Wednesday 2 March 2011

Lansley's reforms will privatise the NHS

Reports today that private healthcare firm IHP is in talks with a number of GP consortia to take over their NHS commissioning budgets, and to potentially drive savings in the costs of delivering services to generate profits, are not surprising.

For months, senior figures in the NHS and beyond (including a Tory MP) have been warning that Andrew Lansley's reforms will open the door to the privatisation of almost every aspect of the NHS. Lansely and Cameron, meanwhile, said nothing of this publicly pre-election... although the signs were there.

The BMA will, on 14 March, vote on whether to overturn its leadership's policy of critical engagement with the government. Meanwhile, almost every part of the medical and healthcare establishment is in opposition to the reforms - including very many GPs themselves. And, as it has become clearer that this is a policy of privatisation, opinion against the reforms has hardened.

For what does privatisation bring? Not equity of patient care. Not even efficiency, as the Commonwealth Fund has demonstrated. And not necessarily better care either.

In the example of the IHP deal there is the huge danger that - as is commonplace in the US system - proft-making firms will actively seek to avoid where possible supporting patients deemed too expensive: those with long-term medical conditions or with terminal illness, for example.

Most duplicitous of all is Cameron's attempt to turn what is a demographic problem - an ageing population and consequent rises in health care costs - into a problem specific to state-delivered health care (in a similar manner that he has portrayed a crisis caused by then banks into one driven by excess public spending).

In fact, as he know doubt well-knows, rising costs are a huge issue for privatised systems too - something this blog will focus on in the next post.

The terms of this debate have been used in language so nuanced that much of the public isn't seeing these reforms for what they are. Those on both sides of the argument over Lansley's reforms should be clear: this is about the dismantling and privatisation of the NHS, pure and simple.

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