The NHS is in turmoil

By Tom Keeley

It seems increasing likely that the government is about to exercise an about turn on the NHS reforms. Quite what that might look like is not yet clear. Whatever the outcome of the “listening exercise” we should not forget the huge disregard shown by Cameron and his ministers towards the NHS.

A NHS in turmoil

Due to these abortive reforms the inner workings of the NHS are in turmoil. Experienced health service managers are privately saying that it is worse than the confusion caused during the introduction of the internal market.

Primary Care Trusts have seen their staff numbers depleted, as senior managers have looked to secure their future elsewhere with NHS trusts and large private companies that were expected to run consortia. The result of these movements is that PCTs are currently not fulfilling their responsibilities effectively. The PCTs are regional groups of highly experienced managers, who expertly commission health care. They do this as well as any other health service in the world and were becoming increasingly more effective and cost-effective. No more. In the event that the GP consortia are scrapped, the PCTs will now struggle to continue their present role.

Foundation trusts have spent millions of pounds preparing themselves to compete with private companies in a market economy. Senior managers, from the PCTs, have been recruited at huge cost and often on long term contracts. Business models have been drawn up for scenarios that may now never materialise and forward planning has been has been replaced with crisis planning. While this has happened, waiting times have increased.

GPs have been forming hotchpotch alliances and recruiting the services of private companies to manage them. Some London consortia are rumoured to be contractually tied to these private companies, whether they eventually require their services or not. Pathfinder consortia have been taking on shadow commissioning responsibilities, in a test run of the real thing. Some experienced GPs have retired, preferring not to be involved.

Cameron’s reforms

Cameron is fond of saying “the Conservatives are the party of the NHS”. Recently he has been saying the “you can’t trust Labour with the NHS”. But, the fact remains that for 13 years Labour provided solid stewardship of the NHS. We took it from a health service that provided a shocking level of care to one of the best health systems in the world. One that would have survived the current economic strains.

In 12 months the Conservatives have reduced it to a mess that will take years to sort, whether the reforms go through or not. The confusion that exists in the NHS and the danger it represents should not be underestimated. This was caused by the White Paper on Health, which Cameron signed off on and aggressively promoted. These are Cameron’s reforms and he must be held to account for the chaos they have caused.