The NHS Consultants’ Association backs the BMA campaign to withdraw the Health and Social Care Bill.
Following the Executive Committee meeting of the NHSCA on the 4 August 2011, there was a unanimous decision to congratulate and support the BMA over its decision to mount a public campaign to call for withdrawal of the Health and Social Care Bill.
The NHSCA continues to believe that the Health and Social Care Bill represents the greatest threat to the NHS in its history. Despite the government’s proposed changes to the Bill following the Future Forum report, the key policy levers to deliver a full blooded market based system with increasing NHS privatisation remain intact. Worse still, the bill is now even more complicated and will be more costly to implement.
The Royal College of GPs has worked out that the number of NHS statutory bodies is going to increase from 163 bodies to 521! No wonder why Dr Hamish Meldrum, chair of BMA council stated that the Bill was: “Hopelessly complex and it really would be better if it were withdrawn.”
We are now left with a policy mess, at a time when the NHS is facing the greatest funding crisis in its history, with the QIPP efficiency drive aiming to deliver £20bn of savings by 2014. This will actually act as a catalyst to drive increasing privatisation of the NHS, as PCT clusters are forced to ration NHS care due to financial constraints, and NHS trusts come under huge financial pressure to cut costs.
We are already seeing an increase in NHS waiting lists and many PCTs reducing their lists of ‘NHS core services’, both of which result in increasing uptake of private health insurance policies. This has been widely reported in the media (here and here).
The Bill will also abolish the private practice income cap on foundation trusts, which will be under severe financial pressure to treat more PPs to increase their income. Some trusts will be forced into mergers, management takeovers, or even have to close down under the proposed legislation. This pressure will be increased with the introduction of new providers into the system through the ‘any qualified provider’ (AQP) policy, which is just a rebranded version of the previous ‘any willing provider’ policy.
The AQP policy is a key privatisation mechanism and is strengthened by the abolition of the NHS ‘preferred provider policy’. This will clearly impact upon the working lives of doctors as increasing numbers will find themselves working for private healthcare companies. Existing workers will have their terms and conditions protected by TUP legislation, but new employees to the NHS will not have these protections.
The most worrying aspect of the legislation is that once the Bill is enacted, the NHS is highly likely to be subjected to EU competition law because of the more open market nature of the system. This will make it nearly impossible to reverse the policies and the NHS will be finished as a comprehensive publicly funded, publicly provided and publicly accountable system.
It is therefore crucial that the profession backs the BMA over this public campaign to call for withdrawal of the bill. The presidents of the royal colleges should also be lobbied to back this campaign. This is the last chance saloon for the NHS and we must grasp it before it is too late.
Conflict of interest of author: Dr Clive Peedell is co-chair of the NHSCA and also a member of BMA council. However, the decision of the NHSCA exec committee to back the BMA was unanimous.