With MPs meeting to vote on the final report stage of the Health and Social Care Bill next week this is crunch-time for the NHS.
Having only allowed two weeks to vote on the new bill earlier this summer there is a genuine concern that ministers are looking to railroad this legislation through the Commons. MPs will get only two days to debate these amendments next week, as the prime minister and his deputy hope to square everything off before their party conferences.
Individuals and organisations concerned about the changes only have limited time to force the government to re-think its position.
The Health and Social Care Bill: Re-branding not Re-thinking
As you will know the government announced its plans for NHS reform in the Health and Social Care Bill back in January of this year.
It does not need re-stating that the Bill was highly controversial. The original Bill wanted to achieve the following things through changes to the NHS:
• To hand responsibility for the commissioning of services and medication for patients to groups of GPs in ‘consortia.' In my view this would mean they would either have to spend less time providing frontline services or would have to employ private administrators to run them (in many cases this is likely to be Primary Care Trust staff who have just been made redundant at cost) resulting in more tax payer money turning into private profit;
• To increase the amount of private investment in the NHS and allow private companies to run NHS services and use NHS facilities meaning tax-payer money going into the pockets of private health providers;
• To stop local people from campaigning to save their local health services if it was at risk from closure;
• To make the regulatory body Monitor's prime function to promote competition and private investment rather than promote the best quality care.
These initial proposals caused outrage amongst doctors, nurses and the general public and rightly-so. As you will know the result was that David Cameron and Andrew Lansley announced they would conduct a ‘listening exercise' in order to take into account the concerns of health professionals and the rest of the country.
However, despite the work of Dr. Steve Field of the NHS Future Forum and his team in conducting an in-depth consultation and suggesting a comprehensive set of proposals to modify the Government's original intentions, the amendments the Government put forward amounted to little more than a re-brand rather than a genuine re-think.
The new amendments in the Bill have made it much vaguer. This means that although the Government has amended some of the specific points of controversy it has not put sufficient safeguards in their place. For example, the Government have agreed to amend Monitor's key role from that of promoting competition but they have not said what will replace this. As a result I believe even more loopholes for back-door privatisation have been created.
On top of this, while trying to paper over the cracks of an already flawed bill, the government has created a contradiction between what they have said they want and what is actually in the bill. For example, they have said they want fewer commissioning boards than currently exist but with the short-term political fixes they have made to the Bill, it is almost certain that more will be created. This simply means more bureaucracy.
But it isn't just the Health and Social Care Bill which threatens the future of our NHS. During the furore surrounding the phone hacking scandal, the government buried news of its plans for £1bn of NHS spending to be given to private companies. This is on top of £20bn cuts to the NHS across the country.
It is for this reason that along with the BMA and other major healthcare groups, I will still be opposing the Bill and asking for the government to honour its pre-election promise of increasing NHS spending instead of cutting it as it is currently doing.
Hospital and A&E waiting times increase
Cuts to NHS spending are already having an impact. Official data shows that the number of people waiting for NHS care has risen sharply, with hundreds waiting more than a year to be offered treatment.
Despite the efforts of NHS managers to ensure that patient care is not affected by the £20bn of funding that needs to be squeezed from budgets over the next four years, the number of people forced to wait six months has leapt by 61% in a year. The Department of Health's own figures show 11,857 people in June had waited half a year to receive treatment, up from 7,360 in June 2010.
This comes on the heels of evidence collected by BBC Newsnight earlier this year which showed that the number of patients waiting more than four hours for treatment in accident and emergency departments has increased by 63% since the Government scrapped the waiting time target put in place by the last government.
That data (see below) showed an extra 73,000 patients were left with waits over four hours in the last three months of 2010 compared with the previous year.
See the national data here: