It must have been hard for anyone keeping up with the news to have avoided all the politicking around the health reforms in recent weeks (well it’s always been a subject for politicking) as the ‘listening exercise’ came to a close. But I think there has been a big omission in these debates that the politicians have yet to fully explore. While the focus has much been on the particularities of the reforms – GP commissioning, competition etc. – the biggest threat, and not the main focus, has only been mentioned in the preludes to speeches and papers. That threat is the crisis facing the NHS in its entirety. In a Radio 4 programme on 05 June 2011, Sir John Oldham and John Appleby (King’s Fund chief economist) outlined the future of a NHS costing close to 30% of GDP over the next 50 years if we provide services they way we do now. This is quite unsustainable, and a re-organisation of the NHS and GBP20 billion savings by 2015 will not be enough, a new social contract may be needed. But we live in the now, so for now we focus on the current reforms…
All three parties have been quite vivacious about these reforms, often overplaying and aggrandising their claims. But it is no surprise that one way or another, most of the proposed reforms have been on the table or even piloted in this country by both the Conservatives and Labour over the last few decades. It’s just that no one has tried to do it all at once. GP commissioning is not new, nor is introducing a bit of competition and private providers, but somehow when the Health & Social Care Bill was introduced in January things started to unravel for health secretary Andrew Lansley.
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