The Royal College of Midwives (RCM) this week called on the Government to scrap its Health and Social Care Bill.
You will of course know that this bill was not only absent from the coalition deal between the Conservatives and Liberal Democrats, but specifically ruled out by it. In their programme for government, they agreed to “stop the top-down reorganisations of the NHS”. Put simply, there is no democratic mandate for it.
The health service is facing some real challenges in the next few years as it has to achieve unprecedented efficiency targets with a frozen budget and growing demands on its services. Being required simultaneously to cope with those pressures and the unnecessary, bureaucratic and costly distraction of the reforms proposed in the bill is too much. Deliberately or not, the NHS is being set up for failure.
This bill has been struggling its way through Parliament for a year. During that time the RCM has responded to countless consultations and listening exercises, and tried to secure assurances time and again over various aspects of the bill. Despite these best efforts, it is our assessment that the fundamentals of the bill have changed little.
We have not heard anything that convinces us that the changes are necessary. The case has not been made. We remain unconvinced too that the changes will result in improvements in care. And we are disappointed that the legitimate fears and concerns expressed by health professionals and patients have not been addressed.
As things stand, we face subjecting the NHS to full-blown competition and market forces at a time when those very same forces have thrown our economy onto the edge of the abyss. Why take the greed that almost destroyed our entire economy and choose to inject it directly into the heart of the NHS? Greed isn’t good, it’s bad, and it shouldn’t be the driving force behind what motivates those who deliver healthcare within the NHS. Right now the NHS is something special. It exists to care for people. Opening up a US-style free-for-all, where its existence is about providing profit to private companies, is surely not the road down which we want to travel.
The RCM took the decision to go into battle and oppose the bill outright when we asked ourselves what the NHS will look like in five years if this bill goes through. There will be lots of new, private providers, competing with each other. In addition, any remaining NHS providers will be foundation trusts, pretty much free to earn a vast chunk of their income privately, rendering their “NHS” status essentially meaningless. Commissioning services from all these providers may well be carried out by specialist private-sector companies, who, like the private providers, will all be skimming off profit as money flows endlessly around the system… a paradise for accountants, a nightmare for patients.
In short, five years from now the NHS might be little more than a state-funded health insurance system, made up of a fragmented mishmash of private companies competing with each other to provide narrow slivers of care. “NHS” would be the logo on the front of it all – but with no real NHS hospitals, no NHS doctors, NHS nurses or NHS midwives. The NHS that has served us pretty well for over 60 years will be gone, something for people to read about in their history books.
I don’t know about you, but that is not a future I want to see, and that’s why in what little time remains MPs and peers must listen to the growing chorus of opposition to this unloved bill and collectively pull the plug on it.
Cathy Warwick is the Chief Executive of the Royal College of Midwives