The Bill That is Right for the NHS

In the present gloomy times with continuous bad news about our NHS there is one glint of hope – the NHS Bill, which is the positive alternative to the increasing woes piled upon us by our government.

Bill reading 2 outside parl March 2

NHS campaigners outside Parliament for the Bill’s second reading in March


The Bill is a combination of the efforts of Lord David Owen, Allyson Pollock (Professor of Health Policy) and the Barrister, Peter Roderick. The Bill was presented to the House of Commons by Caroline Lucas (Green Party MP, Brighton) with support from SNP, Plaid Cymru and some Labour supporters. It did achieve a second reading, held in March, with the same supporters but no debate as it ran out of time because of filibustering and obfuscation by Conservatives.

All is not lost but to make progress the Bill needs more MPs to support it and the reason most give is that “the public don’t want another reorganisation” – a convenient excuse. But the inconvenient truth is that the public didn’t want any of the reorganisations that have taken place since 1990 nor do they want the continuous reorganisations that are taking place now.

The most important parts of the Bill will be an end to the market with its wasteful bureaucracy estimated at £5-10 billion and replacing competition with co-operation.

The harm of competition can easily be seen from a local example – the neighbouring hospital to my own trust lost two consultants (husband and wife) and could not find replacements. Knowing that patient care would suffer without adequate staff, along with other colleagues, I went over to provide outpatient and ward round sessions on a sessional basis. I advised that they reduced the outpatient sessions in keeping with the reduced staffing levels. However they would not, saying they must continue to compete with us and they could not afford to lose business.

So in the name of competition they struggled on with depleted staff when it would have made better sense to reduce the service to a level they could manage.

The Bill is not “another reorganisation”; it is to restore normality and to avoid it would be to allow the current reorganisations to continue. We do not have a period of consolidation, we have increasing fragmentation with many services reduced to make savings and Public Health budgets slashed.

The recurrent re-disorganisation is most harmful in areas where co-operation is key. One project launched in 2008, the Cancer Survivorship Initiative, demonstrates the point. There are now 2 million people who have been treated for cancer, many of whom have ongoing health needs requiring a structured approach beyond the treatment of the tumour alone.

From 2008 to 2012 pilot projects and rehab schemes were set up showing better outcomes including more patients returning to normal (including returning to work). The DoH wrote a good report on this entitled “Living well with and beyond Cancer” but in April 2013 the initiative ceased and a DoH department was disbanded with no coordination for this important work.

There were local cancer networks who could make some progress then they too were dissolved and replaced by the much smaller units of regional cancer networks. My local network is barely able to function through loss of staff.

I had been planning survivorship services with one of the network staff, now moving on as her post is discontinued.” Who shall I deal with in future?” I asked, “ I don’t know”, came the reply, “there may not be a network but there will be an alliance – I’ve seen a PowerPoint it says providers will need to talk to each other.”

So work requiring co-ordination planning, review and revision as we learn from experience will be replaced by nothing but a statement of good intentions.

If we don’t have a reinstatement of the NHS we will see the principles that made it great – coordination, planning and co-operation – being taken away to be replaced by continual fragmentation.

The Bill is the positive alternative.

Dr Eric Watts

Chair, DFNHS

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