An overwhelming majority of nurses believe the health and social care bill should be dropped, according to a poll by Nursing Times.
The online survey, carried out over the last five days, is the first attempt to quantify what the profession thinks about the government’s controversial and increasingly embattled NHS reform programme.
The majority of the 370 respondents, 77%, thought the bill should be dropped.
Of these 31% said the legislation should be withdrawn but the policy of giving clinicians more influence over NHS commissioning should be retained.
For example, one respondent said: “[There is] potentially a huge opportunity for nurses and nursing to shape and influence commissioning and care provision in line with best practice to reduce variation and pot luck, and truly focus on effectively meeting patient needs with a locally agreed agenda.”
A further 28% thought it should be dropped and the reforms halted at their current stage, with emergency legislation drafted as soon as possible to make the best of and job, but 18% said the bill should be dropped and the reforms reversed as much as possible.
One respondent said: “The NHS reforms will alienate a large section of existing staff – many will leave – standards will drop”, while another said: “This government hasn’t got a clue. It is making change for change’s sake.”
Only 4% of respondents said the bill should be passed because some or most of the reforms were needed. One said: “Major reform is long overdue. I do not have an issue with private companies providing NHS care since the NHS is woefully inefficient and poorly managed.”
A further 4% said the bill should be passed but with the expectation that substantial reform would be needed again in a few years time.
Asked which of the reform policies they were most concerned about, the many highlighted areas linked to increased competition for contracts the perceived threat from the private sector.
Around three quarters of respondents, 77%, said they were concerned that private providers would “cherry pick” profitable areas of care, leaving costly and complex patients to the NHS.
In addition, 48% said they were concerned about increased competition for NHS contracts, including access to private and charity providers, and 43% that NHS trusts were being allowed to increase the amount of private patients they treated.
However, 61% highlighted concern over new commissioning structures leading to regional variations in the quality of care and 52% said they were worried about the transfer of the majority of public health responsibility from primary care trusts to local councils.
Asked which, if any, of the government’s reform policies they supported, 52% of respondents said they backed greater clinical involvement in commissioning decisions and 18% supported new commissioning structures enabling commissioners to respond to local need.
However, 31% said they did not support any of the policies.
The poll result comes just weeks after the criticisms set out in Nursing Times’ joint leader with Health Service Journal and the BMJ, which said the reforms had “destabilised and damaged” the NHS.
Last month the royal colleges of nursing and midwives came out in open opposition to the bill.