13 Dec, 11 | by BMJ Group
Despite the widespread concern and opposition to the coalition government’s NHS reforms, the Health and Social Care Bill continues on its way towards royal assent, which is likely to happen in the spring of 2012. Opponents of the reforms, including the BMA, are concerned that the legislation will lead to increasing commercialisation, fragmentation, and privatisation of the NHS. The recently leaked DH document on commissioning confirmed fears about privatisation of commissioning support, which led to the BMA Council taking a decision to oppose the whole bill and abandon its “critical engagement” policy. The ongoing issues around the duties and powers of the Secretary of State to provide a comprehensive service, which has been deferred to the Lords report stage next month, also raises serious concerns that denationalisation of the NHS is an intention of the reforms, as described in a recent BMJ article by Pollock and Price. When seen from a wider political perspective, it is clear the intention of the bill is to replace large swathes of the public sector with the private sector. This is also in keeping with the recent White Paper on public services reform.
Since very little of this was mentioned in the either the Liberal Democrat or Conservative party manifestos, or the Coalition Agreement, there is a serious problem with democratic legitimacy. This is made worse by the fact that the nature of the coalition means that the government has a majority in both the Commons and the Lords. This would not have been the case if the Conservatives had won the election outright, and it is highly likely that this bill would have been blocked by the Lords via the Parliament Act (deferring the bill by one parliamentary session effectively kills a bill). Since the Liberal Democrats are in such a fragile position after the tuition fees problems, they must stay in the coalition at all costs otherwise they would be wiped out at a general election. Even after Cameron’s EU veto, and the anger this has created in the pro-European Liberal Democrat ranks, the language coming from the leadership is still about keeping the coalition intact.
This is all very bad news for those who are opposing the bill, because it is now almost certain that the bill will be enacted without major meaningful amendments because of the government majority in the Lords, as brilliantly described by Michael White in the Guardian recently. However, although things are now clearly desperate for opponents of the reforms, I still believe that much can be achieved by raising public awareness of the dangers of the bill, and trying to gain a united front of opposition from the major representative organisations of the professions including the BMA, RCGP, RCN, and others such as the UK Faculty of Public Health and Royal Colleges.
The NHS is clearly under huge threat and if the bill is enacted, it will be a completely different healthcare system in 5-10 years time. A system, which I believe will signal the end of the English National Health Service, and a system that will be much worse in terms of access, equity, health outcomes, and cost.
Aneurin Bevan famously said that the NHS “Will last as long as there as folk left with the faith to fight for it.” I certainly have that faith, and that is why I have decided to run from Bevan’s statue in Cardiff City Centre to the Department of Health, Richmond House, Whitehall, London. I will be doing this run, which I’ve called “Bevan’s Run” with my colleague Dr David Wilson, who is a Consultant Clinical Oncologist in Middlesbrough. We aim to cover the 160 miles in 6 days, which is a marathon a day. We start out from Cardiff on Tuesday 10th January 2012 and hope to get into London on the 15th January. We will be passing through David Cameron’s constituency of Witney in Oxfordshire on Friday 13 January. We will be holding a rally in Witney town centre, where we will have several speakers to talk about the NHS reforms. During the run, I will be using my blogsite bevansrun.blogspot.com and Twitter and Facebook to describe our progress and also stimulate debate and awareness about the reforms. This campaign will also be supporting Dr Kailash Chand’s epetition to the Government to “Drop the bill.” It needs 100,000 signatures to trigger a debate in the Commons, which will raise public awareness of these reforms. The key issues that “Bevan’s Run” will be focusing on will be NHS privatisation, the undermining of the founding principles of the NHS, reduction in the number of core services provided by the NHS, the drive towards a mixed funding system of healthcare, as well as the wider political issues surrounding the bill. I will also be calling for all the main professional representative organisations to sign a joint letter to oppose the reforms.
I really hope the profession will get behind and support “Bevan’s Run.” If you use Twitter, then please follow me @cpeedell for updates. Please visit our blogsite “Bevan’s Run,” where you can also link to our Facebook page.
If anyone can get to Witney Town centre on Friday 13 January (around 11am onwards), it would be much appreciated.
Finally, anyone who wants to join in with Bevan’s Run can do so at any stage and any length of the run. In particular, it would be great for people to join in Cardiff, Witney, and the last day in London, which is a Sunday. Please see the blogsite for details.
Remember, the NHS “will last as long as there as folk left with the faith to fight for it.”
Clive Peedell is the co-chair NHS Consultants’ Association which is a pressure group that supports the founding principles of the NHS and believes it should be publicly funded, public provided, and publicly accountable. The NHSCA provides financial support to Keep Our NHS Public and the NHS Support Federation.