Both Lansley and his leader David Cameron are doing the rounds this week in an attempt to alleviate a growing consensus of concern about both what is proposed and how quickly it is happening.
The proposals first outlined in the health white paper and now in the bill are tantamount to the biggest structural change to the NHS since its inception in 1948. By creating ‘GP consortia’ and introducing greater competition for contracts and services the NHS will be dismantled and effectively de-nationalised, creating a ‘postcode lottery’ and greater disparity of service and treatment than we have ever known before.
In a speech on Monday, Cameron smugly denounced assertions that there was no appetite for the changes by referring to around 140 GP led consortia that have come forward. However, Cameron’s confidence selectively overlooks the fact that every single major health organisation is opposed to the changes, including professional associations like the Royal College Nursing, the Royal College of General Practitioners, the Royal College Midwives, Chartered Society of Physiotherapy, the British Medical Association, the trade unions with health membership – such as Unison and Unite – and the NHS Support Federation, the NHS Confederation and the Kings Fund.
Prior to the general election, the Tory leader painted himself as ‘Caring Cameron’ promising that the NHS was safe in his party’s hands. This week the mask has slipped and Cameron has well and truly reverted to Tory type. His real feelings on the NHS were revealed by his slip of the tongue about the NHS being ‘second rate’, cemented by a reverence for Thatcher’s changes to public services in the 1980s and topped off with a cheap swipe at what he termed ‘the vested interests of the trade unions’.
The trade unions have both right and reason to be angry about the Conservative government’s plans for the NHS. Unions are not just the voice of our members in the workplace – the hardworking people that without whom there wouldn’t be a NHS – but also in the wider community. Together we have millions of members, millions of members who themselves, their family and friends depend on their local NHS services.
These changes will not just cost our members jobs, they will cost our future generations a National Health Service that we have benefited from. On the subject of cost, the Kings Fund estimates the structural changes to the NHS will cost between £1.2 billion and £3 billion; at the same time savings are being forced and NHS employees are subject to a two year pay freeze.
There are some in the Labour party, who, it pains me to say, don’t have a problem with the privatisation of public services. On this one we all need to stop, look and listen – the proposals in this bill are on another level. Put in the most basic sense, they are the wrong changes at the wrong time. At a time when, despite Conservative reassurances that the budget is ringfenced, the NHS is being expected to find £20 billion worth of efficiency savings. Strong concerns over the timing of these changes have been voiced by the NHS Confederation who have said; “It will be exceptionally difficult to deliver major structural change and make £20bn of efficiency savings at the same time … we have major concerns that this will not be possible with 45% management cost reductions … after analysing the proposed new system, we have identified significant risks, worrying uncertainties and unexploited opportunities.”
Cameron opined that we need to grow up about the debate on privatisation. But the reality is that these changes are on a scale never before seen. Out of an overall NHS budget of £100billion, £80 billion worth of public money will be given over to groups of GPs. This is despite the fact that the BMA has reported that 80 per cent of GPs don’t think it will improve patient care. Cameron wants to open up our public services to greater competition but there is evidence that price competition in health services is dangerous, and nowhere are such experiments more dangerous than in the NHS where lives really are at stake.
Cameron also said in his speech that this restructuring of the NHS was about making professionals answerable to the people. If these changes go ahead the professionals will be answerable only to private companies. We will have a denationalised health service driven by profit not people and who can do what for less – seeing services scaled right back and in some areas disappearing altogether. The only people that will benefit are those who run or who have financial interests in private health companies. The worse off will be hit the hardest.
It is no wonder then that polls regularly show that much of the public still don’t trust the Tories when it comes to the NHS. What we are witnessing now shows that we are right to fear for our NHS when it is in Conservative hands. We know that time and time again Cameron and Lansley are not being honest about the NHS. They said it was ringfenced when £20 billion efficiency savings are being demanded. When questioned in parliament, Lansley unequivocally stated it was only management jobs that were being lost when we know that clinical positions are already in the firing line. They promised an end to the top down re-organisation of the NHS but instead are presenting us with the greatest upheaval in its history. Not one single person voted for these costly changes – changes that were strangely omitted from the Conservative manifesto and the coalition agreement.
When talking about the NHS this week, Cameron said that “doing nothing will end up in tears.” He is right on one thing – if we do not join together to campaign and argue against these proposals we will all shed a tear when we wave goodbye to the NHS as we know it forever. We cannot let that happen, we must stand up and speak out to save our NHS.