Government NHS Reforms Condemned By Health Journals

Nhs Reform

First Posted: 31/01/2012 06:13 Updated: 31/01/2012 06:13   PA

The editors of three leading healthcare journals have published a joint assault on the government's "poorly thought-through" NHS reforms.

In an unusual move, the three magazine's - the British Medical Journal, Health Service Journal and Nursing Times - published the same editorial, warning that flaws in the "bloated and opaque" Health and Social Care Bill would leave the NHS needing yet another overhaul within five years.

Separately, the BMJ published research suggesting that ditching Health Secretary Andrew Lansley's bill now could save the NHS more than £1 billion in 2013.

The three journals called on Parliament to establish an independently-appointed standing commission to initiate "a mature and informed national discussion on the future of our national health system" and ensure that there is no repeat of Mr Lansley's "ideological and incompetent" attempt at reform.

While accepting that health professional groups differ in their stance on the bill, BMJ editor Fiona Godlee, HSJ editor Alastair McLellan and Nursing Times editor Jenni Middleton said that there could be no doubting the "overwhelming sense of distress and lack of confidence in the government's plans among those who must deliver the service".

They wrote: "Through a combination of poor political judgment and reluctance to engage with criticism, a set of (mostly) reasonable objectives morphed into an old-fashioned top-down reorganisation.

"It also resulted in a bloated and opaque piece of legislation, whose goals could have largely been achieved by other, more effective, means".

Once the bill becomes law, "we will still be in the dark about how much of the new system will work", they said, adding: "We will have an unstable system that is only partially fit for purpose".

And they predicted: "Another major NHS reform programme is guaranteed within five years".

"The NHS is far too important to be left at the mercy of ideological and incompetent intervention," said the joint editorial. "Let us try to salvage some good from this damaging upheaval and resolve never to repeat it."

Writing separately in the BMJ, the Professor of Health Policy and Management at Manchester Business School, Kieran Walshe, said that dropping the bill now would save just over £1 billion in 2013 and would allow NHS organisations to focus on improving efficiency and productivity.

Ministers could then "plan to accomplish much of their intended reform agenda - greater patient choice, more GP involvement in commissioning, increased plurality and competition in healthcare provision - using existing legislative provisions," said Prof Walshe.

"And the NHS could get on with delivering healthcare to patients, and the serious business of finding ways to do more with less."

Responding to the joint editorial, a Department of Health spokesman said: "Our reforms are based on what NHS staff themselves have consistently said - they want more freedom from day-to-day bureaucracy and political interference so they can get on with the job of caring for patients.

"That is exactly what this bill achieves.

"Through the independent NHS Future Forum, we have already had hundreds of meetings, discussions and public debates with thousands of people on the future of the health service. To start this process again would undermine the development of clinical commissioning and prevent healthcare professionals taking decisions in the interests of their patients.

"The Future Forum demonstrated widespread agreement with the principles of change and GPs themselves have written to newspapers to express their support.

"It's completely untrue to suggest that dropping the Bill would save the NHS money. Our plans will reduce needless bureaucracy by a third and save £4.5 billion over the course of this Parliament and £1.5 billion every year afterwards.

"Every penny saved will be reinvested in frontline care for patients."

Shadow health secretary Andy Burnham said: "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.

"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 view that this bill is unnecessary and a distraction from the financial challenge facing the NHS."

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The editors of three leading healthcare journals have published a joint assault on the government's "poorly thought-through" NHS reforms. In an unusual move, the three magazine's - the British Medi...
The editors of three leading healthcare journals have published a joint assault on the government's "poorly thought-through" NHS reforms. In an unusual move, the three magazine's - the British Medi...
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12:49 PM on 01/31/2012
At Prime Minister's Question Time, o local MP asked Cameron "Are you going to close Ealing Hospital?" Cameron replied "we will do what the people want." We, the people do not want our hospital closed, so Cameron was blatantly lying!
majdf18148
I have nothing to declare but my curiosity
12:35 PM on 01/31/2012
The truth is there is as much, if not more, antipathy towards the reforms as there is support. I was a board member on a GP commissioning group until recently and in my experience there is a great deal of concern amongst the ranks of the NHS apropos the reforms. This antipathy is constrained by the recognition that change IS needed but trying to effect change of such magnitude amidst such wholesale financial savings is destined to fail.The two issues are simply incompatible.The NHS is run as a competitive, post code orientated business.The reforms will not change that ethos they will merely divert the buying power from the soon to be redundant Primary Care Trusts to the newly established GP Commissioning Groups or whatever they end up calling themselves. These groups will then try to reinvent effective pathways of care, try to drive down hospital costs, eradicate unnecessary and ineffective treatments and basically spend the NHS funds more wisely and to the benefit of their patients. The trouble is the hospitals hold all the trump cards and Primary Care Trusts have failed for the last decade to do what the Govt hopes the GP groups will achieve. I don't believe the GPs have the time or proper inclination to manage these budgets. Many of them are uninterested, many are not competent to do so, many just want to look after their patients and.......trying to get a group of GPs to agree on anything is a nightmare.
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Allyb999
12:08 PM on 01/31/2012
There are many private healthcare firm waiting in the wings waiting to pounce on the NHS if this bill does go through.
We are slowly but sure heading towards the American system of healthcare. If you can afford it we can do it.
Everyone will soon need private health insurance, then you will spend more time trying to claim than you would spend getting treated.
Private Healthcare firms are there for one thing and one thing only .... Profit.
11:47 AM on 01/31/2012
easy and simple way to save money in the NHS, start charging HEALTH TOURISTS, WHO TRAVEL HERE FOR THE SOLE PURPOSE OF FREE TREATMENT, CHARGEING TOURIST IN GENERAL WHO FALL ILL WHILE HERE, Some of these health journal writers, doctors nurses and more important admin staff, should make sure these people are charged, and payment is made by credit card or health insurance policy on arrival at the hospital, They pay nothing into our health service and abuse it, So don"t complain against cuts perhaps some would not have to be made if the staff ran it as a business for non NHS card holders, My niece who works in a major hospital in london recently treated a boy from the middle east to £ 90k worth of treatment at our expense over a 8 month period, he flew here with his father and a letter from a doctor which was 3 days old turned up at A E and recievied the treatment. It cannot carry on like this, i wrote to my MP who said he new of many cases like this but could do nothing about it, because of H R Laws.
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Allyb999
12:12 PM on 01/31/2012
Alan you argue one side then killed it by then stating human rights law. It is not the doctors, nurses or in fact anyone in the NHS that needs to change the rules. Its the government who would need to sort this problem out.
12:26 PM on 01/31/2012
i think you will find you are wrong there as they can ask for payment before treatment, which they don"t and if they bother to charge they usually ask for a address to send the charges . They are entitled to ask for payment or of of payment before treatment, as long as its not life threatening. Just as we are asked on travelling both within and outside the E U. A identity card would have been perfect with fingerprints and photo on it, because that would prove they have a NHS number but as we know the human rights PC brigade wouldn"t to protect there rights ? for what reason ?
11:45 AM on 01/31/2012
I think our SNP leader, should strike 4 medals. 1 each for Cameron, Lansley, Clegg and Duncan Smith, all of whom by their absence of moral judgement, have drawn more support for Scottish independence, that an army of canvassers.! Thay expect this nation to believe that they invest in a good public health service, when most of their multi million pound financing, comes in donations, from a conglomorate of wealthy private health care company owners, who, we are asked to believe, wish nothing in return for their `investment`.?
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09:59 AM on 01/31/2012
How many gaffs and u- turns before this government collapses...labour now need to get rid of milliband and appoint a CREDIBLE LEADER,..then its curtains for this shambles.
09:28 AM on 01/31/2012
I notice the three coordinated articles refer to the NHS as a system not as a service. The bloated NHS system has long since ceased to be a service with patient care relegated somewhere below box-ticking near the bottom of the whole stinking pile. Thatcher started the rot, then Gordon Brown threw huge amounts of money at it year after year in a blatant attempt to bribe a gullible electorate. Who knows what the answer is, I see the first post on here is from a self-interest group.
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David Brown1949
Not waving but drowning.
11:33 AM on 01/31/2012
And your solution to the nhs problems are?
12:11 PM on 01/31/2012
If you'd bothered to read all of my post you would have got to the bit that says 'Who knows what the answer is.........'. Personally I think it's iniquitous that governments should involve themselves in health other than mental health which poses a danger to the public at large. Doctors at the old mental asylums (NHS in name only, were run as Home Office institutions) were better at medicine than mainstream doctors and kept their patients alive to incredible ages, that's why Thatcher closed them down I presume. Now all those skills are lost and we have doctors who are largely inept.
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Allyb999
11:51 AM on 01/31/2012
The NHS is a system that supplies a service. To many times government have tinkered with the NHS and the only thing it has ever achieved is to make it worse.
The NHS will only ever get more expensive to run, simple economics dictate this. More elderly, more childhood asthma, ever improving drugs ( at a cost ), obesity rising in the UK, rising fuel costs, but to name a few factors.
There is no doubt there are savings to be made but normally saving come at a cost. Private contractors doing the cleaning rather than hospital staff ( then all we hear about is how dirty the hospitals are ).
12:23 PM on 01/31/2012
I agree entirely, tinkering governments resulting in medicine dumbed down to the lowest common denominator. It will get worse, nobody with any real talent wants to work there anymore, leave it to the zombies who toe the line quivering in their boots about being sued which is a convenient excuse for not having adequate skills.
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redsquad
Shootin' from the lip
08:54 AM on 01/31/2012
"Overwhelming support" for the bill eh, Dave? Although it may come as a surprise to most Tory drones, the flunkies at your club don't count as a representative cross-section of the British public,
07:48 AM on 01/31/2012
Please sign the E Petition link below. Help put a stop to the Governments attempt to tamper with our National Health Service.
http://epetitions.direct.gov.uk/petitions/22670