Health service reforms 'damaging the NHS' say journals

31st January 2012 - Three leading health journals have accused the government of introducing legislation which is damaging the NHS in England.

In a joint assault by the BMJ, the Health Service Journal and the Nursing Times, their editors describe the reforms as "an unholy mess" and predict that the changes will prove so destructive that further reform will be needed after five years.

They call for an independent commission to oversee any future changes.

Union opposition

The intervention by the journals comes as several NHS unions and professional bodies called on Health Secretary Andrew Lansley to scrap the Health and Social Care Bill. Mr Lansley has argued that his reforms will put patients first and allow doctors and nurses to run the bulk of the NHS while cutting down on bureaucracy.

In a simultaneously published editorial, BMJ editor Fiona Godlee, Health Service Journal editor Alastair McLellan and Nursing Times editor Jenni Middleton write that, while they have differing views on the reforms, "on one thing we are agreed - that the resulting upheaval has been unnecessary, poorly conceived, badly communicated, and a dangerous distraction at a time when the NHS is required to make unprecedented savings".

Destabilising and damaging

The editorial continues: "Worse, it has destabilised and damaged one of this country’s greatest achievements: a system that embodies social justice and has delivered widespread patient satisfaction, public support and value for money."

The editors add: "We must make sure that nothing like this ever happens again."

In their opinion piece, they acknowledge that the Bill will probably become law and that the reforms will go-ahead, but they urge the government to set up an independent commission to oversee any future changes to the system. They say that "rather than relying on policy makers to build brave 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 organisations could and should play".

Saving money

In a second BMJ editorial published today, Kieran Walshe, professor of health policy and management at Manchester Business School, says that abandoning the Health and Social Care Bill would save just over £1 billion in 2013.

He argues that dropping the Bill now would also put an end to the "damaging period of prolonged organisational uncertainty in the NHS" and "allow NHS organisations to focus on what is the real and urgent problem for the NHS - improving efficiency and productivity, and sustaining performance in the face of years of future financial austerity".

A spokesperson at the Department of Health said it was untrue that abandoning the Bill would save money. "Our plans will reduce needless bureaucracy by a third and save £4.5 billion over the course of this Parliament and £1.5 billion every year afterwards. Every penny saved will be reinvested in frontline care for patients," the spokesperson said in an emailed statement.