lizziec: (Frazer-doomed)
[personal profile] lizziec
I've written to my MP about the Health and Social Care Bill that's currently wending its way through parliament. I do not hold out high hopes that he will vote against it, as he's a Conservative MP who tends to vote with the whip, but I'm hoping he'll take notice. I've tried to be respectful and outline clearly and concisely why I disagree with the bill. At least he can't ignore me because I was rude or using a form letter.

If you're in the UK and disagree with the H&SC bill, which will lead to greater private involvement in the NHS and could possibly lead to the end of the NHS, then please please please take the time to let your MP know how you feel about it using Write to Them. If you need to (lack of spoons/whatever) then please feel free to adapt my letter to your own views.


Dear Mr Brazier,

As a constituent, I would like to express my concern about the Health and Social Care bill currently moving through Parliament, and respectfully ask that you vote against it. If you do not feel that you can do this, I would very much appreciate it if you would please delay voting for it until after the Risk Register has been released and all the information available about the possible consequences of the Health and Social Care bill is available. I would also appreciate it if you would put pressure on the Government to release the Risk Register, in accordance with the recent ruling by the Information Commissioner, which was upheld on appeal. Unless this available for everyone to view before the legislation is passed I will not be reassured that all possible information was available for a properly informed choice to be made before the bill is passed into law.

I understand that the government line is that reform is urgent and necessary, but based on available information about current performance of the health service; I do not believe this to be the case.

According to a 2011 study in the Journal of the Royal Society of Medicine the NHS is one of the most cost efficient health services in the world, second only to Ireland in the last 25 years, based on data from the 11 countries studied. The fully private US system was the least efficient. That means that the NHS saved more lives per pound spent than almost any other system. My concern is that the reforms will add in layers of bureaucracy and lead the NHS to become less efficient.

The government also claim that outcomes in the NHS are significantly worse than in other health systems in the developed world, but I believe this is a misrepresentation.

A data briefing in the British Medical Journal in January 2011 states that in the UK deaths from heart attacks were falling faster than anywhere else in Europe, despite the fact that UK health spending is still only the European average. The Department of Health also recently released data that shows that waiting times for diagnostic tests have been falling, and are continuing to do so.

This does not sound like a health service that is performing so badly that it needs urgent and massive reform. David Cameron himself promised that there would be “No more top-down reorganisations of the NHS”. These reforms were referred to by NHS Chief Executive Sir David Nicholson as “so large it can be seen from outer space”, and could not be described as anything other than top down, coming as it does from central government in a bill so massive that it is longer than the one that formed the NHS. Additionally, there have been so many amendments to this legislation that what was already almost incomprehensible has become completely obfuscated with legalese and no clear purpose beyond that of reform at any costs. I believe that the bill is now so complex that it cannot be properly understood or scrutinised, and the lack of understanding and scrutiny is putting the Health Service, and the principals that underpin it at real risk.

More than that, these reforms threaten to fragment the systems of the NHS further at a time when more cooperation than ever is being required to deal with budget cuts and the complex needs of an aging society. This is because there will be significantly more Clinical Commissioning groups than there are Primary Care Trusts and no guarantees that they will coordinate care. It is also removing the role of commissioning from those from those who know how to do the job to those who not only do not have experience in the problems of commissioning, but also have a full time job already – that of caring for patients.

I believe that this will have two major outcomes. The first is that there will be less cooperation, leading to worse patient outcomes and costing the Health Service more in the long term. I also believe that the Heath and Social Care bill will lead to less trust in those who need to be trusted most. In the NHS under the Health and Social Care bill there will always be the nagging fear and question of whether a GP recommends or does not allow a particular type of treatment because they are concerned with money and making a profit over the health of their patient. This should be a concern that never enters into the mind of a patient, who is often as scared and vulnerable as they will ever be when they visit their GP. My concern is that the Health and Social Care bill will only add to the distress of patients in this situation by removing from them the certainty that what their doctor advises is only based on medical factors.

I am aware that some in Government believe that the plans are already too far advanced to be stopped now, and I am concerned about this argument, given that apparently the organisation and the systems are in place before the legislation has been passed. I do not feel this is an acceptable state of affairs. Surely organisation should wait until after legislation has received royal assent, or what is the point of bills going through the parliamentary process in the first place? Furthermore, the fact that Clinical Commissioning Groups have been formed is being used as evidence that GPs and other doctors are supportive of the reforms. Again, I do not believe this to be the case. The only thing that the formation of Clinical Commissioning Groups proves is that doctors are trying to be prepared for the reforms, which they were told would mean they would need to start commissioning by next year. This preparation should not be taken as an indicator of support among health professionals. Indeed, it seems that nearly every professional body within the NHS has come out against the bill, including the Royal Colleges of Nursing, Midwifery, General Practitioners, Anaesthetists, Ophthalmologists, Paediatrics and Child Health, Pathologists, Psychiatrists, and Radiologists, as well as the British Medical Association.

Of huge concern to me is the fact that, despite safeguards, it’s extremely likely that the NHS will be subject to cherry picking by private providers who will choose to bid for the easiest and most profitable procedures, leaving the NHS institutions with the procedures that are most costly in terms of both time and resources, meaning that they will lose money and go bankrupt. For starters, most private providers do not have facilities for Intensive Care, which leaves the burden of the most difficult care on the NHS. The effects of a hospital going bankrupt and having to close are potentially disastrous, not just to the NHS as a whole, but also to the local community that it serves. I do not believe there are enough safeguards in the existing bill to prevent this problem from occurring.

My concerns over the idea of cherry picking is also applicable to the field of Mental Health. This is very much a Cinderella service even under existing provisions, and while it may be profitable and desirable for various private providers to offer courses of Cognitive Behavioural Therapy, complex therapies and talking therapies cost more, and take far more time. For this reason, I am concerned that Mental Health provision will suffer under this bill.

Finally, I feel it is important not to further open the door to privatisation. The idea of the NHS being free at the point of need is incredibly important. The idea of patients and their families having to worry about the cost of their treatment on top of the costs and worries of having an illness or disability in the first place, as they already do in the American system, is repugnant. All people are worth more.

For the reasons outlined above, I exhort you again to please vote against the Health and Social Care Bill when it returns to the House of Commons, and to make clear my concerns to the government.

Yours sincerely,
[personal profile] lizziec

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