The BMA held an event at Portcullis House on 1 April 2014, to launch our campaign to repeal the Health and Social Care Act, called: 'How do we make the NHS fit for the future without more top-down reorganisation?'
The event was chaired by former Health Secretary Frank Dobson, and featured a cross-party group of MPs including shadow Health Secretary Andy Burnham, Stephen Dorrell and Paul Burstow.
Shadow Health Secretary Andy Burnham MP opened up the speeches highlighting the sustained pressure the NHS was under over the past year, specifically in accident and emergency.
Mr Burnham went on to say that to address barriers to integration a Labour government would repeal the Health and Social Care Act but there would not be a reorganisation of NHS. He said that we are trapped in a hospital model of care and that Labour's vision of whole person care would address that. He said that a Labour government would put the NHS as the preferred provider of services in the NHS.
BMA deputy chair of Council Dr Kailash Chand said the Health and Social Care Act had 'hugely negative' impact on NHS but gave a plea for stability not another big reorganisation.
Dr Chand said that local commissioners must be allowed to organise care without falling foul of competition law. He concluded by saying that for proper integration to be achieved, 'it's necessary to repeal the Act'.
The Chair of Tower Hamlets CCG Dr Sam Everington gave examples of the challenges that his practice faced in the East End of London and how it was meeting those challenges. He said that the NHS currently only deals with 20% of healthcare and we need to look at social determinants of health to achieve holistic care.
Dr Everington listed the range of organisations that had been created as a consequence of the Act and the number of bodies commissioning services. He said commissioning has been broken up in the NHS, saying 'it’s a complete mess' and that it needs to be brought back together. He said that primary and secondary care must work together more to keep people out of hospital. However, there should not be a massive restructuring, just 'tinkering'.
RCN Chief Executive and General Secretary Dr Peter Carter said that there is no evidence that competition increases efficiency and reduces cost in the NHS.
Dr Carter said that 'there is a blight with workforce planning in the NHS' and highlighted a crisis amongst nursing staff in the NHS which has seen numbers of district nurses fall from 12,000 in 2003 to 7,500 today. He called for the repeal of Section 75 of the Act. He went on to quote Simon Stevens, who has started as Chief Executive of the NHS on the same day, saying: 'for the NHS to thrive and survive, there needs to be a radical change in how NHS services are delivered'.
Health commentator Nick Timmins said that the NHS can’t be made fit for the future without a reorganisation if the current policy of bringing health and social care closer together continues. Some reorganisation is required, if the desired aim isto bring health and social care together.
Health Select Committee Chair Rt Hon Stephen Dorrell MP said that the health service should be designed around the experience and need of the person. The experience of the patient/person should be the driving force in thinking about how to integrate health and social care. Mr Dorrell stated that 'form must follow function'.
He also said that we can’t exempt the NHS from change. The NHS needs to focus resources to better meet patients' needs. Mr Dorrell said that a more joined up approach is desirable, commissioners must be empowered to deliver joined up care but an organic approach is needed.
The Chair of the Liberal Democrat Health Backbench Committee Rt Hon Paul Burstow MP said that the reality for the NHS is that there is a continued need for change driven partly by financial challenges. He said that there needs to be a 20 year projection of need to plan NHS services, meet funding needs, and better understand the needs of patients, especially elderly people.
Commissioning for better outcomes is something that needs to be improved within the NHS. Marking the first anniversary of the implementation of the Act, Mr Burstow said that the system and structures must be allowed to mature and evolve.