Andrew Georgiou gives a critical analysis of David Cameron's recent speech on the planned NHS reforms, pointing out that it ignored a key factor, competition.
David Cameron, in a speech at Ealing Hospital yesterday, affirmed his support for Andrew Lansley’s controversial NHS shake up.
In an attempt to shore up support for his government’s ailing NHS reforms David Cameron’s speech sought to explain why change is important for the future of the NHS. What followed, however, were not the words of a man who had taken “time to pause, listen and reflect”. Instead Mr Cameron’s speech neglected to tell the whole story and was almost devoid of any mention of the key issue, competition.
The key plank of Mr Cameron’s address was that his changes were needed in order to save money in the future. He said:
“If we stay as we are, the NHS will need £130 billion a year by 2015 – meaning a potential funding gap of £20bn. The question is, what are we going to do about that.”
He may be asking the right question but he is far from providing the right answer. The truth is that Mr. Cameron’s perilous NHS reforms are going to divert much needed attention away from the key challenge of finding the £15-20bn savings it has been asked for. The King’s Fund rightly points out that:
“Finding the £20 billion in efficiency savings needed to maintain services must be the overriding priority, so the very real risk that the speed and scale of the reforms could destabilise the NHS and undermine care must be actively managed.”
The prime minister may believe that the solution to these funding problems lays in his reform, however the Department of Health disagree. They assert that the funding challenges will “present a significant challenge to the NHS regardless of the structure of the health system”.
So rather than helping to close the £20bn funding gap the government’s misadventure with NHS reform will most likely widen it.
The prime minister also claims that his reforms will see the end of postcode lotteries. However his vision of “an NHS with consistent, high quality care for all – instead of just pockets of excellence” will not be fulfilled under these proposals.
It was just two months ago that the NHS Confederation stated that the government’s plans would worsen the postcode lottery and will mean more variability of access to services. Is the prime minister really saying that he knows more about the NHS than the professionals?
In fact most of Mr Cameron’s harshest critics have been healthcare professionals themselves and Clare Gerada (Chair of the Royal College of General Practitioners), who represents 42,000, GPs believes “that if this Bill is enacted as it currently is that it will cause irreparable damage to the core values of the NHS”.
Mr Cameron’s speech may have been a little sloppy on the detail but it was his silence on the most important part of these reforms that was worrying. David Cameron clocked up twelve pages and almost 4,000 words but only mentioned the issue of competition once. If he intends to ram these reforms through parliament it is this issue that needs addressing the most.
This speech was another demonstration that the government are intent on ignoring all professional evidence and continuing to press ahead unabated. Someone needs to tell the prime minister if he wasn’t talking so much it would be easier to hear what people are saying.
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21 Responses to “Cameron’s NHS reorganisation likely to widen the health funding gap”
Anon E Mouse
George McLean – Cameron is running the government and it’s his shout. If Labour had been more popular they may still be in charge. But they’re not and remember ID Cards? Labour wouldn’t back down over that so why should the government not change the NHS?
Speaking from personal experience of my missus being treated privately and my business partner on the NHS the difference is stark.
Here is a link from The Guardian regarding manager recruitment:
http://www.guardian.co.uk/society/2010/mar/25/nhs-management-numbers-frontline-staff
Anyway you haven’t even commented about the elderly not being cared for or the dirty stinking hospitals we are paying for. For Labour to want to continue this fiasco speaks volumes….
George McLean
@1 and 3 Anon E Mouse
The King’s Fund say that figures for 2009 are doctors + nurses + ambulance staff total 485,904 and managers/senior managers total 42,509 out of total NHS staff of 1,177,056. So, there aren’t “more managers employed than frontline healthcare staff”, at least on this staffing definition. Maybe yours is wildly different. Your figures on differential recruitment rates don’t say anything about totals.
On your other points: I haven’t said the government shouldn’t change the NHS. Shirley Williams in yesterday’s Grauniad had some very positive ideas, but ones that she realised needed to be agreed with staff and patient groups, a very different position from that of Mr Lansley. And in respect of your partner’s positive experience of private medicine, well done her! What a good job the rest of us don’t have to fall back on privatised medicine (for which the NHS picks up the pieces and trains the staff).
P Spence
Cameron and Co are clear about what they are doing and are cynically diverting attention away from the core change they want which is to use competition to dis-establish and break up the NHS as a unified and democratically accountable public service. They have no mandate for such radical change which should be viewed as a reactionary step backwards, driven by dogma and disdain for State provision of any sort. Cameron by dissembling so, further risks aggravating the dire public mood towards politicians.
Anon E Mouse
P Spence – My business partner has a disease in both her shoulder bones. After a wait of nearly three years an operation on the left one on the NHS was performed and the results are 100% positive. It’s good.
On seeing the specialist last week and enquiring when her other shoulder could be done, she now has to restart from the beginning with the X-Rays and physio and the consultation. It’s bonkers.
If there was a choice of provider within the NHS another company would simply say they’d do it immediately because as the specialist said that’s all that needs to be done but his hands are tied.
If she wasn’t so left wing she’d pay for it and the same specialist would do it in another ward in the same hospital.
The system stinks and whilst I agree about the dire public mood towards politicians – remember Gordon Brown was the least popular Prime Minister in history, Cameron the most popular of the three party leaders – I just think this government should get on with it and be damned.
Sitting still whilst patients are left wallowing in filth in NHS hospitals is not an option…
Anon E Mouse
George McLean – My mistake sorry. I meant the increases as a percentage – management was up 84% in a decade (using your year, 1999, as the datum):
There are 375,500 qualified nurses – up 7,080 (1.9 per cent) on 2008 and a quarter higher than in 1999.
There are 44,660 managers – up 4,750 (11.9 per cent) on 2008 and 84 per cent higher than a decade before.
Still don’t know why you won’t discuss the dirty wards…