Our response to the Health and Care Bill

While the global COVID-19 pandemic is still affecting people around the world, and while we are learning to live with its consequences in the UK, the government is pushing through massive changes to the NHS. We believe that this is not the time to introduce top down changes to the organisational structure of the NHS, and that doing so is very likely to cause major damage to the health and well-being of people in Cornwall, particularly to the poorest and most vulnerable.

Surely, while we have a huge backlog of patients needing treatment, a system reeling from the effects of COVID, NHS staff on their knees after two years of heroic efforts on our behalf, and many parts of the system creaking under strain, this is the worst time to be reorganising the NHS.  Years of under-investment meant that we went into the pandemic with waiting lists climbing, huge numbers of staff vacancies, and a shortage of essential facilities.  This is now the time to support the NHS, and help to get things back on track, not to be spending time, energy and money on reorganising management and structures.

Our main concern is that rushing this Bill at this time will prevent proper public debate and scrutiny.  Measures within it could put at risk the fundamental right of people to receive high quality treatment “free at the point of need.” NHS organisations in Cornwall will be reorganised under an Integrated Care Board (ICB) which will not have a statutory responsibility to provide all the health services that people need. The Board can decide for itself what services will be provided through the NHS, and some commentators have questioned whether even emergency services will be fully provided. The ICB may award contracts for specific parts of health services to private companies, and in some cases will not provide particular services, forcing people who need treatment to “go private”. We have already seen the consequences of massive waiting lists as those people who can afford it are forced to pay for private treatment just to get something done – this Bill could make the situation worse. Many people will feel the need to take out health insurance, diverting money that could otherwise be supporting the NHS, while those who cannot afford the thousands of pounds required will just have to hope for treatment somehow, sometime.

It is also very worrying that control of the NHS Integrated Care Board may be moving away from any sort of local accountability or representation, as this Bill would increase the influence of central government and private companies. It gives much greater power for the Secretary of State for Health and Social Care to interfere in the budgets and decisions of the Cornwall Integrated Care Board. There is presently no plan to have patients or residents represented on the Board, but on the other hand private healthcare companies will be able to sit on the Board. This Board will be able to hand out contracts for delivery of services without competition or any transparency in their decisions, and will itself decide what services are to be provided (or not) – so it is likely that local people will have no say in what or how the National Health Service works in Cornwall.

While all this is going on, the government itself admits that waiting lists will continue to climb towards ten million people and there will still be people waiting more than two years for treatment in 2025, despite the so-called “COVID Recovery Plan”. That means that over one in three individual households is likely to have someone on a waiting list – just about everyone meaning you, or a relative or friend, waiting for NHS treatment. Over one million people are living with some form of long COVID. We know all about the problems of a lack of hospital beds and long ambulance waits at A&E. We are still short of around 100,000 doctors, nurses and other staff, and the government refuses to prepare a workforce plan. Furthermore, there is clearly no proper plan to “fix” the social care sector, as the Prime Minister promised.

So our conclusion, sadly, is that this current Health and Care Bill is a wrong set of proposals at the wrong time.  We are an independent campaigning group, not aligned to any political party, and we have spoken up for our local health services for over twenty-five years. Now we simply seek a plan for the right future of health care, for services to look after everyone. We strongly urge our local representatives – our MP Derek Thomas, and our local authority Cornwall Council – to do everything in their power to prevent its highly damaging proposals for the NHS, and we encourage all those reading this to do the same.