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Do we need a cross-party commission on the NHS?

Dr Matt Mayer argues that something needs to change while Dr Bob Gill says that a cross-party commission will lead to privatisation 

YES

We need the NHS to stop being a political football; a tool for parties to use as leverage against each other. That’s why I believe we need an independent commission to produce a sustainable, evidence based plan for the NHS – to give it the funding and planning it needs, rather than just being made up as we go along, at the whim of whoever happens to be in power.

A commission is a group of people appointed by the Government to investigate a matter of important public concern. It’s absolutely key that the Government should be bound by the recommendations of a commission and that such a commission has input from all people who have a stake in the health service: patients, staff, experts, think-tanks, royal colleges and charities all need a say in how the NHS should be funded. One single group cannot and should not presume to know best, nor dictate to the others how it should be run.

That’s why this commission also needs to be cross-party. We need politicians from across the spectrum to back it, and to agree to be bound by its conclusions. Importantly, an independent and cross party commission would make recommendations based on objective evidence rather than political agenda or manifesto promises, as opposed to select committees which are composed of a majority of partisan politicians. Furthermore, a commission would be composed of (and not just take the advice of) members of the public, charities, royal colleges and think-tanks, providing a broader spectrum of expertise and an arguably more objective approach.

I know there is scepticism about a commission because it could simply further politicians’ interests and agendas – surprise surprise, they’re politicians, and the fact that people don’t trust them is hardly breaking news. But politicians run the country, and if we’re to give our health service a future we’re going to need them to buy into the idea. They need to all have a stake in it, otherwise they’ll just blame each other and the whole thing will collapse into a diluted soup of hot air and compromise.

I also hear concerns that a commission is part of some evil master plan to privatise the NHS. I don’t think this is true, parties each have their own red lines – which is exactly why I see safety in a cross-party approach. I believe in a free-at-the-point-of-need health service, which is again why I support a commission. The NHS is already haemorrhaging staff – a third of GPs are planning to retire in the next five years, a fifth of GP registrars are planning to emigrate, and recruitment figures continue to drop. The promise of gaining 5,000 more GPs by the next election is laughable.

Something has to change, drastically and a cross-party commission might just be the way to save the NHS.

Dr Matt Mayer is a GP in Buckinghamshire, and is a member of GP Survival and NHS Survival

NO

A cross-party commission would give the Government an excuse to bring in a raft of privatisation measures.

A look at the backers of this cross-party commission demonstrates its nature: Steven Dorrell, Conservative MP, Liberal Democrat Norman Lamb and Alan Milburn, former New Labour health secretary have had links to privatisation schemes. Can it be wise to trust this tainted ‘all-party’ trio with the future of the NHS?

Genuine NHS defenders, such as Keep our NHS Public and National Health Action party leaders, see the danger and have strongly rejected a commission.

In a letter with over 400 signatories, we have stated that ‘The bill’s apparent aim is to take a neutral stance on the NHS and aim for cross party consensus. In the current political climate and with these champions for its cause we feel this is far more likely to be a move towards validating calls for charges and co-payments, which the Government dare not propose directly itself.’

Our letter also stated that ‘no party has clean hands’ in what has happened to the NHS over the past few years, with ‘crippling Private Finance Initiative (PFI) debt, handing over public buildings to private developers, endangering staff and patients through unsafe and unfair contracts, downgrading medical training standards and allowing American health insurance industry ethics to be ingrained in our NHS culture.’

Campaigners therefore expect a commission to recommend the next wave of the privatisation’s ‘zombie policies’, the imposition of user charges and top-up insurance which betray the heart of what the NHS stands for.

Complicit media reporting reinforces the privatisation lobby’s position, with constant claims the NHS is ‘unsustainable’, despite being ranked as the best value for money health system in the world.

Should a sensible recommendation appear amongst the commission’s proposals, it would either be ignored or used as a figleaf to maintain the deception.

To save the NHS from corporate takeover, we must instead renationalise it immediately, removing all the costly market bureaucracy and the dangerous practice of profiteering from our NHS.

Dr Bob Gill is a GP in Kent. You can follow him on Twitter @drbobgill and he appears in the film Sell-Off which explains NHS privatisation

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Readers' comments (11)

  • The fact that we all have to face is that there will be NO new government money for healthcare. Demands will continue to rise for access to health and social care. Although this government seems to be taking the lead on this, exactly the same will happen in other countries very shortly.

    UK PLC is virtually bankrupt. The U.K. has borrowed proportionally far more than Greece. The only reason that our situation is not as severe is that the interest rates HM government pays are very low. Rates of interest on government bonds could rise at any minute. Just a 1% rise would bring about complete chaos in this country. All public services would be completely decimated. It's quite likely that we would not receive any income and retired doctors would not receive pensions. Don't forget interest rates in the past have been significantly higher.

    What the BMA should be doing is designing a health service that can provide as good care as possible with the decreasing money that will be available as our population ages. This may mean limiting the number of consultations per patient per year. It will probably mean copayment for most patients as exists virtually everywhere else in the world.

    There is no point in continuing to argue for more funds, when they are not going to Materialise

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  • The only reason the government doesn't take even more money out of healthcare is because they know at the moment it would be disastrous for them at the next election.

    So instead they put pressure on healthcare workers by increasing their work and steadily decreasing income. Of course at some stage capital forces will come into play so long as healthcare workers can find better paid jobs with less stress elsewhere.

    To politicians it's just a game. They have to balance the economy, but they also need to win the next election.

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  • Why would we need a commission to tell us what we already know, and what they won't do anything about?

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  • The BMA has a duty to work on behalf of its members. It should make sure the job of a doctor is not too stressful and is appropriately paid. It is not their duty to decide how much the Department of health will give. The BMA should be involved in costing the delivery of health care and if the government will not provide this level then they should be supporting copayment. No government in the world is going to continue to fund increases in healthcare expenditure. It might have been possible, although even then very unlikely, if the world was not facing such a huge economic meltdown.

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  • Please read following article from Oliver Letwin and John Redwood written in 1988. "Britain's biggest enterprise: Ideas for radical reform of the NHS" and written in 1988".
    They thought of privatising NHS in 1988. SO it's all going as per plan. We don't need cross party consensus.

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  • Standard NHS care free at the point of delivery will not last. It is not affordable any more. Demand for healthcare is going to rise enormously.

    So the BMA, in addition to designing an appropriate health service for health conditions and patients, should be actively involved in making certain that groups of doctors (GP federations in GP land) and I am not sure what the equivalent will be in secondary and tertiary care, are able to have control over the health service including their work conditions. Working for virgin health, care UK or United health could even be worse than working for the NHS. So basically the BMA needs to stop expecting more money from the government and look at the wider issues of how doctors and patients will manage as more of the NHS is privatised and make certain that the working lives of health clinicians does not become worse i.e. to become a proper union

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  • Anonymous | GP Partner18 Mar 2016 3:47pm

    agree

    it's time for the BMA to come off the fence and decide do you support doctors or the system.

    1. demand increasing year on year
    2. estimate 4% increase in funding needed yearly to maintain service
    3. with increasing demand - you need much more than 4% increase in funding to deliver what is promised.
    4. supply i.e. funding has been throttled - this means it is impossible to deliver what has been promised to the public
    5. the only part of the supply vs demand equation that has been tackled is staff T&Cs (wage demand). Even if the state gets its way with a 20% pay cut to all staff it equates to a one off income of £20 billion which won't last long with rising demand and capped supply (funding). It is not plausible to raid T&Cs every 5 years.
    6. we may pay less per GDP than other countries but we have a 1.5 trillion deficit with a c 50 billion yearly interest payment. Politicians have categorically stated there is not enough new money for the NHS
    7. with no new money to fund rising demand the NHS is realistically not sustainable i.e. it isn't realistic that the tax payer will want to pay continually rising GDP towards healthcare - why if costs are increasing by 4% per year and national growth is

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  • 7. with no new money to fund rising demand the NHS is realistically not sustainable i.e. it isn't realistic that the tax payer will want to pay continually rising GDP towards healthcare - why if costs are increasing by 4% per year and national growth is

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  • Of course many people will say "why not raise taxes instead of borrowing more or introducing copayments." The answer is that parties that raise taxes do not win elections.

    My view is that the Government is deliberately putting pressure on NHS workers and wants the BMA and nursing unions to support copayments as the solution.That way blame is not put on government(s). And I do mean all Government parties. Despite what you might think the Labour Party understands that healthcare, funded purely through taxes or borrowing, will become unaffordable in the future for the reasons given.

    The BMA should support copayments, but state clearly the reasons why it is the only solution for the future of healthcare delivery. We all know that this is a difficult thing for the BMA to do. However it is the only solution.

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  • The BMA SHOULD support co-payment - it manages demand and creates incentive to not waste valuable NHS resources. What's more, if we want the solution, we must share the political pain.

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