England’s National Health Service Faces Damage From Reforms, Editors Say
Britain’s National Health Service will need another overhaul in five years if “damaging” changes being implemented by the government are allowed to continue, the editors of three U.K. health-care publications said.
The Health and Social Care Bill, proposed by the Conservative-led coalition government, calls for “reforms designed and implemented so badly that another major NHS reform program is guaranteed within five years,” the leaders of the British Medical Journal, the Health Service Journal and Nursing Times wrote in an editorial simultaneously published in all three publications.
The bill, which applies only to England, would be the biggest shakeup in the history of the 64-year-old National Health Service. The legislation includes proposals aimed at expanding the number of private companies that offer health-care services to NHS patients. It would also create an unspecified number of groups to commission services and create a national agency to take on duties now performed by regional trusts.
“Let us try to salvage some good from this damaging upheaval and resolve never to repeat it,” the editors wrote.
‘Drop the Bill’
Stopping the bill would save about 360 million pounds ($567 million) by eliminating the need to set up new groups to manage the NHS and a regulator to oversee the changes, according to a second editorial in the BMJ. It would also save about 650 million pounds a year needed to run the organizations, Kieran Walshe, a professor of health policy and management at the Manchester Business School, wrote in the editorial.
“The government could argue that, in the special economic circumstances of the day, it makes sense to drop the bill,” Walshe wrote. “They would also neutralize an issue which has become increasingly politically toxic.”
The legislation would save 4.5 billion pounds through the next national election and 1.5 billion pounds each year after that, the Department of Health said today in an e-mail.
“It’s completely untrue to suggest that dropping the bill would save the NHS money,” the department said. “Our reforms are based on what NHS staff themselves have consistently said: They want more freedom from day-to-day bureaucracy and political interference so they can get on with the job of caring for patients. This is exactly what this bill achieves.”
House of Lords
The legislation is going through the House of Lords, and any amendments made there would have to be approved by the House of Commons before the bill is submitted for royal assent.
“We repeat our offer today to work with the government on introducing general practitioner-led commissioning on condition that it drops this unnecessary bill,” Andy Burnham, the Labour Party lawmaker who acts as spokesman on health policy, said in a statement. “We can support giving clinicians a bigger role in shaping NHS services, but it could be delivered more quickly, with less disruption and at much lower cost without this bill.”
Parts of the government’s plan, including increased competition, greater choice for patients and more involvement by general practitioners in commissioning treatment, could be accomplished under existing rules, Walshe wrote.
The BMJ is run by the British Medical Association. The Nursing Times and Health Service Journal are published by Emap Inform, which is owned by private-equity firm Apax Partners and Guardian Media Group Plc, according to the company’s website.
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