Clive Peedell is a man for whom I have a lot of time. A founder of the NHS Action party, a consultant in Middlesborough and a member of the BMA Council, few doctors have their finger on the pulse of the NHS the way he has. He's written in the Guardian this morning, saying:
The NHS needs to be reformed to remain true to its founding principles; the question is how. International evidence suggests that increasing marketisation and privatisation of healthcare services leads to greater expenditure, greater variations in care, reduced access to services, and erosion of professional standards. On that basis, the reforms have been heading in the wrong direction for a long time, with all the major political parties supporting policies that increase the role of the private sector in the NHS.
He's right. As he goes on to note:
New Labour's own market-driven reforms laid the ground for Andrew Lansley's Health and Social Care Act, which in turn paves the way for a mixed funding system. Yet, with public and patient satisfaction in the NHS at an all-time high prior to the Lansley reforms, the case for such radical changes has not been made, let alone won.
The basic reform now needed in the NHS is the abolition of all pretence of a market, the creation of single tier authorities for regions capable of investing in quality systems and regional centres of excellence (in may area, Norfolk, Suffolk and Cambridge combined), and the removal of financial incentives for action, with considerably more freedom being given to professionals to concentrate on quality of care.
That's not what we're going to get, as Clive notes:
In the face of public and professional opposition to Lansley's bill, coalition MPs and peers eventually passed the legislation only after receiving reassurances from senior ministers that there would be no NHS privatisation, and a focus on integration of services rather than competition.
However, the privatisation debate has now been reignited by revelations about section 75 of the act and the associated statutory instruments(SI 257 regulations) making their way through parliament. The regulations are aimed at making competitive tendering compulsory for clinical commissioning groups (CCGs), except in emergencies. At a stroke, they inject competition into the NHS and enable the market to decide how services are provided. Thus the reassurances ministers gave about clinicians and local people having control of how services are commissioned look set to be overturned. Private providers will gain rights under EU competition law, which will make it virtually impossible to stop them encroaching into the NHS market.
The NHS is being privatised, now. Inefficiency, increased costs, longer waiting lists, discrimination and a lower standard of care will inevitably follow.
As Clive notes:
Increasing marketisation and privatisation of the NHS goes against the democratic views of the overwhelming majority of the public, who don't want to see their most cherished institution dismantled and fragmented.
It is vital politicians, professional organisations, campaign groups, patient groups and the public stand together and fight for the NHS against a privatisation experiment that has been shown time and again to fail. This will require a concerted effort to counter the spin and obfuscation that surrounds NHS reform, to uncover what is really happening to our healthcare system.
This is my contribution today. Please do something too.