Baffled? Moi?

Opposition to the coalition’s NHS Reforms has stepped up a pace again this week. The Royal College of General Practitioners (RCGP) has released a statement calling for the Health and Social Care Bill to be scrapped. Clare Gerada, chairman of the RCGP stated ’We cannot sit back. Instead, we must once again raise our concerns in the hope that the prime minister will halt this damaging, unnecessary and expensive reorganisation which, in our view, risks leaving the poorest and most vulnerable in society to bear the brunt.’ The Chartered Society of Physiotherapists joined the fray with ‘the views of patients and professionals had been ignored’

These two professional bodies alone represent 84,000 clinicians. They aren’t talking about pay or pensions – they are concerned with patient care.  Add the British Medical Association, Royal College of Nursing, and Royal College of Midwives and the growing body of evidence that this Bill remains unpopular becomes stronger than ever.

Then consider that the editors from three prestigious journals (British Medical Journal, Health Services Journal and Nursing Times) in an unprecedented joint editorial stated that the reforms were already creating ‘an unholy mess’. They agreed that ‘the resulting upheaval has been unnecessary, poorly conceived, badly communicated and a dangerous distraction at a time when the NHS is required to make unprecedented savings. Worse, it has destabilised and damaged one of this country’s greatest achievements’

This all adds up pretty powerful commentary by respected individuals and organisations. The sort of commentary that surely deserves some reasonable and carefully worded response from the architects of this ‘unholy mess’.

Not so. Health Minister Simon Burns said he found the criticism from GPs 'baffling' and in defence of the Bill his best shot was that the RCGP had previously supported some aspects of the Bill. He went on (or should I say whinged on?)  ‘Now we have this constant criticism and I find it in one way baffling, because it's not representative of what I hear GPs up and down the country saying, now that they're beginning to engage in having the powers to determine the care that needs to be commissioned for their patients.’

Hardly a well-considered response and still no real justification or explanation of how these reforms will actually improve the NHS while achieving a 4% saving year on year.

Burns’s boss, Andrew Lansley, has remained remarkably quiet this week, and it would seem that he still finds it incomprehensible that anyone would dispute the validity of his brainchild, despite over 12 months of dissent, growing more vehement by the day.

I agree with the three editors when they suggest that the Bill will no doubt become law and the way forward is that ‘Parliament should now establish an independently appointed standing commission, to initiate a mature and informed national discussion on the future of our national health system. Let us try to salvage some good from this damaging upheaval and resolve never to repeat it’

But back to being baffled – even though everyone involved with the NHS may have to accept that these reforms are now unstoppable there are still some questions that really warrant a decent answer.

 
Why has David Cameron not intervened to at least improve the quality of ministerial statements around this top down reform?
Why has Lansley been allowed to continue with his intransigent rhetoric surrounding key elements of the Bill?
Why have so many independent, intelligent and experienced voices been ignored?
Why was such a drastic, complex, top down shake-up of the state funded health system planned to coincide with major savings demands?

Baffled? It’s not you, Mr Burns who should be baffled. It’s the rest of us…