Filed Under (Health and Social Care Bill, Health Policy, Liberal Democrat Party, Reform of the NHS) by Paul on 09-05-2011
Every now and again you catch people who are not very interested in the detail of an issue that really matters to you, like NHS reform policy, encapsulating how the rest of the world sees that issue.
Last Friday and Saturday, following the pretty historic elections in Scotland and on voting reform (and less game changing elections in England and Wales and Northern Ireland) there was a lot of general political comment on the airwaves. There was an occasional mention of the NHS.
But on Saturday morning BBC news had a discussion between three political commentators who broadly presented the views of the three main political parties. In discussion, there was a suggestion that Lib Dem MPs would be looking harder at the NHS reforms. The Daily Mail columnist – representing Conservative opinion – jumped in to say that it wasn’t only the Liberal Democrat MPs that would be asking questions – all Conservative MPs would too.
He said “The NHS reforms are a basket case, they haven’t been thought through”. Every one nodded.
It struck me suddenly that this has now become a simple truth for people- a received wisdom of the world.
The fact that Andrew Lansley had been in his attic thinking these reforms through for six years apparently has no impact on this current explanation. Received wisdom is that no one could have thought these reforms through because they so obviously don’t work.
The most significant issue for the reforms is that there is now a feeling that they are “bonkers” and that if the Tory party doesn’t want a complete disaster on its hands they must be changed.
Then, on Sunday, Nick Clegg speaking on the Andrew Marr programme said two very important and interesting things.
Firstly he said that it would be better to have no Bill than a bad Bill and that he would not ask Lib Dem MPs to vote for a bad Bill. This provides the Government with a radical way out of the mess if they want to take it. Just stop. Review the wreckage of the NHS and start slowly to think about what to do.
Secondly he said that he thought it should not be the case that GPs were being told that they had to carry out commissioning. This was always one of the madder parts of the reforms. Making GPs do anything is very hard, but something that is of such strategic importance and needs very willing and energetic volunteers, is really daft. Conscripting GPs was never going to work.
So I think we have our first major change to Lansley’s proposals. GP Commissioning will no longer be compulsory. Parts of England will have this and parts will not. We will have a mixed system.
This one change, changes nearly everything. If PCTs had not already been de facto abolished, they would be reprieved.
Obviously there will be more to come.
However on the ground there are already significant changes happening for patients.
Last Thursday I received my first email advert from a private medical insurance company that was selling to me based clearly upon the impact of the Government NHS reforms. A firm providing users with an overall analysis of all private medical insurance, Your health, your choice, beat that quote. Their offer recognised the return of waiting lists to the NHS, something that had become a thing of the past,
“With this type of insurance you are able to avoid NHS waiting lists and secure treatment as quickly as possible.”
Those selling private medical insurance recognise the anxiety that people on NHS waiting lists feel. They recognise that waiting lists have increased over the last year and that therefore they have an opportunity to sell to people on those lists.
The Government have withdrawn the necessity for the NHS to reduce waiting times and by doing so have renewed a market for private medical insurance that had been diminished by the success of the 18 week target.
Up until this time last year I thought the NHS had won this issue. But in one short year the basket case that is NHS reform has increased waiting lists and reopened this market.