Reproduced from the Opendemocracy website
Jacky Davis December 1st 2011
The British Medical Association – representing 147,000 doctors in the UK – finally lost patience with Andrew Lansley’s unloved and unwanted Health and Social Care Bill last week when its national Council voted decisively to move to a position of full opposition to the entire Bill and to campaign against the threatened legislation.
Up until now the doctors’ trades union has believed that it could rescue the parts of the Bill that appealed to some doctors, in particular the proposal that GPs commission care on behalf of their patients. At the same time they hoped that by reasonably engaging with politicians they could mitigate the frankly obnoxious parts, in particular the burgeoning involvement of the private sector in delivering the service, and the emphasis on competition rather than collaboration in the English NHS, an attitude which is completely counter cultural for health care professionals and which has no benefit for patients beyond a spurious ‘choice’ agenda which most don’t want.
However a leaked document – Developing Commissioning Support: Towards Service Excellence – has proved to be the final straw that broke the BMA’s hope that something – anything – could be rescued from this legislation. It is written in the usual impenetrable jargon and double-speak but when translated into plain English it indicates that the private sector will rapidly be taking over the support of commissioning, leaving GPs with little power beyond organizing some specialized areas such as learning difficulties and yet still likely to get the blame for the cuts and closures which will inevitably result from the financial squeeze which the NHS is facing.
It makes a mockery of promises to put the profession and patients in the driving seat, a position which will instead be firmly occupied by the transnational health corporations who see huge opportunities for helping themselves to a large slice of the NHS budget.
With GPs furious about this early betrayal it is now difficult to find anyone outside the Coalition and the Department of Health who thinks this Bill is anything other than a dangerous and chaotic mess. More than a few Tories wish it would just go away. The Lords are trying to water it down with amendments but the Bill is of a piece, woven from whole cloth and no amendment is going to make it palatable or even workable. With Andrew Lansley arousing more suspicions by refusing to disclose the risk assessment documents to the House of Lords (so much for promises of transparency in government) it is astonishing that it is being allowed to stagger on when it would be in almost everybody’s interest to put it out of its misery.
The NHS is after all (Commonwealth Fund Study 2011) one of the most cost effective and popular health services in the industrialized world, and the last thing it needs (according to a recent report by the OECD) is another major upheaval. The ‘crisis’ of the NHS is a manufactured one, scare stories invented to suit the Coalition’s assault on public services, and we are not fooled by bogus statistics about poor outcomes, of which the government should be ashamed.
So here is a suggestion. Halt the Bill now, just stop it and concentrate on rescuing the situation on the ground brought about by starting to implement it before it is law. Then we can take a deep breath and consider in relative leisure how we can improve the NHS without destroying it. Otherwise this will be the Coalition’s poll tax, and they will suffer the political consequences because the public will not forgive the political vandals responsible for the destruction of the most popular institution in this country bar none.
Dr Jacky Davis is a consultant radiologist, co-founder of Keep Our NHS Public and a member of the BMA council. She has written this piece in a personal capacity.
Well said Jacky. You could not have put it more succinctly.
One might wonder how we have come to this sorry position.
It probably started over two decades ago when our profession was edged out of the Hospital Management Boardroom following the introduction of “professional” managers, to whom some of our less publically spirited colleagues cosied up to.
Since then we have been afflicted by a creeping paralysis (a term that used to be used to describe Multiple Sclerosis). Now almost paralysed, but with our mental faculties still intact, we are praying for a miracle that will inactivate that accumulation of NHS antibodies.
How about kidnapping Lansley?
Unfortunately I doubt if the coalition would pay any ransom, no matter how patient-friendly that ransom might be.
It does make one wonder how it is that the majority of MPs have neither the intelligence nor the wisdom to appreciate what they are doing to the NHS.
Without the persistence of many, this Bill would have gone ahead unfettered whereas now, its dangers are becoming public and the fears of the public are materialising. It is one thing to make the health service more business-like but something unacceptable to make it run by business for the profits of the business owners. Management consultants , accountants and solicitors should be helping manufacturing companies to create wealth, not tinkering with the NHS to extract profit from it. It might be more morally acceptable if they did it on a pro bono style basis.
I am a 72 year old diabetic with angina, and a retired NHS chief financial officer. One of my earliest memories is of being ill before the NHS. I knew many former colleagues who had worked in charity and local government medical systems before 1948.
The service, which my wife (a former midwife) and I have experienced is of the highest standard and we cannot imagine how it might be improved other than by removing dental charges.
We think that we can fairly claim to be able to better able than most people to appreciate the NHS that we have now.
In my opinion the current Health minister is as committed to the principles of the NHS as any since Barbara Castle. Many party members would like to see the Health minister become leader of their party.
Some of them are of them are in the Labour Party.
The rest are in the SNP of course.
I’m glad the BMA have finally called for the scrapping of the bill, Jonathon, but they should have done this six months ago. Just as Labour should have done their petition to scrap the bill six months ago. The House of Lords may yet remove the guts from it, but I fear this is all too late.
Sorry, Jackie. Didn’t read the intro at the top..
Just taken offspring to orthodontist. She scores high enough for a brace. Hooray! If she did not, I would raid my savings. I am lucky. I have savings, I was born into a middle class family, have a degree and a professional post. If I did not, we would be totally reliant on scoring enough for said treament. Slightly lower score and financially poorer could mean a lifetime of gum and dental probles, low self-esteem, jaw problems, headaches, who knows? No brace could have meant all this to someone without the financial means. When people ask what the Health Bill would do to health care, tell them about dentistry. Remind them about how a 2-tier system works. Remind them that they dont get their teeth checked up because they cant afford to!