The damage to public health of Lansley’s bill shouldn’t be ignored

Until now, the extent of the potential damage to vital public health work of the health and social care bill has not received the attention it deserves.


Increasingly informed voices are being raised in concern and in protest at the health and social care bill.

Yesterday saw Andrew Lansley pursued through the corridors of the Royal Free under a sizeable police guard, to heckles of “shame on you Mr Lansley” and “you’re corrupt, working for the private healthcare companies, you should be working for the people”.

While a doctor said:

“I’m a doctor of 30 years Mr Lansley, explain to me how this is gonna make patients better because nobody understands your bill.

“It’s got a thousand amendments because it was so poorly drafted, and now you’re even making amendments today because the bill is rubbish and you know it, and you’ve given Mr Cameron one big headache.”

Watch it:

The latest display of public disgust with Lansley follows Saturday’s successful Drop the Bill Rally in Manchester addressed by an animated Andy Burnham, and comes before tomorrow’s demonstration in central London and rally in Central Hall in defence of the NHS.

The government would do well to listen. These are also the voices of patients and voters.

In Parliament, meanwhile, last Wednesday’s House of Lords debate saw detailed assessment of the clauses in the bill relating to public health – now shunted into the realms of local authorities amidst great concern about a loss of expertise.

Back in September last year, Lansley managed to wrap his famously flip-flop logic around this revamp, explaining that if the local authorities ended up out of their depth they could always refer back to medical colleagues for support:

“I always knew the consequence of giving local authorities health responsibilities carried with it a risk of no longer being embedded in the NHS – but we wanted to give it to LAs for a reason – to work alongside all their other key areas of responsibility.

“However if there are any uncertainties they will specifically look at the NHS contribution and those relationships.”

Debating last week for the Opposition, Lord Beecham noted how Dr John Ashton, north west England regional director of public health and regional medical officer, has been admonished for speaking up in concern about the re-alignment – effectively in demonstration of how the government is driving this bill through via a cartload of suppression and fear, rather than in the public interest.

The surprise of the debate came in the form of Baroness Cumberlege, one of the Conservative’s own, adopting a Lib Dem amendment and speaking out in strong terms about the disbanding of the Health Protection Agency in a revamp which would lose its’ worldwide reputation as an independent body and bring it under the absolute control of the government’s Chief Medical Officer/Chief Scientific Officer.

Given the government has being busily trying to distance itself from the NHS at high speed, this converse action appears a highly suspect way of controlling information and research relating to environmental pollution and even espionage (Litvinenko anyone?) This was a heated debate – with much ire from Lord Hunt (of King’s Heath, Labour) in his capacity of president of the Royal Society for Public Health (RSPH).

As Lady Cumberlege (Hunt’s RSPH vice president) said, she has never before brought an amendment to 3rd reading, but in this instance she would. Howe is seemingly keen to resolve matters behind closed doors – but this morning we find more than 500 public health specialists have produced a document to say the health and social care bill will leave public health compromised, weaker and less safe.

Dr David McCoy explains:

“Health professionals and the general public already know that the health bill threatens to do terrible damage to the National Health Service. But until now, the extent of the potential damage to vital public health work has not received the attention it deserves.

“Public health work is vital to tackling some of the biggest health problems we face, including diabetes and heart disease caused by obesity, lung cancer and many other illnesses caused by smoking, and AIDS and other diseases and conditions related to sexual health.

“But the government’s “reforms” will lead to increasing health inequality, and make it more difficult for us to address these health challenges.”

Today sees a lobby of social care specialists. As Lord Owen has said, ‘expectations of social care are not satisfied’ – this is something which will affect every family falling outside the millionaire category – and if the Dilnot recommendations continue to be rejected the future of health provision per se looks extremely bleak.

Brinksmanship is clearly to be the watchword of this week. Aside from spending three hours putting their case in tribunal against the release of the Risk Register, the government have now swished in another 63 amendments of their own for overnight consideration in the Lords – including the worrying abandonment of the LINK replacement Healthwatch.

This seems to definitively add weight to the pronouncement of Baroness Masham (of Ilton, Crossbench) from her redoubtable wheelchair:

“This bill is not very popular – patients are at the centre less and less.”

David Cameron, we hear, is willing to ‘take the hit’ for his place in history as NHS destroyer-in-chief, but is perhaps more bovvered than his bluff and bluster would have us believe, for over the weekend we find that ‘the reins of the future of social care have been taken over by No 10’.

Does this mean that he’s planning to call it the In Memoriam Raisa Plan? Oh how Putin would laugh.

See also:

As opposition grows and grows, Lansley and Cameron carry on regardlessJos Bell, March 5th 2012

Tory support down as Cameron gets an “earful” from ‘yes men’ health summitShamik Das, February 21st 2012

Raising the pension age will be a public health disasterSteve Griffiths, December 18th 2011

Why the government’s proposals on public health are dead on arrivalDiane Abbott MP, March 4th 2011

Public health aspirations undermined by wider coalition policiesTrevor Cheeseman, December 1st 2010

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