Left with the bill: NHS reform is upon us

Like it or hate it, the health and social care bill 2012 is here to stay – well, at least while the present government is in parliament. Among the 3500 pieces of legislation granted Royal Assent by the Queen over the past 60 years, few have had such a tumultuous passage as this health and social care bill that has finally completed its passage through parliament. Most modern legislation is enacted entirely unnoticed by an oblivious public. Some pieces become unpopular once they reach the statute book (such as the poll tax) and, very rarely, some issues become wildly unpopular as they pass through parliament (such as Sunday trading or fox hunting). This health and social care bill probably achieved a world first – losing huge popular support almost as soon as the White Paper that preceded it was published in July 2010 (Department of Health, 2010). 

Unfortunately, the final vote for the health and social care bill on 20 March 2012 ended more than a year of debate and several last-minute bids by many Royal Colleges to overturn or delay the legislation. In February’s editorial, I discussed the YouGov poll (38 Degrees, 2012) in which over 1600 NHS staff were interviewed and only 13% thought Andrew Lansley, Health Secretary, was doing the right thing. Even so, the bill was sent to the Queen for royal assent, and subsequently became law on 27 March 2012.

At the heart of the health and social care bill are the plans for a radical restructuring of the NHS in England, which will give GPs much control of the NHS’s £106 billion annual budget, cut the number of health bodies and introduce more competition between health services. The intention is to reduce administration costs by one third, which the government says is essential if the NHS is to cope with the ever-increasing costs of caring for an aging population and of new, expensive medicines and treatments. 

How sad that in a recent Department of Health survey (The Guardian, 2012), 40% of NHS staff responded that they would not recommend their friends or family to receive treatment at hospitals or clinics where they work. Many of these workers seem disillusioned by the government’s NHS reforms. In what was the ninth annual NHS staff poll, only a third of the total 134000 respondents stated that they believe there are enough workers at their trust to enable them to do their job properly, and 45% said that they do not have time to complete their tasks.

Dr Peter Carter, Chief Executive of the Royal College of Nursing, has stated that: “If ever there was proof of the pressures hitting the NHS frontline then this is it. It is worrying but not surprising that numbers of staff prepared to recommend their trust as a place to work are decreasing. Staff cutbacks are leaving nurses and other NHS workers so stretched that they can feel unable to deliver the level of care for patients that they would wish” (The Guardian, 2012).

Although I work in the NHS, because of the issues that are commonly reported in the news such as hospital-acquired infections, malnutrition on wards and low numbers of staff available to provide the care needed, I actually fear becoming acutely unwell and requiring hospitalisation. Our NHS used to be the envy of many other countries throughout the world, but I suspect such envy is decreasing more and more. 

Will clinical commissioning groups provide a better service for their patients? I guess we will just have to wait and see!