Earlier this week, Mike Farrar, chief executive of the NHS Confederation, described the NHS as "a super tanker heading for an iceberg".
Earlier this week, Mike Farrar, chief executive of the NHS Confederation, spoke out about members “doing their utmost to sustain our services” in the face of what he called a “super tanker heading for an iceberg”.
There will be a great impact on patients caused by what is fast emerging as a randomised approach to cuts, with Farrar now calling for radical action to overturn the mounting chaos.
Shadow health secretary Andy Burnham makes his views on the looming crisis very clear:
“I knew when I was secretary of state that there was a right way and a wrong way to rise to the Nicholson Challenge – and this government has chosen to tackle it the wrong way.
“In just a few months this is causing chaos below the decks.”
Given the continuous pronouncements coming from Andrew Lansley and Simon Burns, you may wonder what all the fuss is about. Where is the evidence to cause such a collective alarm? We are told waiting lists have never been in better shape, neither have any frontline staff been affected (cue incredulous gasps from the Royal College of Nursing) and despite the cuts there continues to be a rise in investment, so really patients should all be completely delighted.
Secretary of State Andrew Lansley and Minister of State Simon Burns would have us believe the results from the British Social Attitudes Survey released last week – which showed the largest ever drop in levels of faith in the NHS – are merely an uninformed aberration caused by troublesome anti-Bill campaigners. So of course, quite rightly, we seek proof rather than empty rhetoric.
• The NHS crisis: A spotter’s guide 18 Jun 2012
In response, Andy Burnham and his junior shadow minister Jamie Reed offer us detailed evidence to back up their accusations:
“Wider, deeper and more accelerated cuts [will] create a postcode lottery whereby 125 SEP treatments are restricted by at least one PCT.
“Despite the government’s promise of no rationing on costs, blanket bans on treatment or lifestyle judgements – this is happening against the backdrop of a £3billion programme of unnecessary change which has literally cast the system adrift into a world of randomness and chaos.”
Burnham and Reed highlight the contradictory statements coming out from Messieurs Lansley and Burns who would have us believe none of this is real:
“What? No, no – there cannot be rationing or blanket bans!” – Herr Lansley
“There will be NO direct rationing by cost – we have put a ban on caps!” – Signor Burns
Data has been gathered, initially as a result of meetings with individual patients and medical teams, and then in the form of thousands of responses to the NHS Check website, and verified by the response of 66% of PCTs, 100, to a survey asking about evidence of restricting, rationing or even dismissal of procedures which have been available on the NHS for decades.
The response is telling – not all PCTs who are cutting procedures are doing so in the same way (well hello postcode lottery), but there are common patterns: Tonsillectomy: 25%; varicose veins: 22%; knee replacement: 21%; hip operations: 18%; non-cancerous hysterectomy: 16%; bariatric – BMI conditions: 15%; planned Caesarian: 14%; paediatric hearing loss myringotomy, hysteroscopy: 13%; trigger fingers, D&C: 12%; erectile dysfunction including implants: 11%; laser treatment or scar revision, wrist ganglion, spinal cord stimulation: 10%. [100 PCT resp.]
As the Labour team seek to highlight :
• Restrictions are linked to arbitrary caps despite the ministers’ claims;
• Restrictions are being introduced which diverge from NICE guidelines;
• Restrictions cover a number of serious treatments affecting patients’ level of pain, mobility and quality of life;
• 22 treatments or services have been stopped altogether by at least 1 PCT;
• Patients in parts of England are left facing charges for essential treatments such as cataracts, knee surgery and hip replacements.
There are also obvious serial offenders such as Kensington & Chelsea and Westminster but perhaps none more so than Bassetlaw, where amongst a range of rationing measures, BMI boundaries are now re-invented with strict criteria for patients in this category to engage in every weight reduction programme in sight – including commercial diet plans, before surgery is allowed, if these are unsuccessful.
Also in the alarming range, further exploration has shown the concerns Lord Collins voiced in autumn 2011 are turning into reality.
Two Essex PCTs are restricting diabetes treatments, directly flouting NICE guidelines. It is well known that if treatment is not made available, the condition of the patient will worsen – and pain aside, the management of additional complications will be more expensive.
Lansley and his team must start considering the consequences of their ‘hard and fast’ approach to the cuts, considering how vital the NHS is to the people of Britain.