Do you realise what a momentous change takes place today, 1st April? Our beloved NHS, as we know it, will be abolished, just short of its 65th birthday. The Health and Social Care Act comes into force with serious consequences for us all, especially older people.
Last year I watched with unease at the health and social care bill during its turbulent passage through parliament and became increasingly concerned about its affect on older people.
Unfortunately very few of us understand its implications and it will affect us all more than any legislation passed in our lifetimes. It is the final stage in the dismantling of the NHS, a process that began around 25 years ago without most of us realising what was happening.
The Government’s case for change is largely based on the assumption that the NHS is no longer affordable, particularly in the current financial climate, and that it needs to be modernised. I believe this assumption is false. Of course things have to change but research overwhelmingly shows that the NHS performs well in comparison to other healthcare systems internationally. It is also cost-effective and highly valued by patients.
Key changes in the NHS
- From 1st April, Primary Care Trusts (PCTs) and strategic health authorities will be disbanded.
- In their place Clinical Commissioning Groups comprising of local GPs among others, will control about £60 billion of the NHS budget and commission local services.
- A new body, NHS England will oversee the NHS
- Responsibility for public health, will transfer to local authorities who will take the lead for improving the health of their local communities.
- Commissioning will take place through competitive tendering and NHS contracts will be opened to the private and voluntary sectors.
- There will be huge profits to be made for private healthcare companies who can’t wait to get their hands on our NHS.
The government claims private providers will improve standards through competition and choice. However experience of the NHS getting into bed with the private sector, whether through private finance initiatives (PFI) cleaning contracts in hospitals or the takeover of the GP out of hours service – has been disastrous so far. Privatisation has driven up costs and produced worse results.
Competitive tendering fragments healthcare. Older patients often have several chronic conditions. In future things like eye screening and dietary advice could be provided separately by different providers, making it confusing for the older person and more difficult for their GP to coordinate.
The government consistently claims the NHS budget is protected while in reality, it is being forced to make cuts under the guise of efficiency savings. Across the country, accident and emergency departments and other services are being closed and thousands of jobs are being lost. Older patients with chronic and complex diseases will continue to lose services essential for their care and receive insufficient and poor quality care on hospital wards. As a result of these changes, people will die.
My heart sinks when I think about the impact of the changes on older people I know and love. Local campaigns are joining up to fight back and I will be joining them. The Government and others with a vested interest may think the fight is over, but the battle to keep our NHS has only just begun, so watch this space!