The NHS and the Government.
Could the NHS end up in a few years time being a franchise,’inadequately overseeing a fragmented and largely privatised service’? Rather in the style of a chain of chicken shops or cosmetic companies?
A new report –The Wrong Medicine. A review of the Impacts of NHS reform in England- doesn’t conclude that this is our fate,but more than hints that it is. The new economics foundation(www.neweconomics.org) has just published this persuasive and timely report into the NHS changes which have abounded since the arrival of the Coalition government. Much of the NHS change since 2010 has been obscured by the seemingly complex nature of the organisation and of its relationships with patients, Government, GPs etc. Amazingly, this report is in plain English, as it were, and manages the miraculous feat of telling the story of NHS change (lets not use the weasel word ‘reform’) so that we, the ordinary voters, can understand the fate of the NHS perfectly.
The report was written was written by Anna Coote( nepotism alert: she’s a friend) and Joe Penney.The simple task they set themselves was to review all the evidence showing that market based competition in the provision of health and care services works.
The evidence is scant to non existent. The authors found that academic studies of competition in the health ‘market’ show that market mechanisms or privatisation ‘have largely inconclusive or negative effects on quality or equity in healthcare’.
In other words, using the Government’s own professed requirement for evidence based policies, there is no evidence that the market is a better way of running the NHS than treating it as a public service.
Which of course it is.
The report lists the unending series of reorganisations within the NHS, stretching back to 1991. There has been one constant in all of this- the application of market rules and principles to healthcare. One odd but fatal result has been that preventive policies- in physical and mental health- receive much less funding and interest than intensive hospital care. There is, the report points out drily, no profit in a healthy person.
The report is succinct and timely. Everyone interested in the NHS should read it before the general election. (There has been very little public debate encouraged about the fate of the NHS).
With all the problems of marketization, the Government insists that the solution is more marketization.’When a patients life is threatened by food poisoning, few doctors would prescribe another meal from the same source.’
But our Government is doing exactly that.