The way we deliver health reflects the society we live in. Both David Cameron and Andrew Lansley would like this to be “Big” but what the proposed reforms will actually mean, is private and unequal.
After two weeks to digest the news that the reforms bought to the table, I thought I’d take a journey, gathering information from meetings, protests and the media and find out what life as a patient with Andrew Lansley could really be like.
Reports of plans to turn the NHS into a “social enterprise”, such as companies like John Lewis, are hoping to soften the blow, but realistically this takes a long time to work, and probably won’t. The NHS will exist as a regulator and a funder but will not be in control of the budget, the hospitals or the workforce.
At your GP…
When you call your GP to book an appointment, you will not get through to a receptionist but a call centre.
When you go to your GP, they may have a limit on the number of patients they can refer to hospital. But if you do get referred it will be to any willing provider, provided they meet the minimum standards set by Monitor and the Care Quality Commission. However, your GPs choice will be regulated by the consortia, which may not include your GP, and they will make the judgement based on cost, choices will always be second guessed by someone else.
The GP consortia…
Any 2 GPs can start a consortium and write their own constitution. They have the options to involve patient and hospital representatives as well as have the option to be reviewed. They will not be obliged to make any of their decisions public. GPs themselves will have both the responsibility and the blame. Overseer HealthWatch, is not yet established enough to function effectively to provide the support required to consortia.
The main idea of GP consortia is to create efficiency savings, but they are likely to fail on this count.
The Providers of your service…
Providers can be anyone from traditional NHS providers, such as your local, friendly hospital or controversial American companies such as Unite Healthcare. Private companies will be able to tender for profit making services, but are less likely to provide essential chronic and comprehensive lifelong care which is not as profitable. Hospitals will be required to keep “designated services”, but those which do not provide these may have some essential services closed, perhaps even resulting in entire hospital closure.
Price competition will decrease standards and probably increase costs, as there is a race for the bottom on price. This will compromise the statistics that Lansley has so lovingly quoted will be improved upon with his reforms.
Could be owned by anyone, but almost certainly not the Department of Health, as Andrew Lansley has recently said he is “Looking forward to a world where the Department of Health does not own hospitals”.
As long as they meet the criteria they can bid to provide a service at any price, with no standard tariff as exists now, but with a maximum cap. Cost savings, decrease in provider numbers and sole NHS provision of emergency care services, may result in closures of this vital component of healthcare.
Cost savings are not the only reason why hospitals may be missing out, but increased community spending and increases in private patients to jump NHS waiting lists will also factor in.
If you happen to be in an at risk group…
Things could look even bleaker for you.
There is a possibility of disrupted care for those living with mental health problems, who are also being affected by the welfare cuts.
This week, reports of failings in elderly care hit the headlines but this may only get worse as cuts, disorganisation, and lack of continuity of care all impact on this vulnerable proportion of society, which is only increasing in size.
The Services you will receive…
Dependent on where you live and what your local consortium has decided is important depends on what there is to offer. This may lead to a random choice of resources, and even greater increases in postcode lotteries and inequalities.
What you need may be essential, but if you’re local hospital has stopped providing that service because of decreased demand due to competition from private companies and you can’t afford to go private, you have little option but to travel far distance, where there are increased waiting lists.
Your Foundation Trust…
All hospitals are to become or merge with a Foundation trust under the new reforms. This will ensure competition and decrease cooperation, so if you happen to be attending one hospital that doesn’t provide a service you need, there will be little incentive for them to communicate with a neighbouring one to make sure that your care is continual and fluent.
After all that you finally get discharged, unharmed and still alive.
But what if something had gone wrong? Oh yes, you can complain. But as of yet no-one is quite sure who is going to be accountable. This is a right as part of the reforms, but strangely knowing what decisions are being made and why by your consortia of GPs isn’t.
May not have read the weighty edition of the White Paper and will most likely be relying on the briefing, which, as you can expect is government biased and mentions very little on the privatisation issue.
You could of course find your MP here, give them a call, email them, send them a letter, or even pay them a visit. I am sure that they would appreciate a view from a constituent such as yourself about how you really feel about the reforms. Or put together a petition and get as many signatures in your town on it as you can and send it to them, if it worked for the forests it can work for the NHS!
Even if your MP happens to be Conservative, don’t let that put you off, they can always refuse to vote if they don’t agree but don’t want to step out of party line.
If you happen to live in Wales, Scotland or Northern Ireland and are reading this thinking that you don’t need to take action, well, we need you to. Many of your MPs didn’t vote in January, and we need them to vote NO to help make up a majority.
If an MP is making a speech near you about any of the cuts, but especially health and/or welfare, go along and lobby them. Ask lots of questions. And make them know just how unhappy you are about the proposed reforms.
David Cameron in 2009 said, “There are far too many laws being pushed through, with far too little genuine scrutiny from MPs. And excessive ‘whipping’ of MPs by party hierarchies further limits genuine scrutiny. This, too, has to change.” If this is the case then he needs to let a proper consultation on these reforms occur, and it is time for us to let him know that we want this to happen.
Any action is good action, whether it be to postpone the bill with better consultation, amend the bill to prevent privatisation or kill the bill completely, we at Big Society NHS, want change!