NHS reforms ‘could lead to US-style system’

By Ian Dunt

Two separate technical assessments of the government’s NHS reforms have brutally criticised the plans, saying they open the door to US-style healthcare.

The reports will further add to the misery of health secretary Andrew Lansley, whose project is now being criticised by new experts or health professionals almost every day.

A report by Professor Allyson Pollock, from Barts hospital and the London School of Medicine, and David Price, senior research fellow at its Centre for Health Sciences, found the reforms would create a system where the government “finances but does not provide healthcare”.

The experts warned that ‘referral management centres’ could block GPs’ referrals and thereby reject patients.

“These centres are currently rejecting one in eight general practitioner referrals and seem to operate along the lines of ‘prior authorisation’ arrangements in the United States, whereby doctors are required to obtain approval from a higher authority before making a referral for treatment or investigation,” the two experts wrote in the British Medical Journal (BMJ).

“This grossly misleading and groundless account is based on pure fabrication and a serious absence of facts,” health minister Simon Burns said.

“This government is not – and never will be – in the business of privatising or undermining the NHS.

“We are absolutely committed to a comprehensive national health service, free at the point of use and based on need rather than ability to pay – nothing in our plans changes that.”

But the Department of Health’s efforts to shake off the report were hampered by a separate assessment from Dr Mark Porter, chairman of the British Medical Association’s (BMA) consultants committee, who told colleagues that many health trusts would lose “entire departments” under the plans.

Hospital services that were considered low value, such as cataract surgery, were already being rationed in some areas, he warned.

“This is the true cost of shifting care from NHS hospitals into the community or to alternative providers,” Dr Porter said.

“No savings are made for the NHS as a whole, but what is left behind can become a financially unviable remnant with a greater proportion of fixed costs.”

But any Labour attempt to capitalise on the criticism was hindered by Dr Porter’s attack on its private finance initiative (PFI) project, which he said turned private firms into parasites.

“The situation gets even worse when one considers the toxic PFI legacy in the NHS – a legacy of modern facilities and buildings paid for by a completely inflexible fixed cost regime that will now undermine the viability of its own host,” Dr Porter argued.

“In some areas, the parasite will consume its host, and if that is not bad enough, one can foresee the government baling out the private financiers who have made so much from PFI.”

Mr Lansley’s heath reforms have been attacked by the Liberal Democrats, the BMA, health unions and the Labour leadership.

Media reports suggest that Nick Clegg has promised his MPs that he will try to rein in the health secretary.