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NHS Listening Exercise

In NHS on April 17, 2011 at 1:07 pm

The Department of Health has launched its ‘listening exercise’ (accessible through this link).  We should all be contributing to it.  I have sent in this response.  Please feel free to use it yourself, but try to change the odd word here or there if you are going to use it, because otherwise it will look like spam.

How can we best ensure that competition and patient choice drives NHS improvement?

We are interested in your views on this area, including:

  • Which are the types of services where choice of provider is most likely to improve quality?
  • What is the best way to ensure a level playing field between the different kinds of provider who could be involved?
  • What else can be done to make patient choice a reality?

This is clearly a leading question.  The question that must come before this is what is the value of competition, and should it play any role in the NHS?

By the introduction of competition, what is meant is the opening up of the market, i.e. consortia to commission from ‘any willing provider’.  Market dogma is that competition drives quality up and prices down in all industries.  This has not happened with the privatisation of public transport or utilities.  The evidence for the benefit of competition within healthcare is scant. (http://www.badscience.net/2011/02/andrew-lansley-and-his-imaginary-evidence/ ) We have already heard that price-based competition will be ruled out, and therefore we should only have quality based competition, but even the evidence for this is very meagre.  It appears that we are being forced down the expensive and irreversible road to market-based healthcare not on the basis of evidence, but on the basis of ideology.  A market-based ideology not explicitly related to the NHS in the Tory or Lib Dem manifestos.

The ‘cherrypicking’ of services argument has already been well made by other people on the message board, so I will not repeat it.

‘Patient choice’ has become a buzz-phrase over the past few years, with little debate as to its actual benefit.  Of course, given the option, people would like to have a choice as to where they receive their care.  However, the prioritising of patient choice over patient care is irrational, and there is no evidence that the public actually wants more choice than it already has.  ( http://www.badscience.net/2011/04/id-expect-this-from-ukip-or-the-daily-mail-not-from-a-government-leaflet/ )

The phrasing of the question above suggests that the government has not fully understood exactly what it is to which the public objects.  It is not the way in which the bill hopes to open up the market, not the way it hopes to introduce competition.  What we object to is actually the introduction of competition at all.  We do not want fragmented services offered by a variety of private companies with an over-riding commitment to profit rather than care.

I am not arguing for the NHS to remain stagnant.  I am arguing that market-based reforms are unproven, expensive, a dangerous way to spend billions of pounds of taxpayers’ money, and a topdown reform of the NHS which David Cameron explicitly promised he would not give us.  (http://www.yorkshirepost.co.uk/news/debate/columnists/david_cameron_there_is_such_a_thing_as_society_and_we_must_start_to_value_it_1_2500825 )

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  1. Hi there,

    I received an email from you about contributing to the Now Then blog, but my reply to the email you sent from has been met by a cyber brick wall. Have you got another email address you could use for correspondence?

    Best,

    Ian

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