Cameron knows best: selective listening on NHS reforms

21 March 2012

Concerned about our NHS? You’re not alone. According to a recent poll, only 10% of voters think the NHS is “safe in David Cameron’s hands”. In fact, you’d be hard pressed to find anyone who thinks the Health and Social Care Bill is a good idea.

The bill, currently under scrutiny by the House of Lords, involves the wide scale restructuring of the NHS, and introduction of competition into service provision. This Saturday the Royal College of Radiologists joined the long list of respected medical organisations opposing the bill; but Cameron and his health secretary Andrew Lansley are still standing strong on the reforms. Who knew a degree in politics made you savvier than the likes of the British Medical Association (BMA) and the Royal College of General Practitioners (RCGP) when it comes to the NHS?

To quote the chair of the RCGP “the bill is a mess”. With the NHS already under incredible financial pressure, these poorly planned reforms are just too much too fast. Changes will become confused, as multiple uncoordinated initiatives are related but not properly linked. Reforms are supposed to reduce bureaucracy, but the structure is becoming increasingly complex, and much of the detail is being left to secondary legislation. The effects of these reforms have not been thought through. This is highlighted by government refusal to publish the ‘risk register’ of the bill, especially after regional risk registers were found to predict extreme risk of ‘reduction in quality of patient care’. While organisations like the BMA share part of the reform’s vision, (achieving clinician lead, patient focused care), the BMA warns that “the government reform is adversely affecting the ability of the health service to deal with the real priority of improving the quality of care in the face of financial challenge”. The medical organisations have a clear message: the NHS needs change, but this change must be evolutionary, not revolutionary.

What is interesting is that medical organisations are opposing the reforms more on a practical basis than on controversial, ‘political’ grounds of privatisation. While it is clear many of them believe that privatisation would lead to a shift in focus from patient care to profits, perhaps they hoped the government would be more receptive to a practical objection.

No such luck – ‘trust me, I’m a Doctor’ doesn’t seem to wash with our PM, who continues to ignore the plea of the medical community. The RCGP represents 44,000 GPs, 90% of whom ask for withdrawal of the bill. But these 39,600 GPs have got nothing on Cameron – so confident is he in his knowledge of NHS matters, that he didn’t feel it necessary to invite the RCGP (or any of the leading medical organisations opposing the bill) to the No. 10 Health Summit on reforms last week because they were not “constructively engaged in implementation”. It is always encouraging to know the leader of your country is in touch with his inner child; selective listening is the oldest trick in the book. But we aren’t about to pin the NHS’ decrepit remnants to our fridge with a magnet and pretend its all ok.

The bill is also meeting increasing opposition from the crossbench peers, the conservative cabinet and the Lib Dems, with Clegg ‘losing more activists than he did on tuition fees’. There are even reports that Clegg himself is considering withdrawing support – Shirley Williams recently revealed that Clegg hadn’t even read the bill when he gave it his backing last year! Cameron claims he is “prepared to take a hit” with these reforms and that the “right thing isn’t always easy”. Well, he’s got one thing straight, it definitely isn’t easy to come clean to an entire country, and I would guess that’s why he’s not doing the ‘right’ thing right now. Either that or we should just trust him – after all, he is our Prime Minister…

Karissa Singh is a first-year Natural Scientist at Homerton