Charities warn NHS on cuts

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Lansley says patients can exercise choice –

but what happens if there is less choice?

Normally, when a Government wants to change things, it is Unions that jump up and down, waving banners and proclaiming loudly that these changes will penalise people.

Today, when the Government wants to change the NHS, it is charities – normally regarded as institutions that keep their heads down – that are doing the banner waving.

Now, eight leading charities have fired a warning shot across the Government’s bow, to say they are concerned that patients risk having less of a say in the running of the NHS in England under the proposed shake-up. In a letter to The Times, they said:

As the Health and Social Care Bill reaches committee stage today, we — eight of the UK’s leading health charities, representing millions of patients — call on MPs to make crucial changes to ensure the NHS will be answerable to everyone it serves.

We support the Government’s aim to put patient involvement and democratic accountability at the heart of the health system. However, there is a gap between rhetoric and reality. The reforms will place £80 billion of the NHS budget into the hands of GPs, but plans to make GP consortia accountable to the public are far too weak. The plans will allow local authorities to replace existing democratically elected overview and scrutiny committees with their own systems. Hence, we urge the Government to amend the Bill and insist on a strong independent scrutiny function led by democratically elected representatives.

Greater patient and public involvement leads to better care and more efficient services, yet the proposed reforms do little to give patients a stronger voice at a local level. The new local HealthWatch bodies described in the Bill will not have the powers or resources to ensure that patients have a say in their local health services. If they are to serve a meaningful purpose they must be significantly strengthened.

What makes the Charities worried?

Normally health charities are fully involved in helping people who need them, but in an unprecedented intervention they have added to their massive workload, and are taking up on widespread criticism of the reforms by health unions and MPs last month,when the bill paving the way for the changes was published.

We all know many GP practices are being given control of much of the NHS budget, under the changes laid before Parliament. Part of the reasoning was that it would help empower patients, but the charities, including Breakthrough Breast Cancer, the British Heart Foundation, etc. say it could weaken patient involvement.

However, despite evidence mounting to show the contrary, Lansley and the government still insist the changes will  give patients “real clout”.

  • Lansley says they will be able to “exercise choice”,
  • but when the service that they would choose has been closed down, what choice is there for patients?
  • And wasn’t it Lansley who wants to close down LINks – and replace them with Healthwatch – who will have far less patient involvement?

What’s happening currently?

Currently Managers working for primary care trusts (PCTs) are responsible for planning and buying local services, but from 2013  GPs working together in consortia would take on responsibility for this under the reforms.  Pilots are already starting, and once the process is complete, two tiers of management – PCTs and the 10 regional health authorities – will be scrapped.

The letter questioned the powers and resources being given to the local Health Watch bodies, which will be set up across the country to represent patient interests in the new NHS structure.  Last year LINks saved the NHS £126 million (Lansley’s words), yet he wants to get rid of them and replace them with Healthwatch.  What’s that going to cost?

Warning

If we don’t do this well and thoroughly we could end up with patient and public involvement weaker than it is and no-one really wants that”, says Andrew Chidgey of the Alzheimer’s Society, echoing concerns expressed by the Patients’ Association.

“If the new NHS is to properly serve patients and the public, this democratic deficit must be addressed and the voices of patients heard by those making crucial decisions affecting their lives.”   The letter also said the proposed scrutiny arrangements – local authorities are being put in charge of monitoring GP consortia – meant the lines of accountability were “too weak”.

The eight signatories to the letter are the Alzheimer’s Society, Asthma UK, Breakthrough Breast Cancer, Diabetes UK, National Voices, Rethink, the British Hearth Foundation and the Stroke Association.

Their criticisms represent a new area of concern about the changes.

A Department of Health spokeswoman said the letter raised “constructive” points, adding: “We will work together to ensure the bill, which is in its early stages, delivers the reality of improved patient involvement.”

However, she disputed the suggestion that patient power could be diluted, citing the ability of Health Watch to trigger official NHS inspections.  But who will get Healthwatch to investigate?  Will patients have that power?  It seems unlikely.

Last month, the House of Commons’ health committee said the plans had taken the NHS by surprise and could threaten its ability to make savings.

Meanwhile, in another letter, also published in the Times, six health unions, including the British Medical Association, warned of their “extreme concerns” that greater commercial competition in the NHS would end up undermining care.

The NHS Confederation, which represents managers, has also suggested hospitals may have to close.

Mark Simmonds was the Conservative Health spokesman for so long.  He had sensible ideas for reforming the NHS, so isn’t it time the Coalition climbed down, got him back from ‘exile’ in Boston or wherever, and put him in charge?

Lansley has learnt not to annoy journalists by sending out a daily stream of press releases – but he still has a lot to learn.  And quickly.  Before the NHS is in total disarray.

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