Too late to stop NHS reform? Medical journals launch rearguard defence

Cameron and Clegg make their case during the listening pause. Critics believe it may already be too late to stop the changes going ahead.
Cameron and Clegg make their case during the listening pause. Criticis believe it may already be too late to stop the changes going ahead.

By Ian Dunt

Three leading journals have launched a coordinated defence against Andrew Lansley's NHS reforms, despite widespread resignation to the idea that it may already be too late to stop it.

The bill is currently in the Lords but changes to primary care trusts and strategic health authorities have been taking place on the ground, making it hard to envisage any reversal of the policy.

A joint editorial in the Health Service Journal, Nursing Times and British Medical Journal said that even now it would be wiser to scrap the legislation rather than fully implement it.

"The coalition government’s NHS reforms now command little support from the health professions, healthcare organisations, think tanks, patient groups, the media, or the public," the editorial reads.

"With many voices now calling for the bill to be withdrawn, it is worth giving serious consideration to what would happen if the government were to abandon it, and what the consequences would be for the NHS and for patients."

The journals argued that the "unholy mess" of NHS reform would require another substantial reorganisation within five years just to correct the damage it does to the health service.

The move brings medical experts firmly into line with unions. The Royal College of Nursing, Royal College of Midwives, the British Medical Association and the union Unison are all implacably opposed to the reforms.

Ministers had to step in at the last minute to prevent medical royal colleges, which set standards in the NHS, from joining them.

"The chorus of protest against David Cameron and Andrew Lansley's ill-conceived plans for the NHS grows louder by the day, uniting voices across the health world," shadow health secretary Andrew Burnham said.

"This is a powerful and scathing critique of the government's handling of its NHS re-organisation from three of the most respected voices in healthcare.

"It reflects the strength of feeling in the health professions and echoes the widely-held that this bill is unnecessary and a distraction from the financial challenge facing the NHS."

The Lords are unlikely to demand too many changes from the bill currently going through the second chamber, although unconfirmed reports over the weekend suggested Mr Lansley was prepared to offer up to 200 amendments when it returned next month to alleviate the concerns of critics.

The focus of resistance would then swing back to the Lib Dems but with Nick Clegg having made a great deal of noise about changes secured during the 'listening pause', he is unlikely to marshal MPs against it now.

Regardless of events in parliament, changes have been taking place on the ground to make the reforms a reality.

The existing 151 primary care trusts have been merged into 50 commissioning clusters. Strategic health authorities have been merged into four hubs. Enough GPs have come together to manage the commissioning boards and a new specialist national board is part-formed, with chief executive Sir David Nicholson already in place.

The medical journals and Labour say that £1 billion can still be saved if the plans stop now.

The NHS Commissioning Board, 20 clinical commissioning groups and new regulator Monitor will together account for most of that sum by 2013.


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