make no apologies for saying this again: the NHS is one of our greatest institutions. We should be proud of it and be prepared to fight for it. As Nye Bevan said, ‘the NHS will last as long as there are folk prepared to fight for it.’ Yet time and again our politicians tell us that the NHS needs huge reform, that it is underperforming and too expensive. Is this true? Let us look at the facts.

NHS performance has been analysed by many international bodies. All of them, without exception, report that the NHS performs better than almost all other health systems and that it has results as good as, or close to, the best in the world. Nobody is going to pretend that there are not things that could be done better. Of course there are. But is there any health service that is perfect? I challenge you to find one. The reality is that every health system has flaws, but that ours takes care of the most disadvantaged in our population and provides a level of care of which we should be proud.

So why, in a time when we know that the nation is cash-strapped, and huge savings have to be made in the public sector, is the Government choosing to embark on the most sweeping top down reorganisation the NHS has ever seen? Those of us who have been in the NHS a long time have seen many reorganisations. The truth is that, for front line staff, they often make little difference. For us in Public Health they tend to have more of an impact, as reorganisation impacts directly on our jobs. I remember, as a very junior registrar, being told by my then boss that he had had to apply for his own job seven times. We both laughed. At the time, I failed to understand the trauma that this could induce, but the truth is that the laughter was genuine because, whatever happened, the NHS went on and we were able to make the system work.

Then came Shifting the Balance of Power (unfondly known as StBoP). That was a big one. It caused much angst and disruption, we had total planning blight for two years, and then the NHS settled down. I don’t actually believe that anything improved because of StBoP, not did we save any money, but some politicians felt better for a little while. I may not have liked what happened, but we live in a democracy and I put up with it.

And now this. This is totally different. For the first time I am not prepared to ‘put up with it’. This is too important. Because this does not reorganise the NHS – it dismantles it. Do not be fooled by the weasel words. ‘You exaggerate’, I hear you cry. I only wish I did. The NHS was set up in such a way that the Secretary of State for Health had a duty to provide a comprehensive health service for all, free at the point of delivery. Free to all of us: you and me, those we love, those we don’t like, those we admire, those we despise, the rich and the poor, those who live in palaces and those with nowhere to lay their heads. That, basically, is the whole point. But this Bill removes that ‘duty to provide’; it does away with geographical boundaries, it is no longer the safety net it was. Do we really want that? Do we really want to go back to the days when ability to pay determined our health care. I know I don’t. That is why, this time, I am not laughing and shrugging. I am speaking out, and trying to get this stopped. Please help.