Organisational Responses To The Reformed Reforms
The governments’ response to the Future Forum fails to satisfactorily address all the concerns of the BMA; specifically regarding the competition role of Monitor, and the duty of Andrew Lansley to provide comprehensive health services. They are concerned by the government’s determination for all trusts to have foundation status and believe that the exposure of the NHS to competition law will embroil commissioners in endless legal action at the hands of unsuccessful bidders for NHS services.
The Royal College of GPs Chair, Dr Gerada, had this to say on the governments’ response to the Future Forum: “We are pleased that the Prime Minister now seems to be addressing the concerns that the RCGP has been raising since the outset - competition, choice and the role of the private sector; ensuring that the Secretary of State remains accountable for the health service and how we deliver improved and joined-up care for our patients as a result of the reforms.”
The King's Fund
Chief Executive Chris Ham has said that the amendments signalled a “more promising approach” than the original Bill. However, although he believes there is “much to welcome” in the proposed amendments, he also argues “the sheer number of changes being made to the structure of the health system risks creating confusion and additional bureaucracy.”
CEO Mike Farrar on the proposed amendments to the Bill: “The Government has shown that it has listened to the NHS on its reform plans and has responded positively to what the NHS wanted.” He added “We are pleased to see that the government has recognised the importance of promoting integration but believe it is also important to recognise that for some services the use of choice and competition is also an essential route to deliver the best patient care.” He also applauded “the importance of a stable transition” while hoping there will be real momentum towards localism. The NHS Confederation represents providers and commissioners of NHS services in England.
UNISON feel there have been some victories from the listening exercise, but believe significant problems remain: the policy of ‘Any Willing Provider remains’; the private patient income cap remains; EU competition laws are still likely to be invoked by private companies; the Secretary of State will not be responsible for securing NHS services directly; and there is no suggestion that staff rights will be honoured. UNISON is therefore still opposed to the Bill.
UNITE also remain opposed to the Bill, and are calling for it to be scrapped. They object to the fact that the proposals are untested and not based upon evidence, and will begin a rapid slide towards privatisation and the introduction of social insurance. UNITE are calling for constituents to call on their MPs to say ‘No’ to the Bill, arguing that the Bill will put competition ahead of patients needs.