Wednesday, 3 August 2011

In the name of NHS Reforms

The Government is planning huge changes in the NHS.  In the past few weeks it’s had to amend some of its proposals, because of opposition from NHS workers, the trade unions, the Labour Party, and the general public. But most of what the Government wanted to do, it’s still doing. The NHS is in grave danger.


The Government wants to scrap SHAs and PCTs by April 2013. In fact SHAs and PCTs have already started restructuring, downsizing, and making staff redundant.

Instead of having SHAs and PCTs to coordinate local NHS services, the Government wants to hand over the health budget to groups of GPs. These groups were originally going to be called “GP consortia”. Now the name has changed to “clinical commissioning groups”. The groups will have to have a token doctor and nurse on their board, but they’ll still be GP-run. Other parts of the NHS workforce are unlikely to get a look in.

These GP groups would have to buy the services they want direct from providers, which is a bad idea. GPs would be put in an awkward position, because they’d control the purse-strings. GPs would have more opportunities to make money off the NHS. They may even be allowed to charge patients for services currently provided free on the NHS.


The Government says it “strongly expects that the majority of remaining NHS trusts will be authorised as Foundation Trusts by April 2014″. Foundation Trusts are semi-independent organisations. They have more ability to change staff terms and conditions. More Foundation Trusts means a worse deal for patients. The Government wants to allow Foundation Trusts to take in as many fee-paying patients as they like. NHS patients would be pushed to the back of the queue.


The Government originally said it wanted the healthcare regulator to “promote competition” in the NHS. Because of the public outcry, the Government changed its wording slightly. It now says it wants to “prevent anti-competitive behaviour”. That’s not a big difference! Hospitals would be fined for any collaboration which the regulator thinks is “anti-competitive”. The idea is to make it easier for the private sector to muscle in on NHS contracts.

The Government doesn’t want the NHS to be the “preferred provider” of healthcare any more. Instead, “any qualified provider” will be free to operate under the NHS brand. The Government is planning to push the “any qualified provider” initiative from April 2012. It’s essentially another way of opening up the NHS to more private competition. In case the competition gets too fierce, the Government is having to put in place measures to deal with hospitals that become insolvent.

The Tories and Lib Dems are running down the health service. The NHS faces a four-year budget freeze and £20bn of “efficiency savings”. This is despite the Government having pledged to increase NHS spending in real terms every year. Yet Tory Health Minister Andrew Lansley is willing to waste upwards of £3bn on implementing his “reforms”.

NHS staff are bearing the brunt. Pay for many NHS workers has been frozen. There is growing job insecurity as well as downward pressure on terms and conditions. Downbanding is a big problem. Because of the cuts and reorganisations, the ability of staff to deliver patient care is deteriorating. More treatments are being rationed and waiting times are up. And if the Government’s plans for the NHS go through, there will be plenty more trouble ahead.