23 Oct 2014

Can a new plan ease fears over the struggling NHS?

There are those who believe, most passionately, that the NHS is being privatised by stealth and that its privatisation is part of a grand plan by the Tories, worked out in secret around various Notting Hill dinner tables.

Equally there are those who think private companies are being given too much access to the NHS and that, while patients will still not have to pay, the inevitable consequence of letting those companies in is that some services will fall by the way side.

Then, I suppose, there is a third group who believe that the NHS will struggle on regardless and that its status as the nearest thing to we have to religion will ensure the politicians do the best by it.

Today, the Chief Executive Simon Stevens (pictured below, right) laid out what he thinks is the way forward, and that includes asking for an extra £8bn by 2020 to implement a plan which includes switching funding from hospitals into other community-based services including GP surgeries.

Without the extra £8bn on top of planned increases in line with inflation, patients could suffer “severe” consequences.
The ideas have been largely welcomed, although the political parties haven’t quite said how they might pick up the obvious gauntlet thrown down.

The new chief executive of the NHS, Simon Stevens, has his blood pressure taken by practice nurse Lesley Dobson during a visit to Consett Medical Centre in Consett

Nobody is in any doubt that the NHS is struggling. The signs are everywhere, from GP surgeries to A&E departments. Sometimes the signs are not even as obvious as that. I was told recently of a service for people with neurological diseases to help them with bladder conditions, which has been chopped. It’s not a very sexy headline but, oh my goodness, those poor patients.

So a plan is good. And NHS England’s plan seems as good as any. But it will not assuage the fears of the first two groups about privatisation.

And on the Today programme Mr Stevens failed to truly answer the questions put to him on privatisation. Instead he said that “sometimes there will be a case” for a patient needing, for example, a hip operation to use a private provider paid by the NHS.

He said that it would ultimately be up to patients to decide who they wanted to provide that service.

Yet the issue that is never addressed from Whitehall is the lack of level playing field. When we, as journalists, ask to see the business case or know the profit margins or request financial details if the service should fail to deliver on its contract (as has happened numerous times), we are told that it is subject to commercial confidentiality.

There is currently little control, because of the way the system is set up, over whether a contract goes to a private company, a social enterprise or the NHS. Labour has said it wants preferred bidder status for the NHS, but it is not clear they can do that under current legislation.

All this will undoubtedly be hashed out in the run-up to the election. Although whether it will be resolved… I hate the phrase, but only time will tell.

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