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At the heart of general practice since 1960

Will the NHS survive another five years of the Tories?

Dr Andrew Hardie says the Conservatives are making the NHS more effective but Dr Jackie Applebee argues that a Tory majority means the fight is on to save the NHS

YES

Prime Minister David Cameron has often described his tremendous gratitude to the NHS for how it looked after his son during his short life. Ten NHS doctors and nurses have just been elected to Parliament as Conservative MPs. These are just two examples of the deep and personal connections the NHS has with the Conservative party.

It was a pleasure to see so many positive messages about our NHS in the Conservative election campaign; they stand in stark contrast to the carping - and often untrue - stories from the Labour party.

I’ve spent the entirety of my professional life working for the NHS. But I know that if it fails to adapt to change, it will wither and die. I was driven to become a Conservative candidate in 2010 by the frustration of seeing how the last Labour Government, with its top-down bureaucracy, was failing to modernise the service. With so many deserving causes, it simply isn’t justifiable that a huge increase in expenditure resulted in a 3% decrease in productivity under the Labour administration.

The Conservatives are moving the NHS forward. For instance, putting public health back into local authorities’ hands is bound to help further the integration of health and social care. I have already seen this produce a cross-fertilisation between the two and it is another example of how new structures are beginning to break down the ‘silo’ culture that has so damaged service integration.

Additionally, the Conservatives’ plan to create CCGs gave responsibility to GPs, who know their patients and know the structures of the NHS. GPs’ dynamism and creativity has become a driving force in commissioning.

CCGs have led to more effective healthcare, making full use of modern devices and techniques, and drawing on GPs’ expertise to carry out more work in primary care and reduce unnecessary hospital referrals. This has maximised resources and resulted in less time being wasted for patients.

Labour’s bureaucratic approach to the NHS demonstrably failed to produce real, effective change for the people whom the service is meant to serve. Despite some small, headline-grabbing successes, the party failed to address the more important task of adapting the fabulous creation of 1948 to today’s needs.

The Conservatives know how to introduce modern advances effectively to make the patient journey to care easier.

Dr Andrew Hardie is a retired GP and a Conservative councillor in Sutton Coldfield

NO

Now that we have a majority Conservative Government, the Health and Social Care Act will not be repealed, which may finally kill off the NHS.

Privatisation, which accelerated under the Coalition, will continue apace and there is likely to be a transatlantic trade agreement that makes a return of the NHS to public ownership almost impossible. Billions will be wasted as the market promotes competition and fragmentation over collaboration and integration.

A two-tier NHS will now be enshrined. Cash-strapped trusts, many tied into usurious PFI contracts, may have little choice but to exploit the Act’s provision that allows up to 49% of their work to be in the private sector - pushing NHS patients to the back of the queue.

Figures show private firms won 37% of contracts awarded in England last year. This trend will continue, with Jeremy Hunt remaining as health secretary. Former minister for government policy Oliver Letwin, who allegedly said in 2004 the NHS ‘will not exist’ within five years of the election of a Conservative Government, is now a full member of the Cabinet, perfectly placed to ensure his prediction comes true.

NHS funding is falling as a percentage of GDP, while demand rises. Even if the promised £8bn a year by 2020 materialises, it will be nowhere near enough. And former NHS chief executive Sir David Nicholson said the extra £22bn savings called for by his successor Simon Stevens will be hard to implement.

Experienced staff are leaving the NHS, while pay freezes, cuts and unmanageable workloads have brought morale to breaking point - a problem that will only worsen with the Tory majority.

But history shows GPs and other health workers can join with patients, fight back and win. The Save Our Surgeries campaign in east London won a reprieve for the practices worst hit by the MPIG withdrawal, and the people of nearby Lewisham successfully campaigned to save their hospital.

Midwives, nurses and radiographers have shown they are ready to stand up for the NHS by taking industrial action. GPs could follow their lead by, say, collectively refusing to undertake activities not directly related to patient care. Founder Aneurin Bevan said the NHS ‘would only last as long as there are folk with the faith to fight for it’.

The time for that fight is now.

Dr Jackie Applebee is a GP in east London and chair of Tower Hamlets LMC

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Readers' comments (18)

  • As a life-long Tory voter and sometime party member I have to disagree with Dr Hardie.

    Cameron and Hunt are overtly creating a crisis of collapse in general practice so that they can blame it on GPs and step in to save the day with their big corporate chums like Branson. Is it mere coincidence that they appointed United Health's head of overseas expansion as chief exec of NHSE?

    At my practice we have been advertising for several new GPs for many months. We are in a lovely part of a lovely and attractive town in one of England's most popular areas and we still make decent profits yet how many applications have we had? Not a single one. General practice is in total meltdown, caused by the actions of Cameron, Lansley and Hunt and it is not an accident, this is their deliberate policy to create the crisis so they can "save" general practice by selling it off.

    You can certainly accuse Labour of top-down, uncaring, micro-managing, smothering bureacucracy. And what have Cameron, lansley, and Hunt done instead? Imposed the biggest, costliest, most pointless, top-down, uncaring, micro-managing, smothering bureacucracy ever. And created management chaos and management sclerosis as well. Jeremy Hunt refused an NHS 1% pay rise last year on the basis it would cost £250million that he didn't have to spend, while neatly ignoring they have spent something like £3billion on Lansley's clinically insane idea to simply re-arrange the bureaucracy's deck chairs. Funny how they can find eye-popping sums for their personal vanity projects but can't find 1/12th of that amount to pay the overworked and undervalued staff on which the whole edifice relies.

    As for your statement that "CCGs have led to more effective healthcare", well I nearly choked on my coffee.

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  • So glad that a retired GP can give an opinion on current coal face reality.

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  • No, it is neither national or a health service .

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  • Yes, I think those who actually work day to day have a better understanding of the issues.

    "CCGs have led to more effective healthcare, making full use of modern devices and techniques, and drawing on GPs’ expertise to carry out more work in primary care and reduce unnecessary hospital referrals. This has maximised resources and resulted in less time being wasted for patients."

    There are so many things wrong with this statement it's hard to know where to start!

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  • "CCGs have led to more effective healthcare, making full use of modern devices and techniques, and drawing on GPs’ expertise to carry out more work in primary care and reduce unnecessary hospital referrals. This has maximised resources and resulted in less time being wasted for patients."!!!!

    WTF !!!

    What is he smoking!!!

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  • Vinci Ho

    Editor ,truth is:
    This debate will be more credible if it was between Sally Woolaston and Jackiee Applebee.

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  • Dr Hardie appears to have jumped head first down the rabbit hole.

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  • Sorry Dr Hardie, you are a party member and propagandist with no evidence to back up your fantasist claims for what CCGs have achieved

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  • It's already dead. I remember 3- 4 years ago standing in a car park after a locality meeting speaking with several other young GPs who had recently qualified, along with myself. The discussion was was overwhelmingly negative and centred mainly around the fact that most of the doctors (probably 5 or 6 early 30s GPs) couldn't wait for the NHS to be privatized (or part privatized) so that we could finally get some semblance of control over our workload and conditions like out dentist colleagues.

    3 out of those 5 or 6 including myself have all left the NHS to work abroad. Another member of the group has left medicine altogether to work in industry.

    I've been away from old blighty for almost 3 years now and keep hearing from my old chummies just how bad things are over there. One of my very good friends is a VTS teaching lead, who mentions ST1, ST2 and ST3 ( formerly GP registrars) talk endlessly about qualifying and then emigrating, so much so that they've started spinning how things will improve shortly, in a effort to convince the credulous few to stay and stem the blood loss. If the young and foolish can't be convinced to stay, join a partnership and instead prefer to locum or emigrate ( in some cases within days or weeks of qualifying) what hope is there????

    I haven't Even mentioned the folk in the twilight of their careers who, if treated correctly, might be convinced to slog it out for another few years, yet choose to retire prematurely.

    The funny thing is that as a newly qualified GP even in 2010, just a few short years ago ( seems now like an eternity though) I would have laughed at anyone who would have told me I would be living and working abroad as a GP. The reality however is that the future for young GPs like myself was becoming more and more dreadful and many have had to take a stand. Working abroad has opened my eyes to exactly how controlling and despotic the NHS is. Where I am now my views and opinions are respected and sought after. My pay is linked to how hard I choose to work.

    If the NHS and govt can't protect it's most valuable resources it's already as good as dead and buried. A couple more years of the same and the majority will hold this view.

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