Labour Pains

‘Richard Branson’s company becomes one of the first of many vultures to start picking over the rich, tender flesh of the NHS now that it has been splayed open by the (Health) Bill.’ So wrote pseudonymous Telegraph doctor Max Pemberton on the news that Virgin Care has won a £500?million contract to provide community services across Surrey and began running these services, as well as the county’s prison healthcare, on April 1.

When Telegraph columnists slate private healthcare provision, the government knows it has a problem but the groundwork for all this was done by Labour. In January 2009, it published Transforming community services: enabling new patterns of provision. ‘This guidance is intended to help PCT providers of community services to move their relationship with their commissioners to a purely contractual one and consider what type(s) of organisations would best meet the future needs of patients and local communities.’

The Health Bill cements and accelerates Labour’s vision of a competitive market for healthcare but may come a cropper if the public aren’t sufficiently involved in the decision making. Section 242 of the NHS Act 2006 makes clear that formal consultation is required in ‘instances in which the manner

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The Nicholson Health Service

On March 26, at 18:00, MD posted a draft copy of the Health Bill Risk Register on this site that had been anonymously leaked. The Government’s persistent refusal to publish it prompted angry debates in both chambers and widespread press attention. Yet a week after posting it, MD has received not a single press enquiry. A few papers picked it up, but the mood was one of intense apathy. The story was not the risk register, but the refusal to publish it, and now the Bill has passed, what’s the point of exposing the risks?

The draft register – which dates back to 15 October 2010 – is helpfully colour coded into red, amber and green, and the risks are largely red. In essence, the NHS top brass – lead by former communist party chief executive David Nicholson – are petrified that such a massive, unforeseen change in structure and the unpredictable consequences will see them lose control over money, strategy and power. The delay in the passage of the Bill has simply allowed Nicholson time to claw back his power to the point that the NHS is now more centrist than it was under

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Justice for Debbie Westwick

In July 2006, Debbie Westwick, a 43 year old nurse, was diagnosed with cancer of her left breast. She was treated at the Kent & Canterbury Hospital, where she worked, by oncologist  Howard Smedley and surgeon David Jackson. Unbeknown to her, Dr Smedley was subject to ‘supervision undertakings’  imposed by the GMC for reasons that they refuse to reveal. Mr Jackson was suspended in the middle of her treatment, subsequently sacked and referred to the GMC.

Westwick had surgery, (a lumpectomy, with lymph node sampling), in July 2006. The histology revealed 4 out of 7 nodes sampled were cancerous and that there was tumour left behind in two of the margins of the breast wound. She needed an urgent mastectomy and node removal but instead was given chemotherapy and radiotherapy. Debbie realised she needed more urgent surgery but her surgeon was now suspended and mastectomy and reconstructive surgery were delayed until September 2007. There were four fundamental failings in her treatment, all of which breached national guidelines: performing a lumpectomy rather than a mastectomy for a multi focal tumour; not removing the breast when the initial surgery failed to fully remove the cancer; not clearing the

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After the Bill

Health secretary Andrew Lansley gave a surprisingly chipper performance at the Nuffield Trust Summit on February 29. The audience of health policy experts was divided as to whether he was demob happy or just convinced that his Health Bill will be voted through by May 9th, despite the final twitchings of the Lib Dem corpse. Lansley had the confidence of a man who’s brought his own power point slides, a luxury rarely afforded to him on Newsnight, and he proceeded to drown the opposition in detail. He is truly the health secretary who knows the most and listens the least.

Very few policy experts felt the legislation was necessary and many felt it would be counterproductive, imposing yet more bureaucracy from the centre. This view was echoed by the board of NHS Tower Hamlets Clinical Commissioning Group, who have written to the Prime Minister and asked him to withdraw the Health and Social Care Bill. The government has already ignored the objections of 27 professional bodies, but this CCG is lead by Dr Sam Everington, an innovative GP who was Lansley’s special guest at the Conservative Spring conference in 2010 and who’s practice in Bromley by Bow

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Cameron’s Conflict

Why has David Cameron decided to go to war with the NHS? With just about every professional organization and journal opposing the Health and Social Care Bill, public support for it at 18% and Downing Street briefing the Times that the Health Secretary should be ‘taken out and shot’, Cameron has decided to be ‘at one with Andrew Lansley.’ In turning the Health Bill into a confidence vote, with the Lib Dems driving the getaway car, it’s extremely unlikely to fail. But it will hand Ed Milliband so many open goals in the run up to the next election, even he can’t fail to score.

It’s doubtful Cameron has read the Bill in its entirety –  it was unintelligible even before the 300 amendments – but Lansley does a very convincing line in whispered one-liners. The Bill will apparently ‘safeguard the NHS for the future’, ‘put patients first’ and ‘give frontline staff the right to determine how the NHS budget is spent.’ Lansley insists that to achieve this vision, the NHS needs a lot more legislation and a lot more competition, but there is no evidence-base for these reforms so  it’s a huge leap of faith getting staff

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