Thursday, January 06, 2011

Alternative plan for NHS reform

This below is a response to Lansley's plans for dismantling the NHS. It was drawn up by Dr Tim bland, and has developed supporters through email lists. Tim is trying to get it into the letters columns of papers, without success so far. I believe this is because it is information-dense, and the media cannot cope with information. They deal with impressions.

Alternative Agenda for Healthcare Reform


Letter for publication in The Guardian

Sir, Following Polly Toynbee’s comment article on the NHS published on page 29 on 4.1.2011 we are a doctors’campaign group who would like to keep the pressure up on the Government with an alternative agenda for NHS Reform. Healthcare does need reforming, but not in the destructive way the Government is signalling; so what should the government do? Unfortunately Labour is not offering a constructive alternative at the present time.

1 Put the White paper on hold and have a time of national consultation with all stakeholders. The new Secretary of State is moving “too far, too fast” with a level of reform that carries a huge risk of major failure. We need a national rethink on the way forward for the next 50 years, not the next five.

2 The coalition government needs to realise that this White Paper risks bringing about the end of the NHS as we know it by causing complete chaos followed by fragmentation and piecemeal privatisation. We should not put responsibility for running the whole NHS onto GPs, as is proposed by Mr Lansley.

3 We believe that the Government does want to retain our state-run healthcare system i.e. NHS, but that it is missing a golden opportunity to introduce changes that place more onus on individual responsibility for health and associated costs. The only way to save the NHS is to reform it. However, Mr Lansley is increasing patient expectation when he should be increasing patient responsibility.

4 A new contract would need to be established between the State and the Population for the continuation of a universally applicable, state-run, healthcare system. This would involve the Population accepting a reduced scope of NHS services, the State committing itself to long-term healthcare provision and all parties recognising that the NHS’s performance is crucial to the success of the greater project for national debt reduction.

5 Be true to the sensible, Conservative manifesto commitment to have no more major, reorganisational change in the NHS. Keep most existing structures in place and bring about rational, consensus-based, incremental change. This will be far less expensive and leave doctors free to focus on efficiency savings instead of being diverted to major reorganisational change.

6 Have a full, informed debate on the expensive, 20 year, experiment of the purchaser/ provider split, which began in 1990 with Kenneth Clarke and Margaret Thatcher. A decision needs to be made now on whether to keep it or get rid of it.

7 Abandon blind faith in the ideology that the free market will be an effective agent for “saving” the healthcare system. This blind faith is a pre-2008 idea, utterly discredited since the Banking Crisis broke upon us. This supreme faith in the free market needs to be downgraded onto a par with the many other healthcare ideologies in the intellectual market.

8 Focus on doing something urgently about the state of our hospital sector. Consultants should be given back power from managers and also the accountability that always used to go with the crucial link between each patient and their named consultant. Restore the traditional “firm system” of consultant-led teams; this could only be done by finding some way of reducing the drastic effect that the EWTD is having on our healthcare system; this would enable restoration of continuity of care in hospitals and proper training for the next generation of doctors, especially future surgeons. Do something about the national scandal of PFI costs that are bleeding the NHS dry. Get rid of the plethora of centrally driven targets.

9 Don’t force any change upon GPs that compromises their vital advocacy role on behalf of their patients or diverts their attention from patient care. Each patient has to know that his GP’s sole consideration is the patient’s best interest.

10 Make sure that the U.K retains its high level of medical training, medical research and public health, which are some of its greatest strengths.

We believe these ideas could be developed into a pragmatic, centrist philosophy for sustainable state-run healthcare that could command widespread support for many years to come. We want to bring this alternative agenda for NHS Reform to a wider, national and parliamentary audience

The NHS Twenty Ten Group of U.K. Doctors

Dr Tim Bland, GP, Chairman

Mr Wael Ismael, general surgeon

Dr Raj Patel, haematologist

Dr John O’Moore, GP

Dr Raj de Silva, neurologist

Dr Mohsen Khorshid, dermatologist

Mr Bhik Kotecha, ENT surgeon

Mr A Sivaraman, spinal surgeon

Dr Pushpa Chopra, GP

Mr Jag Chawla, ophthalmologist

Dr Ashok Kumar, GP locum

Dr Chaman Sajjanhar, GP retired

Mr Bhabu Chopra, ENT surgeon

Dr John Lee, GP

Dr Abdul Jabbar, GP

Dr S Subramaniam, GP

Mr Chitta Chowdhury, ENT surgeon

Dr Mani Subramanian, GP

Dr Badi Beheshti, GP

Mr Krishna Vemulapalli, orthopaedic surgeon

Dr Sridevi Vemulapalli, GP locum

Dr Maryline Punungwe, GP locum

Dr Pamela Punungwe, GP registrar

Dr Richard Lawson, GP locum

Dr T. C. Bland


Chairman of The NHS Twenty Ten Group of U.K. Doctors

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