Health Bill: facts and fiction, by Carol Propper
I have to admit to being stunned by the level of misinformation that is currently accompanying the Health and Social Care Bill as it is introduced into Parliament.
Yesterday, the shadow health secretary John Healey stated that ‘the changes would make the health service profit centred rather than patient centred, health secretary Andrew Lansley said ‘competition would be on quality and not cost’ and that as the health service is free at the point of delivery patients obtain the best medical outcome rather than the cheapest option. Meanwhile, Karen Jennings, head of health at Unison, stated that the only survivors will be the private health companies which are ‘circling like sharks’ and MPs say ‘the reforms have taken the NHS by surprise’.
None of these statements has much basis in either fact or evidence. The reforms being introduced in the bill are essentially a continuation of the reforms started under the previous administration, albeit at an increase in pace and scale. The Labour reforms introduced competition between hospitals for patients and patient choice of hospital and a system of regulated prices. Lansley has changed the buyers of health care from local PCTs to general practitioners, but under Labour the PCTs were supposed to act on behalf of their local GPs anyhow. Why Healey believes that increasing the pace of reform and replacing the PCTs with GP consortia should mean the NHS switches from being patient to profit centred is completely unclear.
GPs have not been seen by politicians as profit centred previously. In fact, perhaps because GPs see so many voters each week, most politicians studiously ignore the fact that GPs are private contractors and not NHS employees. In addition, the new GP consortia will probably employ a fair number of ex-PCT staff. So it seems unlikely there will be a radical shift in values on the purchaser side.
Yesterday, the shadow health secretary John Healey stated that ‘the changes would make the health service profit centred rather than patient centred, health secretary Andrew Lansley said ‘competition would be on quality and not cost’ and that as the health service is free at the point of delivery patients obtain the best medical outcome rather than the cheapest option. Meanwhile, Karen Jennings, head of health at Unison, stated that the only survivors will be the private health companies which are ‘circling like sharks’ and MPs say ‘the reforms have taken the NHS by surprise’.
None of these statements has much basis in either fact or evidence. The reforms being introduced in the bill are essentially a continuation of the reforms started under the previous administration, albeit at an increase in pace and scale. The Labour reforms introduced competition between hospitals for patients and patient choice of hospital and a system of regulated prices. Lansley has changed the buyers of health care from local PCTs to general practitioners, but under Labour the PCTs were supposed to act on behalf of their local GPs anyhow. Why Healey believes that increasing the pace of reform and replacing the PCTs with GP consortia should mean the NHS switches from being patient to profit centred is completely unclear.
GPs have not been seen by politicians as profit centred previously. In fact, perhaps because GPs see so many voters each week, most politicians studiously ignore the fact that GPs are private contractors and not NHS employees. In addition, the new GP consortia will probably employ a fair number of ex-PCT staff. So it seems unlikely there will be a radical shift in values on the purchaser side.