Medical professionals warn against “extraordinarily risky” NHS reform

Coalition’s flagship Health and Social Care Bill could cause health service to shrink and jeopardise

Medical professionals have warned that the government's proposed reform of the NHS is "extraordinarily risky", ahead of the publication of the flagship bill on Wednesday.

The report, by the NHS Confederation, made up of the British Medical Association, the Faculty of Public Health and royal colleges representing general practitioners, hospital doctors and surgeons, accepts the need for reform but expresses grave concerns.

Broadly, the criticisms it levels fall into two categories – the handling of the reform, and its actual content.

On the first note, the Health Secretary, Andrew Lansley, is criticised for failing to convince patients or medical professionals of the need for reform – important given that this is the biggest restructuring of the NHS since its inception. "The absence of any compelling story about why the reforms are necessary or how they will translate into improved outcomes is of concern," it says.

The government's attacks on NHS managers also come under fire for being "unpleasant and demotivating". The plans focus on giving control of NHS budgets to GPs and cutting down on middle managers, meaning that managers will be expected to drive through reforms while also being purged.

Even more worrying, though, is the second "category" – the potentially negative consequences of the bill. The report notes that the switch to a system where GP consortiums can send patients to whoever offers them the best service will force the NHS to shrink to make space for new private health-care providers.

The government's argument is that introducing market mechanisms will improve quality of care and efficiency. The report concedes that this can be the case, but warns: "This will not happen naturally when, as in the case of the NHS, the size of the total market is not increasing. Closure of existing services will be necessary."

Lansley's policy of "price competition", which will allow hospitals to compete for patients, is also alarming. The NHS Confederation analysis shows that it could jeopardise standards of care.

The report's parting shot is that it is "extraordinarily risky" to restructure the NHS when it also has to save £20bn by 2014-2015.

Overall, the impression is of a poorly thought-through bill that could have hugely damaging results for free and equal health care. David Cameron is to give a speech tomorrow, aimed at allaying the fears of the medical profession and reassuring health professionals that the reform plans will not be rushed. We must hope that he listens to their concerns.

Samira Shackle is a freelance journalist, who tweets @samirashackle. She was formerly a staff writer for the New Statesman.

Photo: Getty
Show Hide image

The Liberal Democrats are back - and the Tories should be worried

A Liberal revival could do Theresa May real damage in the south.

There's life in the Liberal Democrats yet. The Conservative majority in Witney has been slashed, with lawyer and nominative determinism case study Robert Courts elected, but with a much reduced majority.

It's down in both absolute terms, from 25,155 to 5,702, but it's never wise to worry too much about raw numbers in by-elections. The percentages tell us a lot more, and there's considerable cause for alarm in the Tory camp as far as they are concerned: the Conservative vote down from 60 per cent to 45 per cent.

(On a side note, I wouldn’t read much of anything into the fact that Labour slipped to third. It has never been a happy hunting ground for them and their vote was squeezed less by the Liberal Democrats than you’d perhaps expect.)

And what about those Liberal Democrats, eh? They've surged from fourth place to second, a 23.5 per cent increase in their vote, a 19.3 swing from Conservative to Liberal, the biggest towards that party in two decades.

One thing is clear: the "Liberal Democrat fightback" is not just a hashtag. The party has been doing particularly well in affluent Conservative areas that voted to stay in the European Union. (It's worth noting that one seat that very much fits that profile is Theresa May's own stomping ground of Maidenhead.)

It means that if, as looks likely, Zac Goldsmith triggers a by-election over Heathrow, the Liberal Democrats will consider themselves favourites if they can find a top-tier candidate with decent local connections. They also start with their by-election machine having done very well indeed out of what you might call its “open beta” in Witney. The county council elections next year, too, should be low hanging fruit for 

As Sam Coates reports in the Times this morning, there are growing calls from MPs and ministers that May should go to the country while the going's good, calls that will only be intensified by the going-over that the PM got in Brussels last night. And now, for marginal Conservatives in the south-west especially, it's just just the pressure points of the Brexit talks that should worry them - it's that with every day between now and the next election, the Liberal Democrats may have another day to get their feet back under the table.

This originally appeared in Morning Call, my daily guide to what's going on in politics and the papers. It's free, and you can subscribe here. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.