‘It will be hard for GPs to keep one eye on the patient and the other on the balance sheets’ – Nurses and midwives reject Health and Social Care Bill

Midwives, local residents and other health workers demonstrate in defence of maternity and A&E services at Whittington Hospital in north London
Midwives, local residents and other health workers demonstrate in defence of maternity and A&E services at Whittington Hospital in north London

Nurses and Midwives have strongly criticised the Health and Social Care Bill published last week, calling it a toxic prescription for patients and a re-organisation too far for NHS staff, said public sector union Unison on Monday.

In a highly charged meeting of Unison’s Nursing and Midwifery Committee, the members called on the government to listen to the many years of experience they represent, and learn the lessons from previous failed experiments.

Ann Moses, Chair of the Committee and herself a nurse at Diana Princess of Wales Hospital, Grimsby, said: ‘The timing of the Bill for the NHS and patients could hardly be worse.

‘Staff are being told that hospitals have to find £20bn in efficiency savings, and that means frontline nurses and staff losing their jobs or not being replaced.

‘This massive re-organisation will make life for patients and staff tougher.

‘When a patient comes in for a hip operation they need a whole care package – from crutches when they leave, to occupational and physiotherapy.

‘I think handing over the commissioning to GPs will fragment patient pathways.

‘I know a patient who went into a private hospital recently, had a hip replacement and came out with a follow up appointment six weeks later.

‘It was fortunate that they knew me, because they came out with no crutches, no care package, no support – in fact I took out their stitches.’

Fears about the long-term future of the chronically ill and those with mental health problems were also high on the list of concerns from the nurses.

Gail Adams, Unison Head of Nursing, said: ‘There is a very real danger that patients with on-going, long-term conditions such as Alzheimer’s, the elderly and disabled or those with mental health problems will not get the treatment they need.

‘It will be hard for GPs to keep one eye on the patient and the other on the balance sheet.

‘This highlights the fundamental change of the relationship between GPs and patients.

‘Patients want to have confidence that their GP will always put their health needs first, not the need to balance their books. GPs should be patient champions but they will be forced into making some very tough decisions.

‘There are nurses now sitting with redundancy notices in their hands.

‘It is a complete falsehood for Lansley to suggest that the NHS is protected from cuts. The situation can only get worse if this Bill goes through.’

Unison is continuing its campaign against the Health and Social Care Bill and will be seeking to influence MPs and others during its passage through Parliament.

A letter signed by nearly 200 nurses, including Royal College of Nursing (RCN) members, which questions government plans to reform the NHS, was published in The Times newspaper on Monday.

It says that the Bill’s market-driven system will result in healthcare decisions being made on the basis of price rather than clinical need, with serious implications for standards of nursing care.

It also quotes RCN figures indicating that 27,000 nursing posts will be lost.

It follows another letter written to The Times last week, signed by the RCN, which described the Health and Social Care Bill as ‘extremely risky and potentially disastrous’.

Monday’s letter read: ‘Sir, We are frontline nurses, together with other nurse colleagues, who are protesting against the parliamentary Bill to “reform” the NHS.

‘We already struggle to give good care. Despite the fine words, there has been no real increase to the NHS budget, while figures from the Royal College of Nursing show that 27,000 nursing posts are being cut.

‘The proposed reforms will make matters much, much worse.

‘Not least, they will force “any willing provider” of health services – private, social enterprise or NHS – to compete with each other on cost and so standards of care are bound to fall.

‘We are the biggest group of healthcare professionals in England, and staffing costs are the biggest budget item in any health service, so providers of health services will have to cut (even more) posts, and probably salaries, to be competitive.

‘Expensive services will suffer the most – emergency and follow-up care, mental health services, care of the elderly, management of long-term conditions and end-of-life care – most of them disproportionately dependent on skilled nursing.

‘Care will be skimped or services simply priced out of the market, and the consequences for health long-term will be serious for patients and costly to society.

‘Radical change has clearly been under development for a long time, despite no mention in any election manifesto.

‘The proposed reforms will be rapid, costly, and staggering in scale: they presage nothing less than the complete restructuring, if not privatisation, of the NHS, so that healthcare becomes a commodity to be bought and sold by private companies.

‘We are deeply concerned that, in such a market-driven system, healthcare decisions will be made on the basis of price rather than clinical need, with serious implications for standards of nursing care.’

Separately, the Unite union said that ‘even the City is wary of health secretary Andrew Lansley’s NHS reforms’, with a top executive likening them to being politically ‘worse than the poll tax’.

In a letter to the Financial Times last week, Tom Brown, senior credit executive with Norddeutsche Landesbank likened the new structures – which will give GPs control of 80 per cent of the NHS budget by 2013 – to certain aspects of rail privatisation.

He said that the way ‘private health corporations are swarming around GP practices, like bees round a honey pot, with offers to manage their future multibillion healthcare budgets – also confirms that an opportunity to make risk-free profits out of taxpayers’ money can be sniffed a mile off by those less naive than those planning this reform.’

Unite said that ‘Brown’s intervention dovetails with a new YouGov survey saying that 57 per cent of the British public say they do not trust the government much or “at all” to deliver on the NHS.’

Unite national officer for health, Karen Reay, said: ‘It is heart warming that even senior executives in the City, a bastion of Tory support, are waking up to the deep flaws in the health secretary’s misguided and grandiose ambitions for the NHS.

‘This, coupled with the YouGov poll, adds to the deafening crescendo of criticism of the plans to basically privatise the much-cherished NHS. The coalition needs a massive rethink on this.’

Trade unions must do much more than criticise government policy and urge the coalition to ‘listen’.

Such a line is a deception of their members, instead they must organise the occupation of closure-threatened hospitals, and mobilise for a general strike to bring down the coalition and go forwards to a workers government and socialism.

That is the only way that the NHS will be defended.