Who will run the new NHS?

Who will run the new NHS?

This is a matter that has been concerning me for some time, but which has been brought to the fore by the article written by Dr Charles Alessi and others. The authors have been longstanding proponents of the Bill- indeed, they helped to define some of the principles it enshrines. Yet their latest article is critical of the current form of the Health and Social Care Bill. Is this because, like almost all the rest of the Royal College of General Practitioners and the vast majority of the medical profession, they see it as a danger to the NHS, to the health of the public and to the increasing inequalities in England? Sadly, no. It is because they think that their anticipation of unfettered clinical commissioning is being trampled on by an increasingly bureaucratic version of the ‘reforms’. They begin to perceive, as many of us have been saying for some time, that this will not be clinical commissioning at all.

The fudge currently being perpetrated has FIVE layers of bureaucracy replacing the three we currently have. It has an NHS CB that will try to centralize most things. It has Monitor trying to second-guess many commissioning decisions. Perhaps worst of all, it will ensure that most commissioning decisions are made not by clinicians, but by the private sector organisations that will provide them with the ‘support’ they need. The reality is that the new NHS will not be run by clinicians for patients. It will be run by a combination of private sector organisations that will have a duty to consider the bottom line of profits before anything else. It will be subject to EU competition law and will be subject to all the restrictions this imposes. The Dutch, who moved towards this model, have found how costly it is. One of their commissioners has just been fined €7 million for not complying with competition law. And today the Co-operation and Competition Panel (CCP) found a PCT had breached conflict of interest rules by involving GP commissioners in a consultation on the closure of a Darzi centre – on the grounds their practices and other provider interests stood to benefit from the decision.

This Bill takes us close to the American model of health care system; one that has served them so badly that they are desperate to reform it; one that is markedly more expensive than ours; one that leaves many people in a poverty trap and unable to access decent health care; one which has some of the greatest health inequalities in the world. Do we really want this model? I don’t think so. If you agree with me, then do something about it. Write to your MP; agitate. There is very little time left to save England from the ravages of the Health and Social Care Bill.