NHS reforms

Huge response to reforms consultation

The members of the NHS Future Forum charged with recommending overhauls to the reforms met over 6,700 people at more than 200 ‘listening’ events and meetings with more than 250 relevant organisations.

The consultation also received more than 3,000 comments via its website, 25,000 emails, 600 questionnaire responses, and also got people’s thoughts via webchats, social networking sites, and regional events organised by the Strategic Health Authorities.

The Future Forum pointed out that many of the emails especially were very similar, as the wording had come from campaign groups who encouraged their members to contribute.

But the Forum said: “Nonetheless, our approach is that if an individual sees fit to

take part in such campaigns, their email is fully considered.”

In his letter to David Cameron, Nick Clegg and Andrew Lansley explaining his recommendations, Future Forum chairman Professor Steve Field said: “I am clear that the reason people have been so willing to enter into a meaningful, constructive and insightful dialogue with us and with each other is not because they don’t believe the NHS needs to change but because they want any changes to be the right ones and to feel ownership of them.”

He clearly set out the political problems the Health & Social Care Bill has faced, despite widespread medical agreement on the outcomes the legislation is aimed at achieving, saying: “At best, the Bill has received lacklustre support from many staff groups, open hostility from others and has been lambasted in much of the press. This opposition was not merely political – it stemmed from genuine fear and anxiety that the reforms would not deliver the improvements that we all want.

“This fear and mistrust was expressed by many patients and staff that we met. Many told us that they feared for their own job prospects, others because they feared that their NHS was about to be broken up and in their words ‘privatised’.

“Some of this fear was misplaced and the result of a failure by the Government to clearly explain how the structural and technical details of the Bill would help the NHS improve today and tomorrow. Undoubtedly, the debate has focused too heavily on the means, without a clear enough link to the ends – the provision of high quality care and improved outcomes for patients.

“However, in other areas we found people’s concerns to be justified. Whilst there was never any intention to introduce a market in the style of the utilities sector into healthcare, the Bill contained insufficient safeguards against cherry-picking and was not sufficiently clear that competition would only exist when it served the interests of patients not profit. In other areas, whilst NHS staff supported the general thrust of the reforms, they were anxious that the deadlines would force them to take on responsibilities before they had the skills or capacity to undertake them in a way that would improve patient care. And, in a few areas, such as the proposals for education and workforce training, there were genuine concerns that there was simply not enough evidence or detail to justify such radical change where the consequences of failure are so significant and long-lasting.”

Apart from overall chairman Professor Steve Field, four senior healthcare professionals led each workstream that contributed to the report.

Sir Stephen Bubb, chief executive of the Association of Chief Executives of Voluntary Organisations, was lead for ‘choice and competition’; Dr Kathy McLean, medical director of NHS East Midlands, was lead for ‘clinical advice and leadership’; Julie Moore, chief executive of University Hospitals Birmingham, was lead for ‘education and training’; and Geoff Alltimes, chief executive of Hammersmith & Fulham Borough Council, was lead for ‘patient involvement and public accountability’.

There were also another 44 members drawn from across the NHS, academia, local government, voluntary sector and charities.

The full list is at

www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_127540.pdf

Tell us what you think – have your say below, or email us directly at [email protected]