{"id":8929,"date":"2011-05-20T14:22:28","date_gmt":"2011-05-20T13:22:28","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=8929"},"modified":"2011-05-20T14:22:28","modified_gmt":"2011-05-20T13:22:28","slug":"annabel-ferriman-what-a-way-to-decide-the-future-of-the-nhs","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2011\/05\/20\/annabel-ferriman-what-a-way-to-decide-the-future-of-the-nhs\/","title":{"rendered":"Annabel Ferriman: What a way to decide the future of the NHS"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/site\/channels\/icons\/annabel.jpg\" alt=\"Annabel Ferriman\" width=\"160\" height=\"110\" align=\"left\" \/>Suddenly Health Secretary Andrew Lansley\u2019s proposals to \u201creform\u201d the NHS look safe. For more than nine months, since the publication of <em>Liberating the NHS<\/em> last July, doctors, nurses, think tanks, and academics have been begging Lansley to re-think his ideas. By the start of the \u201cpause\u201d in April, it looked as though the government would take some of these criticisms on board and make concessions.<!--more--><\/p>\n<p>Now that looks unlikely.\u00a0 This week saw the return of tribalism in politics.\u00a0 Lansley got a rapturous response from the 1922 Tory backbench committee on Wednesday night.\u00a0 All the MPs banged their desks to show their support, cheered him to the rafters and lauded his reforms as the saving of the NHS.\u00a0 Why? Had they been scrutinising new research about the effect of GP commissioning on health outcomes or the financial implications of all trusts getting foundation status?\u00a0 No, of course not.\u00a0 They loved him because he was one of them and not one of the \u201cyellow bastards\u201d (the Lib Dems), whom they are saddled with in coalition government.<\/p>\n<p>Ever since the Lib Dem leader Nick Clegg said that the Health Bill had to be modified, support for Lansley has been growing. The Tories are no more convinced now that the reforms will work than they were before the AV referendum and the local council elections on 5 May, but they don\u2019t want those Lib Dems to steal any credit for \u201csaving the NHS.\u201d\u00a0 This is Tory politics blue in tooth and claw.\u00a0 They hate Clegg for trying to exercise more power at a time when he and his followers should be accepting less, since the local elections showed the Lib Dems at a new low.<\/p>\n<p>For a brief few weeks in April and May it looked as though the government might be swayed by research on healthcare to make some sensible changes. But now it is goodbye evidence based policies. Farewell rational decision making. Welcome tribal politics, wheeling and dealing on amendments to the Health and Social Care Bill, and fancy footwork on the part of Cameron and Lansley.\u00a0<\/p>\n<p>All the research work done by the Nuffield Trust on the US experience of handing over commissioning budgets to doctors over the past 20 years might just as well never have happened (<a href=\"http:\/\/www.bmj.com\/content\/342\/bmj.d337\">BMJ2011;342:d337<\/a>). Carol Propper, of the London School of Economics, whose research showed that price competition in health services led to lower quality of care and higher death rates, might just as well have not bothered (<a href=\"http:\/\/www.bmj.com\/content\/341\/bmj.c7366.full\">BMJ2010;341:c7366<\/a>). And the Health Committee need not have spent months taking evidence for their report in April,which warned that the reforms would demoralise the workforce and divide primary and secondary care further rather than bringing them together (<a href=\"http:\/\/www.bmj.com\/content\/342\/bmj.d2180.full\">BMJ2011;342:d2180<\/a>).<\/p>\n<p>No, all this is likely to go by the board because if the Tories are seen to concede anything on the Bill it will look like a feather in Clegg\u2019s cap and a dent in Cameron\u2019s virility.\u00a0 What a way to determine the future of the NHS.\u00a0<\/p>\n<p><em><strong>Annabel Ferriman<\/strong> is the news editor, BMJ<br \/>\n<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Suddenly Health Secretary Andrew Lansley\u2019s proposals to \u201creform\u201d the NHS look safe. For more than nine months, since the publication of Liberating the NHS last July, doctors, nurses, think tanks, [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2011\/05\/20\/annabel-ferriman-what-a-way-to-decide-the-future-of-the-nhs\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[116],"tags":[2053,14755,1939],"class_list":["post-8929","post","type-post","status-publish","format-standard","hentry","category-editors-at-large","tag-andrew-lansley","tag-nhs","tag-nhs-reforms"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Annabel Ferriman: What a way to decide the future of the NHS - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2011\/05\/20\/annabel-ferriman-what-a-way-to-decide-the-future-of-the-nhs\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Annabel Ferriman: What a way to decide the future of the NHS - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Suddenly Health Secretary Andrew Lansley\u2019s proposals to \u201creform\u201d the NHS look safe. 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