NHS Reforms - Health and Social Care Bill 2011

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We get told that the NHS reforms going through The Lords this week are privatisation of the NHS, that they put the NHS at risk, and that are not wanted by health professionals. This afternoon I’ve been searching for an article online to sum up arguments for and against the bill, as I don't think I understand the changes very well.

All I seem to come across are open ended statements. For example in a letter in The Telegraph some health professionals state that “the proposed reforms will disrupt, fragment and weaken the country’s public health capabilities”. But don’t explain why this is the case and I couldn't see any reasoning.

The bill is making The Left rabid. For example Polly Toynbee states that “The NHS may not survive this volcano of ideology”, and seems to put this down to GPs being allowed to manage their services. I can’t really find any other thread of argument in her writing. Usually I can at least see the issue they claim is at stake.

I have looked at the summary of the bill on the Department of Health’s website, and to be honest all sounds fine to me (though full of Jargon and waffle, and i'm no expert!).

What passages of the bill are people so concerned about? Far from destroying the NHS the funding is ring fenced as far as I can remember, so it is safer than any other public sector institution in this regard. I'm not having a go (right now ), I just don't understand, and there seems to be a lot of fuss about it. I wonder if those complaining understand either!

[JagLover]

As originally proposed the bill was a welcome step towards the european model of public funding but independent hospitals competing for patients.

It may have been too emasculated to do much good, and there is a need to make sure that the spreading private provision of NHS procedures introduced under Labour is not reversed, but seems worth pursuing nonetheless.

Of course much of the workforce are opposed. In general any workforce would oppose fundamental upheaval and a logical end result of the measure is the closing of 'failing' hospitals besides. Add to this further chipping away at the monolethic NHS with all that entails in terms of national pay bargaining and Turkeys don't vote for Christmas.

What the BBC, and others like them, fail to realise however is that the NHS is not run for the benefit of its workforce but that of its patients and far from being the envy of the world the NHS offers one of the lowest standards of care in the developed world.

The debate on Health in this country contrasts only two very different models the NHS versus a distorted view of Amercian health care. The superior European model is ignored.

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JagLover said:

the NHS offers one of the lowest standards of care in the developed world.

The debate on Health in this country contrasts only two very different models the NHS versus a distorted view of Amercian health care. The superior European model is ignored.

Utter bks.

Until that point you made some valid points, however, on this you are quite wrong. In many outcome measures we out perform the American health care sector, and are much better value for money, returning superior quality, at lower cost. European 'models' are patchy, some countries are good others poor. To simply lump them into one section, is simplistic nonsense.

With regard to the OP, it's a difficult decision. Instinctively I thought that dismantling the PCT bureaucracy and firing a few pointless accountants, and handing control to the GPs would be a better model and would save money, and make the service more locally directed, however, it's not that simple. Some GPs are very geared up and happy for these changes, as they have experience in management, and management of large budgets, particularly some of those who were around in fundholding days, others however don't see how they can deliver care and be responsible for massive budgets.

Another issue is that in many cases the GPs will be commissioning for work that they themselves might provide, which then screws specialists, who have no say in how care is delivered. The Govt has tried to address this by ensuring that specialists will be on the commissioning groups, but then this is a huge conflict of interest.

Involvement of the private sector can have it's benefits, but unlike the previous poster, who has no knowledge at all about how this has worked in the past, there is much risk also. Labour privatised the NHS more than any previous govt, handing tenders for NHS work to private companies like Netcare. It was a disaster. They charged huge quantities of money, delivered little, indeed less than NHS depts that changed their systems to become high volume centres and they cherry picked easy cases but then refused to deal with any of their complications. They then packed up and disappeared to SAfrica or Canada. Labour had no idea how to negotiate the tenders, and so they were screwed and wasted huge amounts of money, and moreover, they entirely sidelined the UK medics, who were offering advice about how changes could be made at a fraction of the cost to deliver the same quantity of work.