Tag Archives: british medical journal

Healthcare Rationing in UK – Health and Social Care Reform Bill unfit for purpose?

18 Jan

UK readers will be aware the government is pressing ahead with reforming the NHS despite failure of Parliament to agree the legislation yet amid concerted opposition for across the political spectrum and in the face of opposition from health professional organisations.

It is gratifying for GPs like me to read in this week’s BMJ the opinion of Professor McKee who is a Public Health expert: the reforms make no sense.

Expert struggles to understand NHS Bill (18/01/2012)
A top public health expert has described the government’s new Health and Social Care Bill as “completely unintelligible”.
Professor Martin McKee from the London School of Hygiene and Tropical Medicine, UK, describes his efforts to understand the bill in the British Medical Journal today (January 18).
“I know my students will expect me to explain the changes proposed by the Department of Health in England,” he writes. “If I am to do so, I need to understand them first. Here lies the problem. No matter how hard I try, I can’t – despite 25 years of experience researching health systems, including writing over 30 books and 500 academic papers.
“I have tried very hard, as have some of my cleverer colleagues, but no matter how hard we try, we always end up concluding that the bill means something quite different from what the secretary of state says it does.”
For a start, Professor McKee says, he can’t understand the problem the changes are trying to solve. Arguments that the NHS is performing badly have been totally discredited, he writes. In fact, independent sources have shown that the NHS is now improving at a faster rate than almost anywhere else, and would have done even better if it was not continually reorganised.
Secondly, he is struggling to understand what is being proposed. Private companies are increasingly being used, yet the prime minister insists that he will not privatise the NHS.
Lastly, he cannot understand why so much is happening now, and why the bill is already being implemented even though it has not passed into law.
“I’m hoping that someone, somewhere … will be able to help me,” he concludes.

http://www.bmj.com/content/344/bmj.e399 [subscription required, sorry]

So (1) Why are GP commissioners and other commentators on the NHS reforms so sure the proposals will work?  None, as far as can be seen, have anywhere near the academic credentials of Professor McKee.  Can we, the public, trust the judgement of the talking heads on our TVs and radios?   (2) In my opinion the people tasked with safeguarding the NHS should stop acting as if the NHS reforms are going to happen.
George Bernard Shaw advised reasonable opposition to imposed changes over 100 years ago. That is one history lesson many have forgotten. The Commissioners appear so caught up in making the local NHS look ready for change they have forgotten that, likely as not, another reorganisation will be foisted on us in 10 years or so?   If fewer people engaged with “the next big thing” I do not think we would not be in such a mess.
Meanwhile there is another debate about public service pensions which is obfuscating the real issue which is the Health and Social Care Bill.  This must not be allowed to mask the clear and present danger to the NHS.   If you feel as strongly as I do about the threat to healthcare which is being rushed in before the legislation has passed all the legal hurdles it is still not too late to make your views known to your MP and the House of Lords.

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