h1. Open Letter To Don Foster MP About The Health and Social Care Bill

p(meta). 6th September 2011

Here’s a letter I sent to my MP Don Foster prompted by the return to parliament of the Health and Social Care bill (i.e. the NHS reforms). I have written to him before and received boiler-plate replies stating his support for the bill.

Dear Don Foster,

As you know, now is a crucial time for the future of the NHS. I have written to you about this previously and you said that you support the bill. I am writing to urge you to reconsider this.

The bill, even with the much-publicised amendments, will not achieve any of the goals that the government claims. It will massively increase bureaucracy and cost, replacing the current PCTs and SHAs with CCGs, HealthWatch, Monitor and more layers of paperwork. It will also increase costs - the NHS is known to be one of the most efficient healthcare systems in the world.

The following points summarise my main concerns:

1 - Monitor retains sweeping powers to inveigle competition into the NHS. Overseas companies running Trusts is already on the agenda at the DH. Many ex-Ministers are already paid by the private sector and a German company is in talks to take over a hospital.

2 - The Secretary of State divests himself of a direct duty to provide healthcare and transfers it to GPs to decide what is free on the NHS.

3 - If GPs save money from buying patient care they will be given bonus payments that they can spend, personally.

4 - GPs will be able to set-up private companies to treat their own patients and get paid, effectively, twice for the same person.

5 - GPs are able to devise their own CCG constitution and make up their own governance rules.

6 - Commissioning is too complex for GPs. They are already creating PCT-look-a-likes, many with private sector support that will deflect cash from care into fees.

38 Degrees have also paid for some independent legal advice which contradicts some of the assurances from the government: http://www.38degrees.org.uk/NHS-legal-advice/

Patients will no longer be assured that their GP is working in their best interests. GPs will go from having their patient’s best interests at heart to worrying about budgets. This is wrong. Also, GPs are not managers, they are doctors. It is absolutely right that much-maligned managers in the NHS do the managing - it’s a nonsense to claim that doctors will be better (or cheaper).

It is not the introduction of the private sector and ‘choice’ that will improve the NHS, it’s the elimination of the misguided internal market. Just doing that will save millions. These reforms will make the situation worse.

Finally, the ‘change is required because the NHS is unsustainable’ is a nonsense. The proposed changes have no basis in evidence that they will be more efficient - it is simply expensive to treat people who live longer. It is not ‘unaffordable’, we can easily afford it. No government that continues to fund things like nuclear weapons can morally claim that healthcare is unaffordable. Perhaps the government should stop funding weapons of mass destruction before telling us we can’t afford to continue to invest in improving the NHS? That aside, spending on healthcare is something we can choose to do if we wish. Claiming the money is not there is simply dishonest - the UK spends less on healthcare as a percentage of GDP than most other Western countries. If they can afford it, so can we.

Please assure me that you will not support the bill while these serious flaws remain. Nobody voted for these changes, and there is no merit to them.

Yours sincerely,

Dominic Tristram

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