40 health care experts warn that the Destroy the NHS / Health and Social Care Bill will “[usher in] a significantly heightened degree of commercialisation and marketisation that will lead to the harmful fragmentation of patient care; aggravate risks to individual patient safety; erode medical ethics and trust within the healthcare system; widen health inequalities; waste much money on attempts to regulate and manage competition; and undermine the ability of the health system to respond effectively and efficiently to communicate disease outbreaks and other public health emergencies”.

David Cameron responds: “Of course there are doctors and others within the NHS that are wary about parts of our proposals, about greater choice for patients, about greater competition with the NHS.

“There have always been opponents to that, but the point of the exercise we held in the summer, when we paused and restarted the reforms, was to bring more of the health service on board, and many GPs, many doctors and many in the health service recognise that change is necessary if we are going to drive up standards in the health service, in which we invest and care about so much.”

He added: “I think the reforms are right, I think they will improve patient care. Above all, they will be good for patients. They are going to give you more power and control over the care you get, a greater choice too, which I think patients will welcome.”

It appears that there is a choice between 40 accomplished health professionals and a former Bullingdon Clubber with a track record of lying and broken promises to get elected.

Professor Norman Williams, head of the Royal College of Surgeons warns that rationing operations in the short term will cost more in the long term.

Andrew Lansley to address the NHS-destroying Conservative Party Conference today.

A few recent news articles about the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.

Scrap NHS reforms, doctors tell Lords | Society | The Guardian

Experts including 40 directors of public health say government’s health and social care bill will cause ‘irreparable harm’

Sarah Boseley

More than 400 senior doctors and public health experts are calling on the House of Lords to throw out the government’s health and social care bill, saying it will do “irreparable harm to the NHS, to individual patients and to society as a whole”.

The signatories include Professor Sir Michael Marmot, the author of several reports on the links between wealth and health that suggest children born into poverty are penalised for life.

Marmot has until now not been openly critical of the coalition’s approach, and instead has offered encouragement for David Cameron and Andrew Lansley’s apparent enthusiasm for public health.

But Marmot and others in senior positions have now concluded the bill will damage all aspects of the health service.

“While we welcome the emphasis placed on establishing a closer working relationship between public health and local government, the proposed reforms as a whole will disrupt, fragment and weaken the country’s public health capabilities,” says the letter.

“The government claims that the reforms have the backing of the health professions. They do not. Neither do they have the general support of the public.”

The letter details the harms the experts believe the health reform bill will do.

“It ushers in a significantly heightened degree of commercialisation and marketisation that will lead to the harmful fragmentation of patient care; aggravate risks to individual patient safety; erode medical ethics and trust within the healthcare system; widen health inequalities; waste much money on attempts to regulate and manage competition; and undermine the ability of the health system to respond effectively and efficiently to communicate disease outbreaks and other public health emergencies,” the letter says.

In their judgment, the signatories say, the bill “will erode the NHS’s ethical and co-operative foundations” and “will not deliver efficiency, quality, fairness or choice”.

The signatories include around 40 directors of public health from around the country who have taken the difficult decision to go public with their concerns. There are also two senior members of the Faculty of Public Health, one of whom, Dr John Middleton, is a vice-president. Other well-known names include Professor John Ashton, director of public health in Cumbria, and Professor Michel Coleman from the London School of Hygiene and Tropical Medicine.

Dr David McCoy, consultant in public health medicine at the Inner North West London primary care trust, one of the organisers of the letter, said he was surprised at the number of people prepared to sign. “I think if we had continued to collect signatures, I’m quite sure we would have collected another 200 It is having a snowball effect,” he said. “I think the feeling is incredibly strong.”

There was a lot of debate about whether we should call for outright rejection or amendments, but there is a feeling the whole package of reforms is harmful and we need to express our position in the strongest terms. I think there was a feeling the forthcoming reading in the House of Lords is the last chance of minimising the harm and damage.”

The public health community has not spoken out in this way before. “I think there has been an attempt to work with the reforms and work behind the scenes to optimise the proposed reforms,” said Dr McCoy.

Dr Middleton said there was no great opposition to the planned move to place public health services such as smoking cessation within local authorities. “But the letter is a recognition from the public health community that the reforms proposed around the NHS are deeply damaging to the public health in themselves,” he said. There was concern that they would lead to inequalities in healthcare and less access for the poorest and most deprived to the services they need.
…

Cameron defends coalition NHS reforms – UK Politics, UK – The Independent

…
Mr Cameron told ITV1’s Daybreak: “Of course there are doctors and others within the NHS that are wary about parts of our proposals, about greater choice for patients, about greater competition with the NHS.

“There have always been opponents to that, but the point of the exercise we held in the summer, when we paused and restarted the reforms, was to bring more of the health service on board, and many GPs, many doctors and many in the health service recognise that change is necessary if we are going to drive up standards in the health service, in which we invest and care about so much.”

He added: “I think the reforms are right, I think they will improve patient care. Above all, they will be good for patients. They are going to give you more power and control over the care you get, a greater choice too, which I think patients will welcome.”
…

Commentary: these reforms will leave NHS a poorer service – Telegraph

* Dr David McCoy is a Consultant in Public Health Medicine in Inner North West London and Senior Clinical Research Fellow at the Centre for International Health and Development, University College London

[snipped a long but interesting section on the health service in Apartheid South Africa]

Now in the midst of the NHS’s transformation, I am struck by the contrasts to South Africa. Instead of strengthening the functional integrity of the health system, the reforms have created chaos and disorganisation.

Instead of protecting the public and patients from the corrosive effects of commercialisation, competition, private capital and the financial motive is being encouraged. And instead of directing more money towards benefiting patients, a rising proportion of expenditure will be siphoned out of the NHS as surplus value for private profit or on the infrastructure required to“manage competition”.

The NHS may remain publicly funded and mostly free at the point of service. But it will become a poorer service; and it will stop being a single, comprehensive and universal system for all. It will become a more fragmented and uneven collection of service points operating in parallel to systems of private insurance and with multiple tiers of care.

As for public health, when the reforms were first announced, many professionals saw the glint of a silver lining. The government was proposing to elevate the profile of public health by creating a dedicated public health agency and ringfencing public health budgets.

The proposal to move certain functions to local government was welcomed as a means of placing greater emphasis on ‘upstream’ determinants of health such as education, housing, diet, leisure and exercise. Even the ‘Big Society’ chimed with the evidence that social empowerment and solidarity underpin good health.

However, there are a many threats to public health. Organisational disruption has resulted in huge amounts of money, time and energy being diverted from real work, including the sustained development of shared knowledge, understanding and trust across the different elements of the health care system, local government and communities – vital for the building of participatory and integrated responses to rising unemployment, youth alienation, fuel poverty, social inequality and homelessness.

Public health will also be downsized and subjected to competition and commercialisation, including a ‘reductionism’ in which it will be broken up into discrete interventions, some of which will be commoditised and outsourced.

The direct involvement of businesses in the formulation of public health policy, contrary to professional advice and evidence,also signals a backward step in the urgent need to regulate the food, alcohol, sugar and tobacco industries.

The relationship between public health and clinical care may also become more distant. At the moment, local public health and clinical budgets are mostly held together within Primary Care Trusts.

But in the future, public health and clinical budgets will be spread across different organisations, potentially undermining the public health function of bridging clinical medicine with the social context and physical environment of families and patients. Cancer screening, immunisations and communicable disease control will become harder and more costly to deliver.

Critics of the reforms are frequently labelled as being ‘anti-privatisation’. But it is commercialisation, the intrinsic tendency for health care markets to fail and the damage that competition does to patient care, trust and ethical practice that lie at the heart of most objections.
…

Health is a lottery in out-of-control NHS, warns top surgeon – Health News, Health & Families – The Independent

A postcode lottery has returned to the NHS with “a vengeance”, the leader of Britain’s surgeons warned yesterday, as hospitals look to secretly cut costs without consulting doctors or patients.

Professor Norman Williams, the new head of the Royal College of Surgeons, said some hospitals were now rationing operations that would have otherwise saved the NHS money in the long term, because of a short-term desire to cut costs.

“We are back at the moment to a postcode lottery with a vengeance,” he told a fringe meeting at the Conservative party conference. “This is happening without any transparency of public debate and often without clinical involvement.”

Today Andrew Lansley, the Health Secretary, will address the conference and highlight some of the progress the NHS has made in investing in frontline services by taking away “bureaucracy” from the NHS. He will also announce new mandatory language checks for NHS doctors to ensure only those who can speak “a good level of English” are allowed to practise.

Highlighting some of the problems thrown up by the Government’s reorganisation of the NHS, Professor Williams said some health authorities were now unilaterally restricting operations which had significant clinical benefit.

Some were refusing to give gastric bands to morbidly obese patients while others who needed hip or hernia operations were also being denied them.
…

 

27/11/13 Having received a takedown notice from the Independent newspaper for a different posting, I have reviewed this article which links to an article at the Independent’s website in order to attempt to ensure conformance with copyright laws.

I consider this posting to comply with copyright laws since
a. Only a small portion of the original article has been quoted satisfying the fair use criteria, and / or
b. This posting satisfies the requirements of a derivative work.

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