Dr Kailash Chand: Scrap the market approach to healthcare

The government has asked the health service to save £30bn by 2017 - so much for it finding additional money for the NHS.

The NHS reorganisation is facilitating and encouraging privatisation and outsourcing, which wastes money on profits instead of using it all to run the NHS. The creation of a market ethos-led NHS and the corporate philosophy of treating health as a commodity and the patient as a target have resulted in a colossal waste of funds, with little real benefit to the patient. There is not a scrap of evidence that the price goes down and efficiency increases if private companies deliver NHS care.

In fact, the evidence points the other way. Costs increase and services may well get worse.

Money is being wasted on turning healthcare into a market, in which providers must compete rather than co-operate and GPs are legally required to spend money on expensive, lengthy tendering processes. Far from being in charge, GPs are rubber-stamping decisions imposed by NHS England and commissioning support services.

Successive governments in the past two decades have encouraged a 24-hour, consumerist environment - the 'dial-a-pizza' approach to healthcare.

Alarmist perceptions of ageing as a fundamental threat to the NHS are overblown. It is undeniable that this presents new challenges to health and long-term care, but the solutions are there.

Long-term care, social care and healthcare should be integrated at different levels of provision, and strengthening primary care is the key to addressing the matter.

So can the NHS rise to the challenge? What is healthcare going to look, feel and sound like in five or 10 years?

Is the current model sustainable or will it have to change? In either case, how will it do so? The only way to sustain and reshape the NHS to improve and meet the challenges of the future, including care for an ageing population, is to strengthen its founding principles, as a publicly funded and publicly accountable NHS.

  • Dr Chand is BMA deputy chairman, but is writing here in a personal capacity.

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