On 13 June NHS Future Forum, the body overseeing the government’s “listening exercise” on health service reforms reported and recommended changes to the government Bill.
Most of the recommended changes are cosmetic.
The Forum recommends that Public Health England (the body which will give advice to the new GP consortia, and to the government) should be an independent body, taken out of government control, and that all organisations involved in NHS care or the use of NHS funds should be “subject to ... high standards of public openness and accountability”.
The timescale of the changes should be altered and the previous deadline of 2013 extended where necessary.
The Secretary of State for Health should still be ultimately accountable for the NHS.
There should be better integration between different NHS bodies.
The report strongly urges the government to allow other health workers, such as nurses, specialist doctors and other clinicians to be part of the decision making.
It says that Monitor (the Independent Regulator of NHS Foundation Trusts), should not enforce competition within the NHS, and should only promote it in order to “improve quality, promote integration and increase citizens’ rights”
The report said it did not want private companies to “cherry pick” NHS services, but also that competition, if “properly regulated”, would not threaten "the fundamental principle of an NHS that is universal and free at point of delivery”. Privatisation stays.
There were also no suggested guidelines for defining what “good quality” is; presumably it relates to efficiency, rather than waiting times, quality of care, and survival rates.
So much for this listening exercise.
Dr David Price, of Barts & London School of Medicine and Dentistry, told Solidarity that he found a striking similarity between the “Future Forum language [and] the language of a Department of Health briefing”, suggesting that the document may actually “have been written by the Department”.
On the day after the report was released, David Cameron announced his acceptance of certain parts of the recommendations, specifically parts relating to accountability.
There are also plans to replace GP consortia with “clinical commissioning groups”. These will not cross any local authority boundaries. David Price believes this should be welcomed. The consortia had previously been criticised for not having geographic responsibilities to all patients (allowing consortia to “cherry pick” their patients and services).
However, ministers a week ago were not minded to make that change, and until such plans are fleshed out, they should be regarded with a degree of suspicion.
Cameron insists that the NHS will not be privatised. But, with the levels of market competition still included in NHS plans, his claims remain completely false.
We need to step up the campaign to defend the National Health Service.
