Don’t go to market

Fascinating though this election campaign has been, the debates on health have been largely predictable. No politician wins votes by promising to close hospitals or take away services, so it's not surprising that all three parties have, more or less, pledged to protect the NHS, promising to save huge amounts of money without affecting front-line services, and without giving much in the way of detail.

But away from the campaign trail, the axe is already being sharpened. Strategic health authorities have been told to achieve efficiency savings worth £20bn and staff are starting to see the consequences. More than half of GPs in a recent survey said cutbacks to local services had begun. Since we the British Medical Association (BMA) launched our election manifesto in December, we have pointed out the folly of "slash-and-burn" cuts, arguing that during a time of financial difficulty, health care is even more important.

But we have also been calling for a new approach to service provision. At a recent hustings, I asked the three candidates for health secretary to explain where they stood on the role of profit-making companies in the NHS. All three continued to advocate private provision of NHS care, albeit with slight differences in emphasis.

That this consensus exists is perhaps surprising. Surveys of the public show little appetite for private provision of NHS services, and there is scant evidence that the market experiment in England has improved standards or efficiency. It is worth noting that every eight cases diverted to an independent-sector treatment centre cost the taxpayer the equivalent of almost ten cases dealt with by the NHS.

So what's our message to the next government? Naturally we'd like you to give NHS staff a greater say in determining policy and services. But we also urge you to abandon this obsession with market "reforms" that continue to divert public money away from the front-line services you have promised to protect.


Chairman of the British Medical Association council