Get Red Pepper's email newsletter. Enter your email address to receive our latest articles, updates and news.

×

Lancet editor and doctors write: The fight for our NHS goes on

As the health bill becomes law, Richard Horton, editor of The Lancet, and doctors Jacky Davis and Jonathon Tomlinson issue a call to action

March 22, 2012
7 min read

Photo: DulcieLee/Flickr

Richard Horton: “With the government’s health and social care bill having passed through parliament, what now?

First, we must realise that although we may have lost the legislative battle, we have not lost the argument. When Labour’s Andy Burnham turned over the keys to the Department of Health before the 2010 election, the mandarins told him that if he came back there was only one issue to worry about – the money. What he could not do was devise another fantastically ambitious NHS reorganisation. The NHS had to be about quality and efficiency.

When Andrew Lansley’s bill was published, Burnham knew that proposals for the biggest upheaval in NHS structures since 1948 were not what the country could digest. The health select committee agreed. Running a £20 billion efficiency programme alongside a massive change in philosophy (a new era of private sector colonisation of health services) was simply reckless. Not one expert inside or outside government believes this is a sensible strategy.

We are about to see a phase of unprecedented chaos in our health services. Those of us who opposed the bill should not gloat as this confusion takes hold. People will die thanks to the government’s decision to focus on competition rather than quality in healthcare. The coming disaster puts even greater responsibility on us to overturn this destructive legislation and remove this undemocratic government.

Second, therefore, we must begin collecting rigorous and reliable information on what is happening to our health services. When the Conservatives introduced fundholding to the NHS in the 1990s, it took years before we learned that the promises ministers had made were false. There was no consistent improvement in services. There were no gains in efficiency. Patients did not benefit from giving greater autonomy to GPs over how they spent their budgets. But the news of this policy failure came too late to influence the political debate.

We can’t allow that delay to happen again. We need to ensure that health professionals who study the NHS – and there are many of them – turn their attention to the bill’s impact on the lives of those who will suffer the fragmentation and disintegration of services. We need to build the evidence base now to show how the government’s policy is hurting people.

Finally, we must convert our arguments and the evidence we accrue into effective opposition. Labour was slow to respond to the Cameron-Lansley assault on the NHS. Those of us outside politics need to work harder to provide the necessary tools to the only opposition we have left. That way I hope we can make the NHS the central issue in the next election. The health of this nation depends on it.”

Richard Horton is editor of The Lancet.


Dr Jacky Davis: “It is inconceivable that we will all sit back and watch our NHS wantonly destroyed.  We must make it clear to coalition politicians that we will not forgive their anti-democratic behaviour. There are more than a million people working in the NHS; our votes and those of our friends and families will be used to punish the politicians responsible for this, both locally and nationally. We must also hold Labour to its promise to reverse the legislation when it is back in power.

The fight must go on in other ways too. Many groups have woken up to the dangers of the health bill and joined with campaigning organisations against it. Public health doctors, medical students and patients have all organised to protest and these groups can work together in future. There must be some sort of public statement, possibly a high-profile conference, to decide the way ahead and it must be made clear to politicians that the fight is not over.

We must monitor the changes to the NHS once the legislation comes into effect. By its very nature it will be increasingly difficult to know what is going on, as the service fragments and financial dealings and patient outcomes are lost behind a convenient curtain of ‘commercial confidentiality’. It is essential that we keep track of the bill’s effects if we are to show we were correct in our predictions of its dangers. The coalition will certainly not be telling us about the problems that arise, their predilection to massage the truth being only too apparent in their introduction of the bill in the first place.

Finally, we need an urgent inquest into the abysmal failure of medical ‘leadership’. Early and united opposition would have seen off the bill long ago. Instead our leaders, in trade unions and professional bodies, saw ‘opportunities’ and decided they could work with it on our behalf. When they were finally persuaded to see the dangers, their policy changed to seeking ‘significant amendments’, despite the fact that the government showed no sign of conceding any.

Few organisations conducted a proper campaign, even after being mandated to do so. The leaders of the professions were only moved to opposition after internal struggles and grass-roots organisation. They have not represented their members. They must be held to account for their failure and the whole structure of representation needs critical examination.

In sum, we will need a combination of actions such as continuing media coverage, evidence about the detrimental effects of the bill, protests, occupations and perhaps a refusal to co-operate with the legislation – for example, a boycott of the private sector. This battle may be over but the war is just beginning.”

Jacky Davis is a consultant radiologist and British Medical Association council member. She is writing in a personal capacity


Jonathon Tomlinson: “The first priority must be to protect patients, in particular those who are least able to articulate their needs or access care. The health bill is intended to convert healthcare and patients into commodities. GP will be pitted against GP and hospital against hospital, vying for patients. Patients will be expected to compare GPs and hospitals in league tables and shop around, competing with each other for increasingly limited resources. Hospitals will be allowed to succeed or fail according to the values of the market, irrespective of patient need.

Since it is far more efficient and profitable to care for people who are motivated and able to care for themselves, it is those patients who are lacking motivation and ability who will be the first to suffer. Services for people with mental illnesses, dementia, drug addiction and language barriers are being cut first because those who depend on them are least able to complain. We will need to take urgent action to protect them. ‘Occupy Healthcare’ as a movement will exist to show that healthcare for vulnerable people cannot be run according to the same business ethics as industrial healthcare. Day hospitals will need to be occupied. There is now a daily picket at the gates of Chase Farm Hospital to keep it open, with a view to occupation to prevent the closure of A&E and maternity.

The NHS has entered the political consciousness of the public more than at any time since it began. One urgent need is for all of us to get involved with the new democratic structures, however toothless they may seem. These range from patient participation in GP surgeries and GP commissioning groups, and membership of Health Watch and health and wellbeing boards to standing as non-executive directors at foundation trust hospitals and so on.

Finally, we have to reject industrial healthcare. It is unsustainable, unhealthy and immoral. It’s time to bring humanity and sustainability back to the NHS.”

Jonathon Tomlinson is a GP in Hackney.

Red Pepper is an independent, non-profit magazine that puts left politics and culture at the heart of its stories. We think publications should embrace the values of a movement that is unafraid to take a stand, radical yet not dogmatic, and focus on amplifying the voices of the people and activists that make up our movement. If you think so too, please support Red Pepper in continuing our work by becoming a subscriber today.
Why not try our new pay as you feel subscription? You decide how much to pay.
Share this article  
  share on facebook     share on twitter  

The new municipalism is part of a proud radical history
Molly Conisbee reflects on the history of citizens taking collective control of local services

With the rise of Corbyn, is there still a place for the Green Party?
Former Green principal speaker Derek Wall says the party may struggle in the battle for votes, but can still be important in the battle of ideas

Fearless Cities: the new urban movements
A wave of new municipalist movements has been experimenting with how to take – and transform – power in cities large and small. Bertie Russell and Oscar Reyes report on the growing success of radical urban politics around the world

A musical fightback against school arts cuts
Elliot Clay on why his new musical turns the spotlight on the damage austerity has done to arts education, through the story of one school band's battle

Neoliberalism: the break-up tour
Sarah Woods and Andrew Simms ask why, given the trail of destruction it has left, we are still dancing to the neoliberal tune

Cat Smith MP: ‘Jeremy Corbyn has authenticity. You can’t fake that’
Cat Smith, shadow minister for voter engagement and youth affairs and one of the original parliamentary backers of Corbyn’s leadership, speaks to Ashish Ghadiali

To stop the BBC interviewing climate deniers, we need to make climate change less boring
To stop cranks like Lord Lawson getting airtime, we need to provoke more interesting debates around climate change than whether it's real or not, writes Leo Barasi

Tory Glastonbury? Money can’t buy you cultural relevance
Adam Peggs on why the left has more fun

Essay: After neoliberalism, what next?
There are economically-viable, socially-desirable alternatives to the failed neoliberal economic model, writes Jayati Ghosh

With the new nuclear ban treaty, it’s time to scrap Trident – and spend the money on our NHS
As a doctor, I want to see money spent on healthcare not warfare, writes David McCoy - Britain should join the growing international movement for disarmament

Inglorious Empire: What the British Did to India
Inglorious Empire: What the British Did to India, by Shashi Tharoor, reviewed by Ian Sinclair

A Death Retold in Truth and Rumour
A Death Retold in Truth and Rumour: Kenya, Britain and the Julie Ward Murder, by Grace A Musila, reviewed by Allen Oarbrook

‘We remembered that convictions can inspire and motivate people’: interview with Lisa Nandy MP
The general election changed the rules, but there are still tricky issues for Labour to face, Lisa Nandy tells Ashish Ghadiali

Everything you know about Ebola is wrong
Vicky Crowcroft reviews Ebola: How a People’s Science Helped End an Epidemic, by Paul Richards

Job vacancy: Red Pepper is looking for an online editor
Closing date for applications: 1 September.

Theresa May’s new porn law is ridiculous – but dangerous
The law is almost impossible to enforce, argues Lily Sheehan, but it could still set a bad precedent

Interview: Queer British Art
James O'Nions talks to author Alex Pilcher about the Tate’s Queer British Art exhibition and her book A Queer Little History of Art

Cable the enabler: new Lib Dem leader shows a party in crisis
Vince Cable's stale politics and collusion with the Conservatives belong in the dustbin of history, writes Adam Peggs

Anti-Corbyn groupthink and the media: how pundits called the election so wrong
Reporting based on the current consensus will always vastly underestimate the possibility of change, argues James Fox

Michael Cashman: Commander of the Blairite Empire
Lord Cashman, a candidate in Labour’s internal elections, claims to stand for Labour’s grassroots members. He is a phony, writes Cathy Cole

Contribute to Conter – the new cross-party platform linking Scottish socialists
Jonathan Rimmer, editor of Conter, says it’s time for a new non-sectarian space for Scottish anti-capitalists and invites you to take part

Editorial: Empire will eat itself
Ashish Ghadiali introduces the June/July issue of Red Pepper

Eddie Chambers: Black artists and the DIY aesthetic
Eddie Chambers, artist and art historian, speaks to Ashish Ghadiali about the cultural strategies that he, as founder of the Black Art Group, helped to define in the 1980s

Despite Erdogan, Turkey is still alive
With this year's referendum consolidating President Erdogan’s autocracy in Turkey, Nazim A argues that the way forward for democrats lies in a more radical approach

Red Pepper Race Section: open editorial meeting – 11 August in Leeds
The next open editorial meeting of the Red Pepper Race Section will take place between 3.30-5.30pm, Friday 11th August in Leeds.

Mogg-mentum? Thatcherite die-hard Jacob Rees-Mogg is no man of the people
Adam Peggs says Rees-Mogg is no joke – he is a living embodiment of Britain's repulsive ruling elite

Power to the renters: Turning the tide on our broken housing system
Heather Kennedy, from the Renters Power Project, argues it’s time to reject Thatcher’s dream of a 'property-owning democracy' and build renters' power instead

Your vote can help Corbyn supporters win these vital Labour Party positions
Left candidate Seema Chandwani speaks to Red Pepper ahead of ballot papers going out to all members for a crucial Labour committee

Join the Rolling Resistance to the frackers
Al Wilson invites you to take part in a month of anti-fracking action in Lancashire with Reclaim the Power

The Grenfell public inquiry must listen to the residents who have been ignored for so long
Councils handed housing over to obscure, unaccountable organisations, writes Anna Minton – now we must hear the voices they silenced


117