Monday, 1 September 2014

Politics: Can we reinstate the NHS?

Can we save our NHS? #MSBlog #MSResearch

"For those of who feel passionate about the NHS will find the following email from Professor Allyson Pollock in our medical school illuminating. The good news is there are people out there who are trying to make a stand on the NHS."

"I lot people have criticised me for highlighting political issues on this blog, but if you look after people with chronic diseases you soon realise health policy is critical to providing coordinated and appropriate health services to people with MS."

Public Health experts launch consultation on draft Bill to restore the NHS
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NHS Reinstatement Bill

Leading public health experts have launched a consultation on a new Bill that aims to reverse the failings of the Health and Social Care Act 2012 and fully restore the National Health Service (NHS) in England as an accountable public service.

The Bill proposes to abolish competition and the purchaser-provider split, re-establish public bodies and public accountability, and restrict the role of commercial companies. It draws on some of the best examples of NHS administration over its history, retains some features of the reforms laid out in the Health and Social Care Act 2012, and would be implemented on a timescale determined by the secretary of state.

The Bill would
  • reinstate the government’s legal duty to provide the NHS in England
  • re-establish district health authorities in England as a special health authority with regional committees and modified functions
  • re-establish district health authorities (coterminous with local authorities), with family health services committees to administer arrangements with GPs, dentists, and others
  • abolish competition and marketised bodies such as NHS trusts, NHS foundation trusts, and clinical commissioning groups, as well as Monitor, the regulator of NHS foundation trusts and commercial companies
  • end virtually all commissioning and allow commercial companies to provide services only if the NHS could not do so and otherwise patients would suffer
  • re-establish community health councils to represent the interest of the public in the NHS
  • prohibit ratification of the Transatlantic Trade and Investment Partnership and other international treaties without the approval of Parliament (and the devolved bodies) if they would cover the NHS.

This Bill is a vital public health measure. It will both restore the NHS in England and reverse more than two decades of policies which have been intent upon privatising NHS services and funding, ultimately to its demise.

As the failures of the 2012 Act become daily ever more obvious, this Bill provides a template for very necessary reinstatement and reform.

The Bill has been drafted by barrister Peter Roderick with the assistance of Prof Allyson Pollock. They have benefitted from discussions with individuals and organisations concerned about the increasing role of the market in the NHS in England over the last 25 years. They wish to consult on the Bill with those who share their concern and our commitment to reinstating fully the NHS as an accountable public service as smoothly as possible and with only a minimal and exceptional role for commercial companies.

NHS Reinstatement Bill

Responses to the Bill can be sent by email to
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  1. do you think you reflect the principles of the NHS Prof G?

    1. Re: "do you think you reflect the principles of the NHS Prof G?"

      No, not anymore! The two founding principles of the NHS are (1) free healthcare at point of access and (2) equity. I have referred several of my patients to my NHS colleagues to write private prescriptions for fampridine under the NHS. In medicine omission, i.e not performing the act by getting someone else to do it, is the same as commission. Private prescribing in the NHS is the beginning of the end; it means that the care is not free at point of access and it is not equitable; only those who can afford to pay for the treatment get it. The philosophical question is to whom is my primary responsibility; the patient in front of me in my clinic room or the NHS's founding principles? Socialist healthcare is under attack on all fronts. Although, I still believe that access to health care is a basic human right the debate has moved onto at what price? It is now all about cost-effectiveness and rationing. I don't like my role as a rationing agent.

    2. If you can't act as a "rationing agent" aren't you shirking your responsibility as an NHS employee? Isn't rationing of healthcare a core NHS principle? If this is the case you don't reflect the principles of the NHS on three fronts.

    3. Anonymous, 3:36:00 pm

      You clearly some cynical leftist who does not have MS. If you have a disease all you want is the best care possible at all costs. Have been following the Ashya King saga? His parents have been arrested trying to get him the best care possible; it is clear that his parents weren't happy with the rationing of his treatment under the NHS. Wait until you or someone close to you gets ill and needs a rationed treatment.

      Prof G I am all for you; please keep up the good work and ignore these trolls.

    4. In some ways I understand that some drugs and treatments are rejected by NICE. How do you compare a child needing expensive Proton treatment with drugs that are not proven or may only extend life by 6 months with poor quality? I wouldn't want the job deciding. However, what I cannot comprehend, is the outsourcing of pathology work (except where the company can't make a profit) and Radiology where patient care is substandard. The private companies wouldn't do it if it wasn't profitable, so the NHS, ie. taxpayer are bankrolling privatisation.

    5. I think any doctor that signs a private prescription in the NHS should be kicked out of the NHS. To save the NHS we need to have clear lines of what is acceptable practice and unacceptable practice.

    6. Re: "I think any doctor that signs a private prescription in the NHS should be kicked out of the NHS. To save the NHS we need to have clear lines of what is acceptable practice and unacceptable practice."

      I am not sure this workable or realistic. Any doctor registered with the GMC can write a private prescription. I think if you did a surveyed in the UK you will find that most medical doctors in the UK who work for the NHS write private prescriptions.

      I suspect you are referring to writing private prescriptions for patients under their care in the NHS? If this is the case you need to take your case to your MP, but I doubt you will get very far. The legislation that allowed private prescribing in the NHS had cross-party support. Some would consider your proposal draconian, including me. We as doctors have an obligation to treat our patients to best of our ability. If the NHS chooses to ration treatments based on cost, why shouldn't doctors be in a position to prescribe a rationed drug privately? Private prescribing is clearly a hot potato and has been endlessly discussed on this blog.

      We tried to set-up a BBC-type Question Time on this topic, but couldn't get a single politician to participate. I wonder why? I suspect the reluctance for politicians to publicise the issue is the answer. I interpret this as all the major political parties have agreed to semi-privatise the NHS; top-up private prescriptions is just part of the process.


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