Reforms will irreparably damage NHS, warn GPs and nurses

PLANNED REFORMS of the UK’S National Health Service, which will give doctors control over the commissioning of £80 billion worth…

PLANNED REFORMS of the UK’S National Health Service, which will give doctors control over the commissioning of £80 billion worth of services, will cause irreparable damage, the Royal College of General Practitioners has warned.

Because of mounting criticism, it is now clear that large elements of the reforms driven by Conservative health secretary Andrew Lansley are about to be abandoned by the Conservative/Liberal Democrats coalition.

The major overhaul of the NHS was not included in the election manifesto of either the Conservative or Lib Dem parties. Nor was it part of the programme for government agreed between the two last May. Now, the Lib Dems, badly bruised by last week’s election results, have moved against reform. More significantly, prime minister David Cameron has distanced himself from Mr Lansley, who could lose his place in cabinet in the summer reshuffle.

Mr Cameron – who ordered a two-month pause in the legislation’s passage through the House of Commons last month – has become convinced the reforms could badly hit his party.

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However, he would be anxious to ensure a retreat would not be portrayed by the Liberal Democrats as a major victory for them, lest it provoke fury among his own MPs.

Outlining the objections of GPs to the legislation, Clare Gerada, chair of the Royal College of General Practitioners (RCGP), said doctors are concerned that the NHS, if it is forced to operate by market rules, will be exposed to the full impact of European Union competition laws. Doctors are not against competition, she said, but it must be proportional.

She pointed to the United States where high charges have made healthcare unavailable to millions of people.

In the UK patients could face charges or have services capped under the reforms, which, Dr Gerada believes, aim to turn the National Health Service into “an insurance type model” with the NHS serving as “a brand name only”.

Meanwhile, she said the legislation, as drafted, would remove the duty that currently exists under law for the secretary of state for health to provide a comprehensive healthcare system across England.

“This underpins all the systems, the powers, the legislation that we currently have within the NHS.”

While numerous signals are being given that major changes will be made to the legislation, Prof Steve Field, chairman of the Royal College of General Practitioners who has asked to spend two months hearing views on the problems with it, said he had not been asked to inspect the legislation itself.

“A lot of what we’re looking at is not at the Bill at all and is about education and training and workforce design,” said Mr Field. Nevertheless, he said both Mr Cameron and Mr Clegg want changes.

Meanwhile, the Royal College of Nursing warned that Mr Lansley’s plans would “seriously destabilise” the NHS. “Waiting lists are going up and at a time when the NHS is being asked to save £20 billion, this is not the ideal climate to undergo these radical changes,” said general secretary Peter Carter.

Mark Hennessy

Mark Hennessy

Mark Hennessy is Ireland and Britain Editor with The Irish Times