NHS reform 'complete waste' warning

Doctor's equipment, a sphygmomanometer and stethoscope Dr Michael Dixon said he feared GPs "will walk" from the clinical commissioning process

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Opening most of the NHS in England to private firms could alienate doctors and render the reforms "a complete waste of time", a GP who helped draft the plans has warned.

Dr Michael Dixon told GPs' journal Pulse that he feared GPs "will walk".

He says the legislation's wording on competition must be amended or doctors could get "bogged down" in the process and distracted from patient care.

The government insisted there was no policy to privatise NHS services.

Budget responsibility

The balance of power is about to shift dramatically within the NHS, with GPs and other clinicians given much more responsibility for spending most of the budget in England.

There is already competition for services such as physiotherapy, hearing tests and dermatology - which could be expanded to many other areas of care. Essential services such as A&E would be protected.

But the issue of involving the private sector to introduce competition for services was vehemently opposed by some critics within the medical profession when the changes were drawn up.

Ministers responded by agreeing to introduce competition in a more managed and balanced way. However, there is fresh concern that legislation about to go through the House of Lords will force nearly every service to be put out to tender. Critics have said this is a blueprint for privatisation and goes against government assurances.

Dr Dixon, who heads the NHS Alliance - an organisation which represents doctors, nurses and managers on the front line - said the danger with the current wording of the rules was "that it seems to put a duty upon the commissioner to go for competition with all contracts that are made".

He warned that doctors would "start getting bogged down" in dealing with competition and would end up taking their "eye off the ball".

He told the BBC that getting the right level of competition was vital: "It means not having to introduce competition willy nilly - but using it when it's in the interests of patients.

"I don't want tenders, which cost a lot of money and time, when a local provider is doing a good job.

"Sadly, I think this is what one or two of the clauses might lead to."

'Nail in coffin'

Meanwhile, more than 1,000 doctors have written to the Daily Telegraph claiming the legislation makes "virtually every part" of the NHS open to private firms.

They wrote: "We are concerned about the government's proposed secondary legislation (under Section 75 of the Health and Social Care Act) to force virtually every part of the English NHS to be opened up to the private sector to bid for its contracts.

"These regulations were proposed on 13 February and will become law on 1 April unless MPs first insist on a debate and then vote them down.

"Parliament does not normally debate or vote on this type of regulation, but it is possible. We urge parliamentarians to force a debate and vote on this issue to prevent another nail in the coffin of a publicly provided NHS free from the motive of corporate profit."

The government said the rules were about ensuring the process was fair to all concerned.

Sources close to Jeremy Hunt said he was aware of the concerns but was "confident" the regulations were in keeping with the promises made.

It is understood that ministers will be writing to peers who will be addressing this issue next week to "allay fears". There is also consideration being given to rewording parts of the regulations.

Labour MP Andy Burnham, shadow health secretary, said: "The government needs to start listening and they should start by withdrawing these regulations without delay.

"What is now clear is that the medical professions and Parliament have been treated with contempt - the overnment is now forcing competition through the back door.

"People have never given them the permission to put the NHS up for the sale and they need to be forced to remember that."


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  • rate this

    Comment number 207.

    194. Graeme
    So your saying socialism, communism (indeed even fascism), are not imposed by central planners. Ok.

    199. Billythefirst
    What part of "Remove the compulsory "contribution" from our wages, & allow the NHS to stand on its own merit." don't you understand?

  • rate this

    Comment number 206.

    For example, have a hip operation privately now if you pay the extra 'private care supplement' or wait a year for the NHS. Obviously this happens already (private insurance) but I suspect it will become more widespread.

    Opening the NHS up to private sector involvement will be a huge mistake and I suspect once done it will be too expensive to reverse, rather like dental care.

  • rate this

    Comment number 205.

    Belatedly,Dixon,Burnham,the LDs et al are waking up to the true Tory agenda for the NHS.Why on earth didn't they spot the privatisation regulations reserved to the SoS when the then Bill was going through Parliament last year?Pathetic democratic scrutiny.Meantime we have Nicholson retained to implement this disgrace.Can it get any worse?

  • rate this

    Comment number 204.

    Just get a feeling that what happened to dental treatment is being applied to primary care. A 2-tier system where a significant proportion of the population will have to pay for their treatment. Those that can't afford it will have to wait. However, medical care is much more expensive than dental care.

    GPs might do very nicely out of it if they play their cards right, rather like dentists.

  • rate this

    Comment number 203.

    where will they go, leaving a nice cushy 120k+ job + massive pension
    Same place as the bankin' "talent"?

    Batiat #188
    But U have choice. U don't with a monopoly. Why are you afraid of choice (freedom)?
    I have a choice of energy providers....they all rip me off to the same extent.
    Ditto banks
    Ditto rail companies
    Welcome to freedom....Rip Off Britain style

  • rate this

    Comment number 202.

    Reform of the NHS matters more than who came 2nd in a by-election, whether we remain a United Kingdom or leave the EU.

    But we won't get a referendum, no Politician will bust a gut campaigning to maintain the current level of service, we'll just sleepwalk into Hellacious Health care.

    In part it's because we won't realize the NHS has been demolished till it's been done.

  • rate this

    Comment number 201.

    GP's will walk

    where will they go, leaving a nice cushy 120k+ job + massive pension

  • rate this

    Comment number 200.

    The National Health Service is just a distraction from the real crusade... Keeping the bankers healthy and happy.

    We can tell this by the way Mr Cameron tries his persuasion in (out in out shake it all about) EEU. UK Bankers can get BONUSES as large as they like even though they have made huge LOSES, rather than normal wages as the masses get.

    Apparently applies to big hospital LOSES too.

  • rate this

    Comment number 199.

    195. Bastiat
    Don't abolish the NHS. Just remove its monopoly.
    Already done old son....those swimmin' in lucre can already jump the queue using NHS trained practitioners...ye can't say fairer than that can you?

  • rate this

    Comment number 198.

    I can never understand how you can make a profit out of caring for sick people. How can that be right? That in itself is sick.

  • rate this

    Comment number 197.

    Anyone remember Flashman's promise to leave the NHS alone? Well what did you expect from a Tory shower wedded to the so-called free market economy. Expect much worse from this despicable shower before you have the opportunity to consign them to the dustbin in 2015. Democracy doesn't work in the UK what we have is what the global ruling elite allow us, it certainly isn't democracy it's slavery.

  • rate this

    Comment number 196.

    Got me bang to rights there - don't know many carrot crunching geordies but if those are your local branches...mine's shut.

    Sounds bally serious Tim - it won't make me say stupid things like the tories are genuinely interested in improving healthcare outcomes via a public NHS will it? Tell me it won't please Tim, I'd rather wear trousers with elasticated waistbands and watch Ant and Dec

  • rate this

    Comment number 195.

    Don't abolish the NHS. Just remove its monopoly.
    Allow people freedom, freedom to choose what they feel is best for them.
    Remove the compulsory "contribution" from our wages, & allow the NHS to stand on its own merit. If it's so wonderful, I'm sure it'll prosper.

    People can then at least choose between the Government's Stafford Hospital of Death, & another provider (who won't kill u).

  • rate this

    Comment number 194.

    188. Errrrrrrrrrrrrrrr No.

    You are comparing apples with onions. Bit like comparing the NHS with private health care providers really!!

  • rate this

    Comment number 193.

    The NHS is there and accessible for all people who require it. It's there to look after the young through to the old no matter what resides in your bank account.
    It's not there for profit! These American insurance, pharmacology and hospital businesses are salivating at the opportunity to fleece this country.

  • rate this

    Comment number 192.

    39. cyprus-hound DO give over. Come back when nine tenths of the wealth in this benighted country is not owed by a tiny fraction of the population, within a wholly biased system that protects the aristocracy, landowners, major shareholders, speculative bankers and all other anointed club members, before it ever does the majority of citizens - who they all live off.

  • rate this

    Comment number 191.

    One would think that Private Healthcare was not available in the UK.
    If a patient is really rich they can afford to go to the best doctors in the world whether that be USA Switzerland UK. et al.

    The National Health Service is and was devised by the (not so wealthy) public, for the public, by acts of parliament.

    Keep them SEPARATE because they are BOTH advantageous.

  • rate this

    Comment number 190.

    Too late for NHS England it's been sold already!!!!

  • rate this

    Comment number 189.

    The government insisted there was no policy to privatise NHS services.


    The fact it is already happening then must be due to policy drift ..?

  • rate this

    Comment number 188.

    You can't afford it because you're taxed to the hilt to fund a monopoly.
    Everyone knows monopolies drive up costs.
    You probably decry corporate welfare for bankers... why don't you decry social welfare also?

    But U have choice. U don't with a monopoly. Why are you afraid of choice (freedom)?

    Both are monopolies imposed by central economic planners no?


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