Health and Social Care Bill: Opposition Grows

I thought that it might be useful to collate some of the strongly worded opposition to the NHS Health and Social Care Bill. The opposition is widespread and includes professional groups, bodies that represent GPs (The very people who will be “empowered” (?) by the BIll, patients groups, and political groups inside and outside of the Coalition.

Letter to The Guardian, 7th February 2012. Sent on behalf of the Royal College of Nursing, The British Medical Association, the Royal College of Midwives and the Chartered Society of Physiotherapy:

We are the representative and professional bodies representing the majority of doctors, nurses, midwives and physiotherapy staff in theNHS. For months our members have been telling us about the chaotic way the reforms are being implemented on the ground, before the legislation has even been passed (Report, 7 February). It has been an unnecessary distraction when the NHS should be focusing on a far more important issue: finding the £20bn in efficiency savings it needs to make at a time when demand is increasing. We are concerned that the bill will mean we end up with a service where it is harder for patients to receive joined-up care. Eleventh-hour tinkering in the form of amendments is not enough; we call on the government to do the sensible thing – withdraw the bill and work with clinicians to bring stability back to the NHS.

The ill-advised bill enters its Lords report stage today. We call upon peers to vote against it.


Signed by: Dr Peter Carter Chief executive and general secretary, Royal College of Nursing, Dr Hamish Meldrum Chairman, BMA Council, Professor Cathy Warwick General secretary, Royal College of MidwivesDr Helena Johnson Chair, Chartered Society of Physiotherapy

Professor Lindsey Davies, President of the Faculty of Public Health (93% of the Faculty’s Members are opposed to the Health and Social Care Bill)  said:

We are now calling on the government to withdraw the bill in its entirety, because it would be in the best interests of everyone’s health.

Our 3,300 members – experts in planning and providing for people’s health – have been closely involved in trying to make the government’s proposed reforms work since they were first introduced. Based on our members’ expert views, it has become increasingly clear that the bill will lead to a disorganised NHS with increased health inequalities, more bureaucracy and wasted public funds.

The bill will increase health inequalities because there is the real danger that vulnerable groups like homeless people will not be included when health services are being planned. Clinical commissioning groups and service providers will be able to pick and choose what procedures they perform and which services they put in place.”

Unless the bill is withdrawn, FPH’s concern is that the NHS will lack the strategic leadership needed to deliver an effective and integrated service. There are major concerns about how emergency planning, screening and immunisation services will work. The bill does not make it clear what costs the NHS will be expected to cover if private providers go bankrupt.

Professor Davies continued: “We also face increasing costs for health services as the private sector will need to make a profit out of commissioning and running NHS services. This will use more taxpayer’s money that could be used for patient care. At a time when the NHS needs to save £20 billion, this is an unaffordable and unnecessary burden on the NHS.

Like our members, we make decisions based on the best available evidence, and we have a clear mandate from them to take this position. We do not do this lightly. We will continue to do all we can to take make sure this bill is fit for purpose.

Over 1,000 GPs wrote to The Independent in October last year calling for the bill to be dropped:

Because it is universal and comprehensive, and publicly accountable, and because clinical decisions are made without regard for financial gain, the NHS is rightly regarded all over the world as the benchmark for fairness and equality in healthcare provision.

The transfer of services to private, profit-making companies will result in a loss of public accountability and a damaging focus instead on low-risk areas that are financially profitable. A confused patchwork of competing providers will deliver a fragmented and inequitable service, and any reliance on personal health budgets or insurance policies will increase inequality.

Because there will be a financial incentive for providing treatment, patients will be over-treated, the potential costs of which are limitless. The possibility of the commissioning role being outsourced to the private sector is also of deep concern.

In forcing through this ill-conceived Bill, without an electoral mandate and against the objections of healthcare professionals, the Government is also ignoring overwhelming evidence that healthcare markets are inefficient and expensive to administer.

The public has been misled by claims that no major reorganisation of the NHS would be undertaken, by repeated denials that what is happening represents privatisation, and by suggestions that the Bill enjoys the support of the medical profession. We do not accept that “things have already gone too far”. The enactment of some of the Bill’s proposals has been premature and possibly unlawful, but some of its most damaging aspects may still be mitigated. We believe that on moral, clinical and economic grounds, the Health and Social Care Bill must be rejected.

This gem, from the Tory Reform Group (Although they have since said this is not official TRG policy):

Mr Lansley seems like a man clinging to a time-bomb that only he cannot hear ticking. The Government urgently needs to look at what he is trying to do and accept that it needs drastic, perhaps total, reconsideration.

Is politics truly the art of the possible? What is certainly impossible is ploughing on without confidence. This is the situation in which Andrew Lansley now finds himself, where self-confidence is no match for the lack of confidence held other people.

That we need urgently to consider what this Health Bill is doing is obvious. In all likelihood that means starting all over again. Moreover, it is clear to me that the current Health Secretary is not the man to preside over this process.

For the good of the NHS, Andrew Lansley must admit defeat and head to the backbenches.

I am not opposed to the whole Health and Social Care Bill. The NHS needs reform, and some aspects of the Bill are encouraging. Much of the Bill remains dangerous, however, despite the 1,000s of amendments that the Government has tabled and the “Listening Exercise” that has been undertaken.

I hope to write over the weekend on the NHS reforms, and how the Bill can be made, to take the TRG’s metaphor, safe.

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