In five years the NHS will require another reform, caution the editors of three leading healthcare publications. In addition, they request a public debate regarding the NHS’s future to “salvage some good” from the government’s “damaging” reforms.

According to a second BMJ report discarding the Health and Social Care Bill, now would save more than £1 billion in 2013.

Editors from the BMJ, Nursing Times, and Health Service Journal, explain that:

“(the NHS) is far too important to be left at the mercy of ideological and incompetent intervention. We must make sure that nothing like this ever happens again.”

They recommended that parliament should set up an independently appointed Standing Commission “to initiate a mature and informed national discussion on the future of our national health system,” as part of this process.

Even though attitudes on the bill vary among health professional groups, the authors explain:

“There can be no doubting the overwhelming sense of distress and lack of confidence in the government’s plans among those who must deliver the service.”

Fiona Godlee, BMJ Editor, Alastair McLellan, HSJ editor, and Jenni Middleton, Nursing Times editor, explain that:

“Through a combination of poor political judgement and reluctance to engage with criticism, a set of (mostly) reasonable objectives morphed into an old fashioned top down reorganization. It also resulted in a bloated and opaque piece of legislation, whose goals could have largely been achieved by other, more effective, means.”

Godlee, Middleton and McLellan believe that once the bill becomes law:

“We will still be in the dark about how much of the new system will work and we will have an unstable system that is only partially fit for purpose.” In addition, they caution that “another major NHS reform program is guaranteed within five years.”

They explain that it’s possible to feel concerned for Lansley when “after years of being told that politicians should get out of the NHS, his proposals to loosen the health secretary’s grip on the service were thrown back in his face.” However, they state “those proposals were poorly thought through, and the government amendment restoring his responsibility for the NHS has failed to reassure some critics.”

According to the editors, instead of depending on policy makers to construct new worlds in back rooms:

“We need a broad public debate on the principles that should underpin the NHS, how decisions on priorities should be made in a cash-limited system, and what role clinicians and private sector organizations could and should play.”

They continue that if this debate is to avoid being characterized yet again by polarized views (often disguised), political point scoring, vested interest, and conspiracy theories to the benefit of none, restraint will be required on behalf of all involved.

They conclude:

“Let us try to salvage some good from this damaging upheaval and resolve never to repeat it.”

In a second BMJ report, Kieran Walshe, Professor of Health Policy and Management at Manchester Business School explains that just over £1 billion could be saved in 2013 by discarding the Health and Social Care Bill now.

In addition, Walshe explains that abandoning the bill now would stop the prolonged and damaging period of organizational doubt in the NHS and would permit NHS organizations to concentrate on enhancing productivity and efficiency, and maintain performed in the years to come of financial austerity.

Even though politically hurtful, Walshe explains that the government could reason that, in the special economic situations of the day, it’s logical to abandon the bill, and that as promised, they have already made considerable savings in NHS administrative costs.

Walshe adds that the government may gain some praise from the public and media for listening and learning, however the it would also neutralize a problem which has become increasingly politically toxic for them.

Walshe concludes:

“They could then plan to accomplish much of their intended reform agenda – greater patient choice, more GP involvement in commissioning, increased plurality and competition in healthcare provision – using existing legislative provisions. And the NHS could get on with delivering healthcare to patients, and the serious business of finding ways to do more with less.”

Written by Grace Rattue