Fw: message from Gabbay

[Guest guest]

The proposed changes that the governmentseem intent on bringing regarding health and social care are very concerning,thought it was important to share the comments made by Gabbay seebelow, he suggests that we should try to prevent this bill from becominglaw.best wishes LorraineFrom: " Gabbay J. " <J.Gabbay@...> " Gabbay J. " <j.gabbay@...>Date: 01/17/12 12:24 PMSubject: I'm worried - pass it on!Dear friendsYou know I wouldn’t normally write to you about such things but many ofmy expert colleagues have been gathering evidence over this past year aboutthe changes proposed in the Health and Social Care Bill and their findingsworry me greatly. So I have taken the liberty of writing becauseI am now fully convinced that the Bill may end up by commercialising healthcare in this country. It reminds me of the way in which we lost much ofour NHS dentistry the UK. Worse, even if not deliberately settingout to do so, it looks as if the Bill will push the NHS towards a systemresembling the USA’s – and if that doesn’t worry you, please read on. It’s not too late to change things if we spread the word more effectively,and we must surely do that, not least following the debate in parliamenton Monday 16th January, as it is still possible for the Houseof Lords of Lords to intervene. The more people know what’s beingdone to the NHS, the greater the chance of minimising the damage. So ifyou find this letter useful please pass it (or bits of it) on to as manypeople as you can. It would help if you could also write to yourMP. It’s surprising how few people are taking the debate seriously even thoughit’s been going on for well over a year. In what follows, (and I knowit’s long!) I have summarised just a small part of the evidence that hasrecently struck me. The links are underlined so you can click on them tofind out more. There’s lots more where thatcame from, believeme! Almost everyone I know connected with the NHS has had concerns of one sortor another about the Bill. See for example the Royal College of GPs surveyof over 2500 GPs published last week in which nearly all of them thoughtbill should be withdrawn.Did you know that theSecretary of State isstill holding out on the House of Lords by not revealing the contents oflast year’s“Transition-Risk Registerâ€a Department of Health report that was drawn up over a year ago to showthe risks of continuing with the Bill? The Risk Register has never beenreleased, despite two instructions from the Information Commissioner todo so. Why are such relevant facts being withheld from the Lords, fromparliament and from the rest of us? What’s being hidden? Perhaps the Risk Register agrees with the available evidence, most recentlycitedby OECD, that theproposed changes may actually reverse the recent progress made by the NHSand make things worse.Many believe that the competitionof a market systemimproves health care. In fact the reverseis probably true, as researchoverwhelmingly shows.For instance, there is an incentive in market systems to do unnecessarywork. In the US system, which is the most similar to the one we seemto be moving to, TheEconomist estimatesthat 10%-12% of all 2009 health care expenditure went on unnecessary treatment.Privatised systems also require higher management and transaction costs(e.g. for billing). Believe it or not, internationalcomparisons showNHS management costs to be among the lowest.Of course our current system has its problems, but what country’s doesn’t?We keep hearing how bad UK cancer care is, for example, compared to othercountries. Yet outcome measures have improvedmarkedly in thelast decade. Another example: a recent OECDreport showed thatthe decline in avoidable mortality in the UK was the second fastest ofall industrialised countries. A 2011study shows thatthe NHS was among the most cost-effective healthcare systems among 17 countries(the USA was among the worst). Another shows that satisfaction with theNHS is at an all-timehigh. It’s strange,then, that the media and politicians feed us the opposite picture witha constant stream of stories about the NHS’s flaws. Is that because acornerstone of the government’s argument for pushing the Bill throughis the NHS’s allegedly poor outcomes? They say that the Bill will put GPs in charge of commissioning health serviceon behalf of their patients (e.g. drawing up contracts with the local hospitals).But the GPs new Clinical Commissioning Groups (CCGs) will need help todo that. Many are turning to private consultancies to get that help. Someof that commissioning support is to be delivered by insurance companies,potentially the very same insurance companies that have had such a maligninfluence on healthcare in the USA. As you may know, quite apartfrom 50.7million US citizenswho can’t afford the premiums, US insurersruthlessly ration care, limit doctors’ clinical freedom and often usethe small print to refuseto pay out. Itseems that these companies are positioning themselves to run large partsof the NHS in future. Is this really what we want? So why this upheaval, which the electorate never asked for and which isalready happening even before the Bill becomes law? (In my own NHS workI constantly hear how the running of the service is already in “meltdownâ€thanks to these changes.) It is not by any means unstoppable if we allmake enough fuss. If you want to know more you can follow the linksabove, and also go to http://abetternhs.wordpress.com/faq/for a clear statement of the evidence on much else about the Bill.If all of this makes you as worried as me, please pass the message on inany way you can. Feel free to copy parts of this letter to your friends,your MP and anyone else you think needs to know. It’s not too late to stem the damage. ---------------------- GabbayEmeritus Professor in Public Health1 ls Close LYMINGTON SO41 3PQ