The reforms are considered by many to be a guise for the privatisation of our health service, says Kathryn Anderson
How can we possibly provide safe care when there isn’t the right skill mix or number of nurses available?
I recently overheard a nurse saying, “NHS reform - that’s a good thing, isn’t it?” to a colleague. I was concerned to discover that neither of them appeared to understand much about how these reforms would affect them or, most importantly, their patients. So what are the reforms about? That’s the billion pound question. Or, in the case of the NHS budget, the £109bn question.
So, what do we know about the NHS reforms and how they will affect you, me - all of us? Regardless of whether we work in the NHS or we are users of the NHS, we will all be affected.
Let’s start with a definition: reform is to make changes in (something) in order to improve it, according to the Oxford dictionary. That sounds reasonable enough. However, if the NHS needs to be improved, these reforms are not the answer.
The NHS was created on 5 July 1948 under minister for health Aneurin Bevan. Without doubt, there have been many reforms of the NHS since that time, most of them needed to ensure the services provided to the population of the UK remained relevant, appropriate and current. Numerous articles, books and theories have been published about the pros and cons of each of these changes. However, never has there been such an incredible out cry of dissent about NHS reform than there is at this point in its long history.
What is it about the latest round of reforms under the Health and Social Care Act 2012, which came into force fully on 1 April that has caused so many learned and knowledgeable people to be so concerned?
In short, it is because these reforms are considered by many to be a guise for the privatisation of our National Health Service. Did you know that with the implementation of the act the health secretary no longer has a “duty to provide” comprehensive national health services, only a “duty to promote”? This is something so fundamental that it effectively amounts to the abolition of the NHS.
The removal of the “duty to provide” healthcare is only the beginning. Most telling is the recent article published in doctors’ journal The Lancet, whose author writes “one might be forgiven for thinking that the current coalition government views the NHS as a failing bank or business. This stance is one of the most cynical, and at the same time cunning, ways by which the government abdicates all responsibilities for running a healthcare system that has patient care and safety at its heart” (17 August). Call me old fashioned, but when a restrained journal like The Lancet uses such language, we should all be worried.
What then does this mean to you and, most importantly, your patients? As a clinical nurse and a manager, my priority is always my patients, with my team members coming a very close second. The first thing that is obvious to me is the reduction in qualified nursing staff in clinical areas. According to Nursing Times (1 March) around 4,000 nurses have lost their jobs in the NHS since the coalition came to power. How can we possibly provide safe care when there isn’t the right skill mix or number of nurses available? Clearly, we cannot.
The NHS reforms will continue apace and the changes will become more dramatic. Before 1948, people lived in constant fear that they or their children would become ill. Unless these damaging reforms are stopped or reversed, those days we thought were gone forever will return.
If you do nothing else, please read, learn and understand what’s happening to our NHS.
Kathryn Anderson is lead nurse at a Foundation Trust and executive member of the National Health Action Party