NHS reform ‘could spell the end of universal healthcare’

The Health and Social Care Bill, now being debated in Parliament, creates a health care market that will abolish the English NHS as a universal, comprehensive public service, write Professor Allyson Pollock and David Price, of Barts and The London School of Medicine and Dentistry.

Under the proposals, up to £100 billion annually of taxpayers’ money is likely to be handed over to large corporations that will run and operate our NHS services for profit.

But commercial health care companies make their profits by selecting profitable services and patients. Unlike the NHS, they do not strive to provide all services to everyone on the basis of need; denial of care goes hand in hand with profit seeking.

All the evidence shows that universal health care for all cannot be delivered by a market.

In order to incorporate this business model, Health Secretary Andrew Lansley proposes to repeal the legal duties on Government to provide a comprehensive heath service. Freedoms created under the new bill will allow corporate commissioners and investors to contract out all NHS services to a range of private providers and redefine the range of NHS services available.

They will also be free to introduce new charges for some elements that are currently NHS services and to make savings by under-spending the patient care budget. These savings will be distributed away from patient care and distributed to staff as bonuses and shareholders as returns on their investment.

Read more on NHS reform in the Channel 4 News Special Report

Also abolished with the legal duties are the structures and means used by the NHS to ensure that health care is distributed according to need not ability to pay, arrangements that in the past have prevented shareholders from establishing ownership and control over health services.

Public ownership and control will also be abolished as NHS trusts disappear and control moves to an external regulator.

Universal healthcare

All the evidence shows that universal health care for all cannot be delivered by a market; it will cost more and fewer people will get care. The winners will be shareholders, CEOs and directors of new companies while the losers will be the poor, the elderly and the infirm – those whom the health service was designed to protect.

The reforms mean that the NHS will remain as a brand name only with health services will be run on US lines by, and largely for, shareholders and profit. The role of Government will be downgraded to tax collector and the NHS will simply a funding agency.

The reforms mean that the NHS will remain as a brand name only.

The Government claims that the changes will be led by GPs, but this is not the case. A majority of GPs oppose the change as does the Royal College of General Practitioners, led by its courageous chair Clare Gerada, along with the British Medical Association, the Royal College of Nursing, the NHS Confederation, and numerous other royal colleges and think tanks, medical students, nurses and doctors. Contrary to Government claims, GPs will not be in the driving seat, rather it will be management consultants or healthcare companies.

The reforms are driven by a market ideology that even the Government’s own research concludes is not supported by evidence. On the contrary,
studies show that if you create a US healthcare system you get loss of care and exorbitant costs for the taxpayer and patients.

The Bill must be amended by restoring the duty of the Secretary of State for Health to provide comprehensive healthcare throughout England. It must restore the geographic focus.

If the Government can retreat on the privatisation of England’s woodlands, it can still do the right thing by the National Health Service. On the other hand, if the Health and Social Care Bill goes through, it will spell the end of one of the great successes of post-war England and a social contract between the Government and its citizens. It will mean a return to fear and the denial of care.

'We are committed to a national health service'
Health Minister Simon Burns told Channel 4 News: "We are absolutely committed to a comprehensive national health service, free at the point of use and based on need rather than ability to pay - nothing in our plans changes that.

"There isn't an option to do nothing. If we want to preserve the NHS for future generations, we must act now. We have protected the NHS and are ploughing in £11.5 billion of funding.

"But the NHS must modernise in order to keep up with the increasing demand on services, an ageing population and rising costs of new drugs and treatments. Our plans release an extra £1.7 billion a year from bureaucracy to be invested in patient services.

"Over 5,000 GP practices, covering two thirds of the country, have already signed up and have started to implement plans to give patients better care.

"We have been clear that we will not allow a situation where profits can be made at the expense of patient care or patient choice. GPs cannot 'pocket' savings from their budget. Commissioning budgets must be used exclusively for patient care."