A leaked memo reveals that the Health Secretary will not remain responsible for the NHS despite repeated ConDem assurances that he would. You can’t trust the Tories – or the Lib-Dem Tories – with the NHS.
- Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
Malcolm Grant, the government’s choice to run the powerful NHS commissioning board, makes remarkable admission
The health secretary will “franchise” the running of the NHS to a quango for up to three years at a time – a move that will result in an unelected academic and the nation’s 38,000 family doctors, rather than ministers, being accountable for the day-to-day running of the health service, according to leaked documents obtained by the Guardian.
In unpublished evidence to the health select committee last week, Malcolm Grant, the government’s choice to run the powerful NHS commissioning board, outlined “an extraordinary transformation of responsibility” that appears to undermine claims by ministers that the proposed legislation will not dilute the government’s constitutional responsibilities to the health service.
At present, the cabinet minister for health has a “duty to provide a national health service” in England, but that disappears in the NHS bill’s proposals.
Grant, a law professor who runs University College London, told MPs that, under the new system, the secretary of state “mandates” the commissioning board to run the NHS every “two … possibly three years” and then retreats into the shadows. The board will hand over taxpayers’ cash to groups of GPs to buy services on behalf of patients.
He admitted there would be “a fundamental change of responsibility and accountability under the bill” because about £80bn of public money would be transferred to the board and GPs. He said these two groups – not politicians – would run the NHS and ensure patients received an adequate level of health provision in England.
“If [GPs] are dissatisfied with what happens in a hospital, they need to deal with it and not simply complain to a secretary of state who no longer has this responsibility, nor to the commissioning board which has given them the responsibility, but to complain to the hospital and get it sorted, and, if it is not sorted, to use their commissioning power to ensure that it is.”
With peers beginning line-by-line scrutiny of the coalition’s NHS bill on Tuesday, the government has been attempting to rebut detractors of all political persuasions influenced by the powerful Lords constitutional committee.
The committee warned last month about the “extent to which the chain of constitutional responsibility as regard to the NHS [will be] severed”. In what is perceived as a sign of panic over the level of peers’ opposition, a 72-page letter from ministers sent to all peers last week conceded a “necessary amendment” might be needed to rectify the impression the government would not be “responsible and accountable” for the NHS.
UNISON, the largest health union, said today that its worst fears for accountability in the NHS were being realised. Leaked documents have today revealed that the Secretary of State for Health would lose accountability for the health service, under plans set out in the Health and Social Care Bill.
Christina McAnea, UNISON Head of Health, said:
“Here are our worst fears for NHS accountability realised. We have long been warning that the Bill would mean the Secretary of State for Health would lose accountability for the health service – and here is the proof. This is just another reason why the Bill represents the end of the NHS as we know it.
“But all is not lost – line by line scrutiny in the Lords begins tomorrow. If peers vote to amend Clauses 1 and 4 of the Health Bill, it could keep the Secretary of State ultimately responsible for the health service. We are calling on them to do so.”
RELATIONSHIPS between family doctors and their patients could be damaged by the Government’s controversial NHS reforms, according to new research published today.
The findings are revealed in a study published by the British Medical Association (BMA), which is described by the association as being the “most significant survey of GP opinion in recent years”.
Every family doctor in the UK was approached to take part in the research and around 40 per cent – 18,757 out of a possible 46,700 GPs – responded.
The figures show that seven out of 10 GPs are concerned about conflicts of interest resulting from the NHS reforms, and the same number also say they are concerned about the impact the Health and Social Care Bill could have on the patient-doctor relationship.
Sixty-nine per cent of doctors, meanwhile, say they are worried about their proposed role as both the commissioners and providers of care.
Dr Laurence Buckman, chairman of the BMA’s GPs Committee, said: “The huge response rate shows how strongly GPs feel about the topics in question, particularly when it comes to the changes being made to the health service in England.
“GPs do not want the trust patients put in them to be damaged by these reforms, yet this is exactly what they fear will happen.
“The Government must take heed and further revise its plans for the quality premium in particular, to avoid any potential damage to the doctor-patient relationship.”
The BMA said the results of the study should “serve as a crucial measure of GP opinion for years to come.”
Some three quarters of GPs said they do not agree with the Government’s proposals to link practice income to the performance of their commissioning group, while 85 per cent do not believe that practice boundaries should be abolished.
Other findings show that 88 per cent of doctors say the “intensity of their consultations” has increased in the last five years, while 84 per cent say the “complexity of their consultations” has increased over the same period of time.
Dr Buckman added: “General practice has undergone huge change since the last time we carried out a survey of this size in 2007 – and this is shown clearly by the belief among the vast majority of GPs that the nature of their work has become more complex and intense.
“Much of the work we do now, such as looking after people with diabetes, used to be done in hospital and even though it’s work we want to do because of the clear benefit to patients, it has made it harder to fit a consultation into a ten-minute time slot and it can make it more difficult to deal with surges in demand.
“I’d like to thank all the GPs who filled in the survey as it has given us a great insight into the GP workforce.
“It will be invaluable in shaping our priorities in the months and years ahead.”