9 May 2011

Doctors warn Cameron over health reforms

MPs prepare to debate the controversial NHS reforms as doctors tell the Prime Minister their concerns. But our Political Editor Gary Gibbon wonders if the tough talking will lead to any real changes.

NHS reforms: cracks in the Coalition? (Reuters)

A political storm is brewing over reforms to the National Health Service ahead of a debate in Parliament.

The Labour Party is challenging Liberal Democrats to speak out against the plans after Deputy Prime Minister Nick Clegg vowed at the weekend that he would block the Health Bill unless it is improved.

Liberal Democrat backbencher Andrew George said saving the NHS was “more important than saving a few egos in the Coalition”.

And the chair of the professional body for doctors has written to Prime Minister David Cameron, outlining “serious concerns” regarding aspects of the proposals. The Royal College of GPs (RCGP) has also suggested amendments to make the reforms more palatable.

The NHS will be in essence a brand name only and it will not be a national health service. Dr Clare Gerada

In a letter from RCGP chair Dr Clare Gerada, the organisation says its key point is that the NHS must remain a wide-ranging service available to all, free at the point of use and based on clinical need, not the ability to pay.

Dr Gerada said: “It appears from our reading of the Bill and from others’ reading of the Bill that we are moving headlong into an insurance-type model of the NHS.

“The NHS will be in essence a brand name only and it will not be a national health service.”

NHS reforms: a pretty dance?
One senior figure in the NHS said to me this morning that for all the headlines about abandoning bills and the rest of it he felt the public and the media were having "a pretty dance" performed for them, writes Channel 4 News Political Editor Gary Gibbon.
Read more from Gary Gibbon on what could happen next in his blog, NHS reform: pretty political dance, but what will change?

The Government has already called a “pause” in the passage of the Health and Social Care Bill to listen to concerns, which have sparked tensions within the Coalition and opposition from unions, charities and some royal colleges.

Dissent over the reforms saw nurses deliver an unprecedented vote of no confidence in Health Secretary Andrew Lansley last month.


The RCGP letter makes nine recommendations over issues, ranging from the need for clarity about the implications of EU competition law to an “absolute” assurance that the bill would not force doctors to breach their duty of confidentiality.

Other recommendations include making sure providers cannot charge patients for services that are currently free and that consortia remain publicly accountable for all commissioning decisions.

The RCGP also called for the proposal to abolish practice boundaries to be revised.

The recommendations conclude: “The future NHS must build on the strengths and values of today’s health service, in particular building on the strengths of general practice.”

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

Political humiliation

Health Secretary Andrew Lansley could be facing humiliation over the bill, as Mr Cameron and Mr Clegg seek to repair the damage done to the Coalition by the AV referendum.

Mr Clegg has said he will tell Liberal Democrat MPs and peers to vote against the Bill unless there are “substantial, significant changes” to the proposals.

“I am not going to ask Liberal Democrat MPs and peers to proceed with legislation on something as precious and cherished… as the NHS unless I personally am satisfied that what these changes do is an evolutionary change in the NHS and not a disruptive revolution,” said Mr Clegg.

What do doctors think of the NHS reforms? 
As the political storm over the NHS reforms heats up, what do those working in the NHS think about the reform - particularly as, in many cases, they are already putting preparations in place to
implement them? Two GPs blog about their opinions on the reforms, and experiences so far, for Channel 4 News - one who is happy to "plough his own furrow" and move ahead with the changes, and one who warns the founding principles of the NHS are at risk.

Read more on the NHS reforms: what do doctors think?