4 Oct 2011

Sharks circling the NHS – doctor warns

A leading public health doctor tells Channel 4 News that private sector “sharks are circling around the NHS” hoping to make profits from the government’s health reforms.

Dr David McCoy, associate director of public health for inner north west London, is one of more than 400 experts who have sent an open letter to the House of Lords urging peers to vote against the health and social care bill when it is debated later this month.

He told Channel 4 News their concerns were motivated by fears about the “commercialisation” of the NHS in England. “It means opening up the private sector to the market by making everything provided to the NHS subject to competition,” he said.

“There are a large number of sharks circling around the NHS. For some people the NHS is an unopened oyster capable of generating high income streams and profits.”

The letter, which was also sent to the Daily Telegraph, says the bill will do “irreparable harm to the NHS, to individual patients and to society as a whole”.

The NHS is an unopened oyster. Dr David McCoy, associate director of public health

Dr McCoy said the Health Department was keen to portray the signatories as “a disaffected minority”, which was wrong. “It reveals real disquiet, not from a group of troublemakers, but from the mainstream of the public health community.”

‘Number one priority’

But Health Secretary Andrew Lansley told the Conservative conference in Manchester the NHS was the government’s “number one priority” and he would never preside over a health service that was “fragmented, privatised or undermined”.

He criticised what he called the “misinterpretation, misinformation, misrepresentation” from Labour and the trade unions on the health bill, saying: “We have always been absoluely clear. We are committed to the values of the NHS, to a comprehensive, high-quality service, free to all, based on need, not on ability to pay. The health bill will safeguard those values, but it will take us further. It will improve quality, reduce health inequalities, empower patients and staff, improve local accountability and strengthen public health services.”

During the health bill’s journey through the House of Commons, the government was forced to delay its passage and mount a listening exercise because of the scale of opposition.

It’s about quality alone. Health Secretary Andrew Lansley

Mr Lansley said: “We asked a group of the country’s top health experts, the NHS Future Forum, to assess and we made the changes they proposed. So that competition drives up quality and is not driving down prices. It’s about quality alone.”

But Dr McCoy said the listening exercise had not appeased the bill’s critics. “The fact that 425 public health professionals have written in strongly worded terms suggests deep misgivings about the bill, despite the amendments.”

Referring to the bill, the letter says: “It ushers in a degree of marketisation and commercialisation that will fragment patient care; aggravate risks to individual patient safety; erode medical ethics and trust within the health system; widen health inequalities; waste much money on attempts to regulate and manage competition; and undermine the ability of the health system to respond effectively to communicable disease outbreaks and other public health emergencies.”

The signatories say the bill does not have the backing of the health professions or the public and will “erode the NHS’s ethical and co-operative foundations”.

‘In denial’

Shadow Health Secretary John Healey said: “Andrew Lansley and David Cameron are both in denial about the scale of opposition to the plans, and together they have failed to show that they are listening to the ever expanding chorus of concern about the Tories’ wasteful reorganisation of the NHS.”

Dr Hamish Meldrum, chairman of the British Medical Association, said: “As this letter demonstrates, doctors have major concerns about the bill. Ideally, we’d like to see the legislation withdrawn entirely. Failing that, it needs to be significantly amended.”

Health bill

The reforms hand the bulk of the NHS budget to GPs, who are expected to come together in consortia to buy healthcare for their patients. Primary care trusts and strategic health authorities are being abolished.

Hospitals are required to become foundation trusts by 2014, giving them more freedom over the services they provide. Critics are concerned about the enhanced role of the private sector in the new NHS.

Lansley’s announcements

In his conference speech, Mr Lansley said foreign doctors will be forced to take an English language test before being allowed to work in the NHS.

He said: “This is not discriminating. We’ve always appreciated how much overseas doctors and nurses give to our NHS. It is simply about our absolute commitment to put patient safety first. So I can tell you today that we will change the law to ensure that any doctor from overseas who doesn’t have a proper level of English will not be able to treat patients in our NHS.”

The pledge follows the case of 70-year-old David Gray, who died after being given an overdose of painkiller by German doctor Daniel Ubani during his first shift in Britain in 2008. Dr Ubani had been rejected for work in Leeds because of his poor English, but was able to find locum shifts in East Anglia, where Mr Gray lived.

Mr Lansley told the conference that hospital infections were at their lowest levels ever, waiting times had fallen and the government was spending more in real terms on the NHS every year. It was also employing more doctors and was succeeding in phasing out mixed-sex wards in hospitals.