Edward Davies: Hysteria. There, I said it.

Edward DaviesOh, behave. I got some grief for saying on a previous blog that some of the criticism of health reform was a bit “hysterical.” I felt a little chastened. I now feel utterly justified.

I just did a Google search for “NHS Arab Spring” which gave me almost 1,000,000 results. I saw the phrase used in the Health Service Journal a few months back but turned a blind eye. The actual Arab Spring was in the news at the time. It was an easy analogy. No harm done. But now the analogy is everywhere.  And it’s mostly referring to a summit of Royal Colleges and the BMA this week to trash talk the health bill.

I’ve got nothing against the BMA, who do in fact effectively own me. And some of my best friends are Royals and/or went to Colleges. But a meeting of the most powerful profession in the country, heralding from some of its most opulent glades, debating disagreement with a democratically elected government, about how to structure the middle management and procurement of its health service is not in any way comparable to the Arab Spring. At all. Even a bit. Even slightly. It’s a meeting. There will probably be biscuits. Good ones. And it’s not visible from space either, David Nicholson.

But frankly it’s just the latest line in a long string of hysterical over-reaction that is reaching fever pitch at the moment. I read in yesterday’s Guardian that “We should be under no illusion that this is where Andrew Lansley and David Cameron are leading us: an Americanised system of privatised care.

It just isn’t. And I can’t understand where other people are seeing it. And yet it’s everywhere. People are really saying this quite a lot. Clever people with letters before and after their names. They really expect an American system here in the UK despite the fact that there is barely a person in the entire country that wants it to happen, let alone a person who is in any position to make it happen. And of course the great irony is that doctors are being offered the driving seat of what will actually happen anyway, so every cry of fear like this against the bill is essentially a great big vote of no-confidence in themselves.

Talking of which I much enjoyed the great big vote of no confidence in the bill from the nurses and midwives last week who threw their toys out of the pram at the government raising the private income cap on foundation hospitals to 49%. This was the final straw. Somehow, the final straw was not the initial proposal 18 months ago to remove the cap altogether, 49% is far worse… There’s no pleasing some people.

So let’s drop this bill. It’s causing utter chaos says shadow health secretary Andy Burnham, grandstanding on the BBC yesterday. But of course when pushed about what to do with the clinical commissioning groups, already formed and ready to run (as per a report in BMJ Careers today), he would of course keep them and allow them to take over existing structures, whatever they may be. So not exactly scrapping it then, Andy, more just continuing it with minor tweaks. Because, let’s face it, this has long been Labour policy anyway.

If this government has handled reform in the most cack-handed manner imaginable (and it has), it feels like a lot of the criticism is responding in kind.

Edward Davies is editor, BMJ Careers

  • Martin McKee

    Read what those of us criticising the Bill are saying. You are right in saying that we won't end up with a US style health system. But you are wrong if you think this is not the intention of the Bill. The problem is that there are four quite separate things going on:
    a) what the Bill says (while also reading related laws on competition etc. that give the words meaning) – and it clearly opens the door for a free market
    b) what the Secretary of State seems to think it says (which is clearly different from a) otherwise he would realise that he won't be able to order nurses to do hourly ward rounds etc.
    c) what the National Commissioning Board is implementing – entirely different from a) and as if it didn't exist
    d) what will happen – a mystery but unlikely to be good.
    But the Bill does matter, as that is what the courts etc. will use when disputes occur – see Co-operation and Competition Panel escalation of challenge to York PCT and Foundation Trust.
    Otherwise you will find yourself in the position of Arthur Dent in The Hitchhikers Guide to the Galaxy when told that his house (and the earth) were due to be demolished. The demolition crew and and the Vogons pointed out that these had been announced, it was his fault for not reading them. This time the message is in the opaque wording of the Bill, not on a different planet or “down two darkened flights of stairs behind a locked doo with a sign saying beware of the hungry leopard”. But do take Douglas Adams' advice please.