Thursday, 1 March 2012

This is what is wrong with the NHS Bill

BFTF has been watching the recent media coverage of the Health and Social Care Bill with mounting concern that so many organisations were against it - but BFTF also didn’t quite understand what specific clauses were causing the furore.

Until now.

A Tweet pointed BFTF towards the site of Prof Allyson Pollock (professor of public health research and policy at Queen Mary, University of London). Allyson, with the help of others, has compiled a series of briefing papers on the Bill, each dealing with a few of the clauses of the bill.

One of these, which briefs on Clauses 1,10,11 and 172, contains a very clear, concise and frightening summary of some of the key problems with the bill :

"Whereas primary care trusts (PCTs) act on behalf of the Secretary of State, clinical commission groups (CCGs) will exercise functions in place of the Secretary of State but without a clear primary legislative framework . . The Government deliberately avoids legislating for Commissioning Groups duties with respect to the services that must be provided and the groups to whom they must be provided . . .CCGs are only required to have “a sufficient geographic focus” but the term is not defined.

It really is very frightening stuff.

Oh and by the way, the bill's proposals were not discussed during the 2010 general election campaign, nor were they contained in the Conservative – Liberal Democrat coalition agreement.

You can out more from those who oppose the bill here:

Nice summary of many of the key points. A lot better than the BFTF post you are reading, to be honest.

A post at giving more details on some of the dangers in the legislation.

And a briefing paper covering similar ground

Also, a moving article against the NHS bill in the Telegraph.

An article by Eoin Clarke on some lobyyists urging that the NHS be dismantled.

In the interests of balance, BFTF should provide some resources in favour of the bill, so here is an article by Baroness Warsi, outlining the Conservative perspective.

And here is a blog post that tries hard to be as even handed as possible.

Letters and Emails
BFTF has challenged the local Conservative Party on a number of these issues via email. They have, it has to be said, responded directly to every point raised. They key points of their responses are shown below :

Regarding Prof Pollock
. . .With regards to your questions about Prof Pollock’s report, it is important to remember that she is a long-time opponent of the introduction of competition into the NHS, and that other academics have taken very different views of the proposals. . .

Regarding providing links to academics supporting the reforms, Notts Conservatives suggested reading the following:
Regards academic reports that support competition in health care, can I suggest the following: Dr Zack Cooper et al , The Economic Journal, Volume 121, Issue 554
Carol Propper, Imperial College London, Healthcare competition saves lives & On the benefits of competition in healthcare
Bloomer, Propper, Seiler and Van Reenen, Stanford The Impact of Competition on Management Quality
Richard Cookson, York University, Impact of reintroducing competition in the English NHS
Regarding Ministerial responsibility
. . There is no alteration to Ministers’ responsibility, only the way in which they are responsible. The Secretary of State’s overarching duty to promote a comprehensive health service does not change, and they will retain ultimate accountability for securing the provision of services with an extensive set of powers to set objectives for and oversee the NHS and ensure that services are being provided effectively. . .
Regarding Geographical areas
. . . CCGs will of course have a geographical area; however these will be of their own defining. CCGs will need to pass a rigorous authorisation test before being given freedom to manage local NHS budgets, and the NHS Commissioning Board’s role in this is to ensure that CCGs are set up in such a way that all GP practices are members of a commissioning group and that there is comprehensive geographic coverage. . .
Regarding increasing the amount of private work allowed in NHS hospitals from 3% to 49%?
. . . The bill looks to enshrine in law the fact that the absolute maximum of their income that can come from private funds is 49%. This ensures that hospitals remain predominantly public funded. The 49% is a maximum, not a target, and indeed many foundation trusts will likely remain at their current 2-4% income from private sources. Ultimately the NHS has been generating private income since 1948. Currently profits from specialised services that are largely delivered privately go to shareholders of those private companies. The coalition partners would rather see that money benefiting the NHS. Hospitals such as Great Ormand Street , which provide special services, can reinvest funding from private sources to the benefit of the NHS. Indeed, GOH already receives something like 10% of its income from private funding.. . .

Other pro-reform / neutral articles (dug out by BFTF)
An article by Baroness Warsi, outlining the Conservative perspective.

And here is a blog post that tries hard to be as even handed as possible.

The "Block the Bridge" protest event against the bill.

Petitions (probably a bit late now, but left on post for refernce)
You may wish to sign one or more of the petitions calling for the government to halt this bill:

Image Source : Wikipedia

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