Letters to Times and Financial Times

Posted on December 13, 2010 | 2 Comments
Health is the next big fight after tuition fees.  Is it not time Andrew Lansley was called to account over his plans for the NHS?
No mandate, no evidence, no thanks…

Letter sent to The Times, appeared, with minor edits,

Monday 13th December 2010.

As doctors we welcome the news that the Prime Minister has asked Oliver Letwin to review Andrew Lansley’s White paper on health, Equity and Excellence: Liberating the NHS. Rather than “liberating the NHS”, these proposals seem to be an exercise in liberating the NHS’s £100 billion budget to commercial enterprises. We believe they will destroy the NHS as we know it.

The last thing the NHS needs at this time of austerity is another reorganization, (costing up to £3bn according to the Kings Fund), damaging morale and the ability to make decisions about NHS economies based on rational planning rather than market forces.

Andrew Lansley’s aims of putting patients at the heart of care, involving clinicians in decisions about the provision of services and reducing managerial costs could be achieved without the massive structural upheavals of abolishing PCTs and SHAs. PCT Boards could be restructured, to give much better representation of clinicians,. members of the public and accountable members of Local Government. The present, costly healthcare ‘market’ could be abolished, saving billions in transaction costs and achieving the £20 billion ‘efficiency savings’ demanded by Sir David Nicholson.

BMA policy is to uphold the founding principles of the NHS (which are held dear by British citizens) and states that health care should be on the basis of public provision, not private ownership, co-operation, not competition, integration, not fragmentation and public service, not private profits. 4 out of 5 doctors believe the reforms will not benefit patients. The recent Commonwealth Fund (Mass) report   found that only 3% of British people thought their health service needed radical restructuring, the lowest proportion of any country studied. With health professionals and the concerned public so opposed to these reforms, it would surely be stubborn folly for the government to impose them.

The final list of signatories is 225 names.

Signatories to Letter to The Times newspaper, published Monday 13th December 2010

 

  Title First Surname Position
1. Dr Sheila Abdullah GP (Retired)
2. Dr Mark Aitken Consultant Physician
3. Dr Amina Aitsi-Selmi SpR
4. Dr Liz Anderson SpR GU Medicine
5. Dr Jackie Applebee GP
6. Mr Matthew Armon Consultant Geriatrician
7. Dr Natasha Arnold Consultant Geriatrician
8. Dr John Atkins Consultant in Fetal Medicine (Retired)
9. Dr Ian Banks GP, President  Mens Health Forum. Member BMA Council
10. Dr Helen Bantock Consultant Paediatrician (Retired)
11. Dr David Bareford Consultant Haematologist
12. Dr Simon Barry Consultant Chest Physician
13. Dr Eric Beck Emeritus Physician
14. Dr Morris Bernadt Consultant Psychiatrist
15. Mr Michael Beverley Consultant Orthopaedic Surgeon
16. Dr Beulah R. Bewley Past president MWF
17. Mr John Beynon Consultant Consultant O&G (Retired)
18. Dr Christopher Birt Consultant in Public Health
19. Professor David Blane Professor of Medical Sociology
20. Dr Lynda Bobrow FRCPath Consultant Histopathologist (Retired)
21. Dr Kambiz Boomla Senior Lecturer in GP
22. Dr Robert Boon Consultant paediatrician
23. Dr David Bramble Consultant Child Psychiatrist
24. Ms Helene Brandon Consultant O&G
25. Dr David Broughton Clinical director medicine for Older People
26. Dr Joan Brown Consultant Anaesthetist (Retired)
27. Dr Raymond Brown Consultant Paediatrician
28. Mr Hamish Brown Consultant Breast Surgeon
29. Dr Peter Bruggen Psychiatrist (Retired)
30. Dr Nick Burns-Cox Consultant Urologist
31. Dr Ann Capewell Consultant Physician/Clinical Director of medicine for Older people
32. Dr Peter Carter Cons. Psychiatrist
33. Sir Iain Chalmers Editor James Lind Library Epidemiologist(retired)
34. Professor N.Ann Chamberlain Consultant Rehab Med (Retired)
35. Dr Kailash Chand OBE Chair Tameside and Glossop NHS
36. Dr Rajiv Chandy Consultant Physician & Gastroenterologist
37. Professor Imti Choonara Professor of Child Health
38. Dr Alice Clack Consultant
39. Dr Charles Clarke FRCP Consultant Physician
40. Miss Jane Cockburn FRCOG Consultant O&G
41. Professor Peter Crome Geriatric Medicine
42. Dr Robert Cumming Haemotologist (Retired)
43. Dr Jack Czauderna GP
44. Dr Jonathan Dare Consultant Child Psychiatrist (Ret)
45. Dr Jonathan Darling Sen.Lect.&Hon.Cons.inPaed.&ChildHlth
46. Dr Gerry Davies Senior Lecturer in Infectious Diseases
47. Dr Melanie Davies Past president MWF Consultant O&G
48. Dr Susan Davies Consultant Pathologist
49. Dr Jacky Davis Consultant Radiologist
50. Dr R.S. Delamont Consultant Neurologist
51. Lecturer Nick Dennis Snr Lecturer Clinical Genetics, South Hampton (Retired)
52. Miss Jane Dickinson Consultant Opthalmologist
53. Emeritus Professor John Dickinson Professor of Medicine (Retired)
54. Dr Paolo Domizio Consultant Pathologist
55. Dr Jo Downton Consultant in Rehabilitation Medicine
56. Professor Christopher Dowrick BA MSc MC CQSW FRCGO FFPHM Professor of Primary Medical care
57. Dr Tim Dowson GP
58. Dr Peter Draper Public Health (Retired)
59. Dr Matthew Dunnigan Senior Research Fellow
60. Dr Mary Edmondson GP
61. Dr Peter Ehrhardt FRCP FRCPCH Consultant Paediatrician
62. Dr. Maggie Eisner Training Programme Dir.for GPs
63. Dr Robert Elkeles Professor of Diabetic Medicine
64. Dr D.M. Eminson FRCPsych Retd.Cons. Child&Adolescent Psychiatrist
65. Professor Anneez Esmail Professor of GP
66. Dr Chris Evans GP
67. Dr Clarissa Fabre President of MWF and GP
68. Mr Barry Fairbrother FRCS Consultant Surgeon (Retired)
69. Dr Catriona Farell Radiology Registrar
70. Mr Barry Fearn FRCS Orthopeadic Sirgeon (retired)
71. Mr John Feehally Nephrologist
72. Dr Tim Fenn GP
73. Dr Jacqui Ferguson Psychotherapist and Psychoanalyst
74. Dr Veronica Fisher GP Retired
75. Dr Fleur Fisher Family Planning doctor and manager. Pst president of MWF. Former BMA spokesperson (retired)
76. Dr Peter Fisher Consultant Physician (retired)
77. Dr Roger A Fisken Retired Consultant Physician
78. Dr Richard Fitzgerald Consultant Radiologist
79. Professor Peter Fleming CBE Professor of paediatrics
80. Dr Jonathan Fluxman GP
81. Dr Andrea Franks Consultant Dermatologist
82. Professor. Geoff Gill Aintree University Hospital
83. Professor Steve Goodacre Professor of Emergency Medicine
84. Dr Michael Gopfert Cons. Child & Adolescent Psychiatrist
85. Emeritus Professor Isky Gordon FRCR FRCP Consultant Oncologist (Retired)
86. Dr Derek Gould Consultant interventional Radiologist. NIHR Senior Investigator
87. Dr Elizabeth Greenhall FP specialist head of Oxford FP
88. Dr Roger Greenwood Consultant
89. Dr Helen Groom Vice chair of MPU & GP
90. Dr Richard Grunewald Consultant Neurologist
91. Dr Richard Gunstone Physician (Retired)
92. Dr Alyson Hall Hon Consultant Child & Adolescent Psychiatrist,
93. Mr David Halpin FRCS Consultant Orthopaedic Surgeon
94. Dr Gervase Hamilton (Retired). Consultant in Public Health Med.
95. Dr AM Hamlyn FRCP Consultant in Public Health Med.
96. Dr N.G. Harrington Consultant Geriatrician
97. Dr Evan Harris Fromer GP and MP
98. Dr David Hawkins FRCP Consultant Physician
99. Dr Roger Hayter Consultant Physician
100. Dr Keith Hertogs GP
101. Dr Julia Hodges GP
102. Dr Wren Hoskyns Consultant Paediatrician
103. Dr Trevor A. Howlett Consultant Physician
104. Dr David Hughes Consultant Radiologist
105. Dr Louise Irvine GP
106. Professor William Irving Hon Consultant Virology
107. Dr Samina Ishaq Lead Consultant Acute Pain Service
108. Dr Penelope Jarrett GP
109. Dr Liz Joekes Consultant Radiologist
110. Dr Chris Jones Chair of exec board Bro Taf local health group
111. Dr Melanie Jones Consultant Anesthetist Past President of MWF
112. Dr Sally Jowett GP
113. Dr Shazid Karim GP
114. Professor Harry Keen CBE MD FRCP Professor of medicine
115. Dr Jessica Kirker Consultant Psychiatrist in Psychotherapy
116. Dr Hillary Klorin Consultant Paediatrician
117. Dr Sebastian Kramer Consultant Child & Adolescent Psychiatrist
118. Dr Alan Lee Consultant Psychiatrist
119. Dr Dianne Lefevre FRCP FRCPsych Consultant Psychiatrist
120. Dr Richard Lehman Sen.Research Fellow,Dept.Primary Care
121. Dr Geoffrey Lewis Consultant anaesthetist
122. Dr Karen Leyden Consultant anaesthetist
123. Dr Anna Eleri Livingstone GP
124. Dr M.R. Lowe Consultant Psychiatrist
125. Dr N.C. Lowe GP
126. Dr Robert MacGibbon FRCGP GP Retired
127. Dr Heather Mackinnon Consultant Paediatrician
128. Dr Anthony Macklon Consultant Physician
129. Dr John Main Consultant Nephrologist
130. Dr Jane Mann GP
131. Dr Pam Martin GP
132. Dr Cath McGrother Consultant in Public Health Medicine
133. Dr Helena McKeown FRCGP. GP
134. Dr Diana Menzies Consultant Psychiatirst in Psychotherapy
135. Emeritus Professor David Metcalfe OBE Professor of General Practice
136. Dr Penny Milner GP
137. Dr David Misselbrook Dean Royal society of Medicine
138. Dr Geoff Mitchell Consultant Psychiatrist (Retired)
139. Dr Sally Mitchison Consultant Psychiatirst in Psychotherapy
140. Dr M I Morcos GP
141. Dr Pat Munday Consultant Genitourinary Physician
142. Dr Julia Nelki Consultant in Child Psychiatry
143. Dr Elizabeth Nevrkla Consultant Paediatrician (Retired)
144. Dr Elizabeth Newson GP
145. Dr Helen Newton  FRCP Locum Consultant in Rehabilitation
146. Dr Malila Noone Consultant Microbiologist (retired)
147. Dr Tiz North Consultant Radiologist & Chair Merton & Sutton BMA Division
148. Dr Susan O’Halloran Retired Consultant Paediatrician
149. Dr Geraldine O’Hara Research Fellow/SpR Medicine
150. Dr Kevin O’Kane Consultant Physician & hair BMA London Regional Council
151. Dr Ellie O’Sullivan Consultant anaesthetist member of BMA CCSC
152. Dr P O’Sullivan GP
153. Lord Walton of Detchant Previous president of GMC Consultant Physician (retired)
154. Dr Stephen Olczak Cons.Physician in Endoc. & Diabetes
155. Mr David Paintin FRCOG Emeritus Reader in O&G
156. Dr Jacqueline Payne GP
157. Dr Clive Peedell Consultant Oncologist BMA Council
158. Miss Audrey Platt FRCOG Consultant O&G (Retired)
159. Dr Janet Porter Consultant Accident & Emergency
160. Professor Neil Pride Emeritus Professor in respiratory medicine
161. Dr John Puntis Consultant Paediatrician
162. Dr I.F. Pye Consultant Neurologist
163. Lord Nic Rea GP (Retired)
164. Dr Merriel Reid GP
165. Dr Gerard Reissmann GP
166. Mr Bryan Rhodes Consultant Orthopaedic Surgeon
167. Dr Kate Richards GP (Retired)
168. Dr Russell Roberts Consultant Nephrologist
169. Dr Sarah Robertson Consultant psychiatrist in psychotherapy
170. Dr Andrew Robins Consultant Paediatrician
171. Dr John Robson GP
172. Dr Tony Roques Consultant Haematologist (Retired)
173. Dr Donna Samuels GP
174. Professor David Sanders Hon Professor Gastroenterology
175. Professor Wendy Savage Past president of MWF. SL O&G (retired)
176. Dr Brian Scott MD FRCP Consultant Physician
177. Dr Alex Scott-Samuel Senior Clinical Lecturer
178. Dr Jim Sikorski GP
179. Dr Brian Silk Consult.Padiatrician, Med.Dir. (Retired)
180. Dr Ron Singer GP
181. Dr Surinder Singh GP
182. Professor Alan Smyth Professor of Child health
183. Dr Ann Solomon GP
184. Dr Nigel Speight Consultant Paediatrician
185. Dr S.Bertel Squire ? Public Health
186. Dr Fiona Subotsky Past President MWF/retired Child Psychiatrist
187. Dr John Sweeney Consultant Physician Sexual Health
188. Dr R.L. Symonds Consultant Psychiatrist
189. Dr Patricia Tate GP
190. Emeritus Professor Ron Taylor Professor of O&G (Retired)
191. Dr Richard Taylor Consultant Physician ex-MP (Retired)
192. Dr David Taylor Robinson MRC Population Health Scientist
193. Dr Katherine Teale Consultant anaesthetist
194. Dr Kathrin Thomas GP & Public Health
195. Dr Sarah Thurlbeck Consultant Paediatrician
196. Dr John Tomkinson Consultant Psychiatrist
197. Dr Jonathon Tomlinson GP
198. Professor David Tomlinson Faculty of Life Sciences
199. Dr Mike Tomson GP
200. Dr Dave Tomson FRCGP GP
201. Baroness Jenny Tonge Family Planning doctor (retired)
202. Dr Norman Traub ConsultantHaematologist (Retired)
203. Dr John Tripp Consultant Paediatrician (Retired)
204. Dr Carol Trotter Consultant in Old Age Psychiatry
205. Dr Julian Tudor-Hart GP, author  & research fellow
206. Dr Gill Turner Consultant Paediatrician
207. Mr Rick Turnock Consultant Paediatric Surgeon
208. Dr Nadja van Ginnekin GP Locum
209. Dr Helen Venning Consultant Paediatric and Adolescent Rheumatologist
210. Dr Paul Walker Public health Editor Health Matters Retired
211. Dr Lucy Walker MRC Research Training Fellow
212. Dr Bill Ward GP
213. Dr Martin Wastie Consultant radiologist
214. Dr Tony Waterston Consultant Paediatrician (Retired)
215. Dr Malcolm Weller Consultant Psychiatrist Adult & Neropsychiatry
216. Dr Diana Wellesley Consultant/Hon Senior Llecturer in Genetics
217. Dr A.J. Wills Consultant Neurologist
218. Dr Barrie Woodcock Consultant Haematologist
219. Dr Pam Wortley GP
220. Sir Nicholas Wright Warden Barts& the London Medical School Pathologist
221. Dr David Wrigley GP,  member BMA Council &GPC
222. Emeritus Professor John S Yudkin MD FRCP Professor of Diabetic Medicine
223. Dr Luke Zander GP(retired)
224. Dr Patrick Zentler-Munro Consultant Physician
225. Dr Pam Zinkin Consultant Paediatrician (Retired)

 

The Editor

The Financial Times

8th December 2010

Dear  Editor

Most of my fellow professionals and even more of my fellow citizens share very serious concerns about  this Coalition Government’s plans for the NHS, revealed in Andrew Lansley’s health White Paper, ‘Equity and excellence: liberating the NHS’ .  Government has just postponed its progress until 2011.  Very many of us feel that it should be entirely abandoned.  The NHS is funded from the public purse and delivered by dedicated and experienced staff.  Their views about major developments of the NHS have been ignored.

Despite pre-election assurances of “no more top-down NHS reorganisations”, respected health observers describe the Coalition proposals as the biggest shake up of the NHS since its inception.  They were produced without public or professional discussion and have had insufficient  testing There are practical, financial and social dangers in the implementation   of this unmandated upheaval and a renewed sense of public anxiety about NHS adequacy. .

It has been credibly estimated that the act of restructuring alone will cost over £3 billion, an untimely and utterly unnecessary expense. NHS staff dismissed from primary care trusts and strategic health authorities will receive generous redundancy compensation and then may be re-employed by the new GP commissioning consortia.   Beyond the ‘reorganisation’ costs, it has been estimated that running the new system is likely to cost £1.2 billion a year more than currently. Duplication and bureaucracy will encumber the disintegrated service when 500 or so GP consortia  try to do the job of the 152 current PCTs.

These totally untested and enormously expensive destructurings of the NHS are to be made at a time when it is required to deliver £20 billion of efficiency savings in the face of falling real buying power.  Inevitably there will be job losses, disrupted services, hospital closures, deteriorations that government will blame on the economic crisis.

Crucially, the policies will have a major impact on public perceptions of the NHS.  GPs will be seen as responsible for economies and cuts.   The priceless bond of trust between doctor and patient will be eroded if the GP is held responsible for commissioning decisions that deny a hospital referral, an expensive test or a costly treatment.  Uncoordinated commissioning will lead to great locality variation in provision resulting in a postcode lottery far greater than anything seen before.  Treatments available to one patient may be denied to a next door neighbour with a different GP.   There will be “no bail-outs for organisations which overspend public budgets”.

The very widely expressed sceptical response to the Coalition’s ill-considered proposals cannot be dismissed as simple ‘resistance to change’ or ideologically driven. Criticism has come from pro-market think-tank Civitas, the respected King’s Fund, the internationally renowned Lancet  journal,  the NHS Confederation, the Nuffield Institute and even the reserved and cautious Royal Colleges.

Only sustained, concerted and well argued resistance will deflect the Coalition from a course which profoundly threatens not only the equitable and progressive development of the NHS but also the government’s claim to found changes on a sound evidence base.  The NHS must evolve.  Let it do so on the basis of changing human needs, clinical discovery and rational resource management  rather than in pursuit of political dogma.

Yours sincerely

Harry Keen

Professor Harry Keen CBE MD FRCP

President, NHS Support Federation

Emeritus Professor of Human Metabolism and Consultant Physician

Guy’s Hospital Campus, King’s College London

Hon Professor Warwick University Medical School

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