NHS reform ‘could hit children with complex needs’

The health workers say they understand that reform needs to happen, but they say the NHS changes in their current form will make it harder, not easier, to find care for children with complex needs.

Bella Northam is precisely the type of child paediatricians are claiming will be at risk if the NHS reforms go ahead.

She has muscular dystrophy and profound learning difficulties. She needs a wheelchair, has a tube in her stomach, wears nappies, glasses and has a hearing impairment.

Bella’s father, Tim Northam, told Channel 4 News that ensuring she received the right care was already an “exhausting” challenge.

My fear is that it will make it worse, principally because it will make it much more complicated. Dr Ingrid Wolfe, paediatrician

“We currently access four different hospitals, and then within that there are about 16 or 17 different services. Then, outside that, there are the community based support and therapy based support as well.”

His wife Ellie Northam added: “It’s the lack of co-ordination between all those services, and the fact that we’ve had to try and piece it all together, has proved extremely exhausting to our family.”

Controversy over changes

The bill for England’s NHS will put the bulk of the health budget into the hands of family doctors and they will have to decide what care to buy. But the changes have been dogged by controversy with claims of privatisation and fragmentation.

Dr Ingrid Wolfe, who is a general paediatrician at Whittington Hospital in north London, told Channel 4 News she feared that complex cases like that of Bella Northam will suffer under the government’s plans to hand more commissioning powers to family doctors.

“My fear, and the fear of a lot of other people who study these things, is that it will make it worse, principally because it will make it much more complicated.

It will add to the bureaucracy, rather than reduce it and it will make it much more difficult to plan, particularly for complex packages of care for children like Bella.”

There’s no way that it is profits before patients, patients absolutely come first. Health Secretary Andrew Lansley

The paediatricians join a growing band of health professionals who are utterly opposed to this bill. They would like to see it withdrawn completely – but the bill itself is currently in the House of Lords and the government has let it be known that it is not in the mood for any more changes.

The former children’s commissioner for England, Professor Sir Al Aynsley-Green, helped prepare the document for the Lords.

He said: “A lot of people have been working for many months now to argue for children, and sadly there has been so little response from government that many of us feel we have to go public on this now.”

But Health Secretary Andrew Lansley has rejected the concerns.

He told Channel 4 News: “Clearly they’ve not, and I’m afraid, I’m sorry about this, understood how it works.

“There is no way that it is profits before patients, patients absolutely come first. And in the NHS, it’s a free service, available to all, based on need.

“And the only way in which NHS providers can meet their obligations in the NHS is to meet the needs of patients.”

He added: “I think, particually where children with serious disabilities are concerned, I’d say two things are really important. One, that there is a clear process by which a statement of their needs is able to be translated into a clear plan for provision of those needs.

“For the NHS, when we are delivering a range of complex health needs, we need the commissioning process to be focused on how to secure integrated services. The bill is very clear, patients are at the heart of it. Now for children with serious disabilities, that’s absolutely what they need.”