David Cameron and the uninvited doctors: that No. 10 guestlist in full

Groups that have called for NHS reforms to be scrapped are excluded from special summit on the healt

What do you do when people disagree with you? Well, excluding them is one option. David Cameron is holding a special summit on the NHS bill today -- very special, as it will only include medical colleges and health practitioners that back the bill.

Strikingly, the British Medical Association and the Royal College of General Practitioners have not been invited, despite the fact that the centrepiece of the bill is giving more power to GPs.

This graphic by Ben Goldacre sums up the invite list:

invite

Downing Street has acknowledged that the guest list is built around supporters of the health bill, stressing that the discussion today is about how to implement the health bill, not about amending or abandoning it. On that basis, they said, there is little point inviting those who have opposed the reform from the start.

However, Cameron has been accused of playing divide and rule with health practitioners. Peter Carter, the head of the Royal College of Nursing was incredulous: "We don't know why we haven't been invited but we, like others, find it extraordinary because at the end of the day, it is nurses, doctors, physios, GPs that actually keep the health service going."

The Prime Minister, who has taken personal responsibility for pushing the changes through, will make it clear today that he believes that it is too late to change course. While excluding dissenting groups may be expedient, such tactics are unlikely to go down well with the public: a Unite/YouGov poll found that six times as many people trust health professionals over Cameron and Andrew Lansley on NHS reorganisation (60 per cent and 10 per cent respectively). Labour has opened up a 15 point lead over the Tories on the NHS. Fifty-nine per cent of people already feel that Cameron has not honoured his pre-election promises on the NHS. Visibly going against the will of medical professionals could seriously compound that loss of trust.

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

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The big problem for the NHS? Local government cuts

Even a U-Turn on planned cuts to the service itself will still leave the NHS under heavy pressure. 

38Degrees has uncovered a series of grisly plans for the NHS over the coming years. Among the highlights: severe cuts to frontline services at the Midland Metropolitan Hospital, including but limited to the closure of its Accident and Emergency department. Elsewhere, one of three hospitals in Leicester, Leicestershire and Rutland are to be shuttered, while there will be cuts to acute services in Suffolk and North East Essex.

These cuts come despite an additional £8bn annual cash injection into the NHS, characterised as the bare minimum needed by Simon Stevens, the head of NHS England.

The cuts are outlined in draft sustainability and transformation plans (STP) that will be approved in October before kicking off a period of wider consultation.

The problem for the NHS is twofold: although its funding remains ringfenced, healthcare inflation means that in reality, the health service requires above-inflation increases to stand still. But the second, bigger problem aren’t cuts to the NHS but to the rest of government spending, particularly local government cuts.

That has seen more pressure on hospital beds as outpatients who require further non-emergency care have nowhere to go, increasing lifestyle problems as cash-strapped councils either close or increase prices at subsidised local authority gyms, build on green space to make the best out of Britain’s booming property market, and cut other corners to manage the growing backlog of devolved cuts.

All of which means even a bigger supply of cash for the NHS than the £8bn promised at the last election – even the bonanza pledged by Vote Leave in the referendum, in fact – will still find itself disappearing down the cracks left by cuts elsewhere. 

Stephen Bush is special correspondent at the New Statesman. He usually writes about politics.