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06.03.12

Over and over again

Detached observers could be forgiven that the latest batch of amendments to the Health & Social Care Bill are said to be to fix problems that we were told were fixed months ago when the Government accepted the recommendations of the NHS Future Forum report.

On the role of Monitor, and competition – and recently on the Secretary of State’s responsibilities too – we’ve been here before. The Bill is now a mess, with many of its former supporters walking away, and a good deal of those unhappy with it on competition grounds unlikely to ever be placated unless most of the Blair-era reforms are undone too.

Ministers say legislation is still necessary, in the face of calls to abandon the bill and simply implement what they say are the key parts of the bill – around clinical commissioning and devolving power – using statutory instruments and departmental instruction.

The lack of a decent reply to this request, which the politics of the situation would seem to demand, does imply that the bill was always more about the competition and private sector involvement than it was about ‘handing power to family doctors’.

Change is necessary in the NHS. Opponents can keep talking about the lack of demand for such change from the public, and the relatively good performance of the NHS according to many international measures, but these, crucially, do not address the future problem of limited resources but spiralling demand. The problem is that nobody now seems to know what this bill is for, and how it addresses that challenge – which will be far, far harder to tackle if managers and clinical leaders in the NHS are still resentful over the botched reforms.

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

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