The Health and Social Care Bill becomes Law

After over a year going through Parliament and 374 amendment generated by the House of Lords, on March 20th MPs cast their final vote and the Health and Social Care Bill was approved by a government majority of 88. On March 27th, it received Royal Assent and will now be known as the Health and Social Care Act (2012).

Different terminology is being used to describe the changes in the NHS that will have to take place – the more positive amongst are calling it restructuring of the NHS while the more negative amongst us are calling the destruction of the NHS. Whichever side of the fence one sits on, it is clear that there are going to be major changes in the NHS with GPs taking control of most of the NHS annual budget of £106 billion, cuts in the number of health bodies and the introduction of more competition into services. All this has to take place at a time of financial cut backs.

Somehow the staff working in the NHS have to be brought together to work in a system  to which all raised serious objections on the basis that patient care will suffer. Those of us who have had to work in systems that go against our beliefs, know this is not going to be an easy task and it will not be surprising if the morale of NHS staff sinks to an all time low.

Possibly the most frightening aspect of the new system is that it is not based on evidence that it will actually work. It strikes me as an odd society that has a great deal of regulation and bureaucracy to ensure that there is evidence of safety and efficacy of prescribed drugs by regulation and bureaucracy and to ensure that research is safely and ethically carried out, yet a change to the whole structure of the NHS is brought in without any real evidence. We are not even being given a reason for the structural changes, certainly not a reason that stands up.

Like it or not, Members of Parliament, our representatives, have made the decisions about our future services. David Cameron and Andrew Lansley may well go down in history but it will not be for the same reasons as Beveridge and Bevan.

Yes, it leaves many of us as patients feeling insecure. Since July 5th 1948 we have had universal healthcare provided free according to need. Is the Health and Social Care Act setting in place a return to an insurance-based system with personal health budgets, year of care funding for long-term conditions and Foundation Trust Hospitals will be able to raise nearly half their funding from private patients? Could we return to the days our parents and grandparents remember, when you didn’t call the doctor because you couldn’t afford the fees? When services can be provided by ‘any qualified provider’, will we even know who is providing the services? Let us hope that this negative approach is ill-founded. Only time will tell…

As patients, we will need to be vigil to ensure that we receive the care and services which will enable us to receive timely, essential treatment to maintain our health.

If you have access to the internet, you can read the NHS Constitution for England, March 2012 by clicking on: 
Hard copies of the Constitution can be obtained from the Department of Health, telephone 0800 123 1002.