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Letter to Baroness Cumberlege Regarding NHS Reforms

In NHS, Politics on October 11, 2011 at 12:21 pm

On Wednesday 12 October, the House of Lords will vote on Andrew Lansley‘s Health and Social Care Bill. They will either wave it through, hold it up or stop it completely.

Lords and baronesses are not used to being written to as they do not represent a particular constituency. Therefore, 38 Degrees and the TUC drew up separate campaigning sites to ‘adopt a lord’. Both sites make it very easy to find a lord or baroness and write them an email explaining why you feel they should vote against the bill. They even give you instructions on how to back up your argument, should you need them.

Here is my letter to Baroness Cumberlege, a Tory baroness whom I met last year at a leadership course that she runs for people working within the NHS. She was elegant and dry. I rather liked her.

Dear Baroness Cumberlege,

I am a doctor, currently working in Australia until February, when I will return to the UK to resume training in anaesthesia. I met you last year at your excellent ‘Politics, Power and Persuasion’ one day course in Bolton.

I am writing to you to express my concerns regarding the Health and Social Care Bill. I would like to start by saying that neither the Conservative Party, nor the Liberal Democrat Party mentioned wholesale reforms of the NHS in their manifestos. Indeed, as I’m sure you are well aware, in 2008 Mr Cameron promised ‘We will stop the top-down reorganisations and pointless structural upheavals that have done so much damage in the NHS.’ (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) In 2009, he repeated the same thought, ‘There will be no more of those pointless re-organisations that aim for change but instead bring chaos.’ (http://www.conservatives.com/News/Speeches/2009/05/David_Cameron_Speech_to_the_Royal_College_of_Nursing.aspx) The coalition parties’ votes were gained under this banner of no reorganisations to the health service. There is no popular mandate for the Health and Social Care Bill.

The evidence that increased competition will improve patient care is sparse, and the studies that have been done have had mixed results. ( http://www.badscience.net/2011/02/andrew-lansley-and-his-imaginary-evidence/ and http://www.badscience.net/2011/02/why-is-evidence-so-hard-for-politicians/ ) Pushing through these expensive, complicated and disorienting reforms without the requisite evidence that they will improve care is risky at best (I’m talking about risks to people’s lives and livelihoods, not political risk).

The impact of competition law on health services remains uncertain as well. ( http://www.38degrees.org.uk/page/content/NHS-legal-advice ) The increased cost of EU procurement procedures has not been factored into the price of the already hugely expensive reforms.

The effect on training remains a huge issue – if services are provided by a host of differing and probably overlapping (a neccessary function of ‘competition’) services, who will hold the responsibility to train? In particular, who will oversee training so that doctors rotate through all of the neccessary fields in a timely manner so that by the end of their training period, they will be competent consultants? This is currently done by deaneries, which will be abolished by the bill.

Competition was discussed in part 3 of the bill, which received very little scrutiny after the post-‘listening exercise’ amendments. Lords Owen and Hennessy are to propose a referral to a special Select Committee to review this section of the bill. I am sure you will agree that an issue and service of such great importance to the health, function and pride of the country deserves at least the level of scrutiny they are propose.

I urge you to support Lords Owen and Hennesy’s amendment. And I urge you to vote against the bill.

Mr Cameron has already broken his promise. The actions of all of the Conservative Party need not reflect this.

Yours sincerely,


38 degrees has also organised a petition which you can sign online.  This will be used as an argument to demonstrate that there is no popular mandate for these reforms.

Finally, I apologise for the uniform, poor formatting on this post. The reason is that I am posting from my smart phone rather than my computer.

Formatting updated 12.10.11


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