It isn’t every month that Health Service Journal gets to cover a newly announced Health and Social Care Bill.
The largest piece of health legislation ever published (three times the size of the founding legislation in 1946) and the most radical in decades, it managed even to dwarf the icy debate over pay freezes that had dominated discussion previously.
HSJ readers flocked to the site following Andrew Lansley’s announcement, commenting as fast as possible on the spiralling number of news angles spawned by the largesse of clauses, quotes and paragraphs that make up the bill. And, unsurprisingly, given that the incumbent government has had to make some of the most unpopular financial decisions in the last two decades, immediate feeling towards the bill fell little short of full-scale outrage.
Hailed by the government as “evolutionary”, it was instead hailed by HSJ readers as “disastrously poor quality”, “non-viable” and a “car crash” of a bill, while the health secretary’s comments as he announced the policy were “absolute bilge” or “unmitigated tosh”, depending on your mood, and simply outlined what one reader described as a “fingers-in-ears approach” to NHS reform.
Denounced as “floundering”, “desperate” and “egotistical nonsense”, the word on the web was that Cameron’s letter was merely “full of spin and rhetoric” but importantly “lacking in detail”, making no mention of the “pound of flesh GPs are expected to give in return” for their new powers - something that is severely lacking in detail for some.
Once that initial furore had calmed a little, however, discussion became more measured. Several readers were in agreement that “change has to happen”, with one admitting that the health service “cannot go on the way it is”. The new structure could “change NHS behaviours” for the good, commenters argued on one story, suggesting perhaps that chinks of light could be seen in the bill - if only in regard to public health, at least.
And while GPs remain thoroughly unconvinced as to the benefits of leading commissioning consortia, the early take up of ‘pathfinder’ groups suggest the changes might be given a fair trial. The eventual abolition of PCTs was, in some quarters, even looked upon favourably: “Consortia won’t employ people with imaginative job titles to sit in meetings and eat sandwiches,” remarked one user.
There is no doubt, though, judging from the wider vehemence on the web this month, that the most radical reform in the NHS’s history has a long, long way to go in persuading healthcare professionals that it really does present a pathway to a world-class health service. And with two years before the reformed structure and processes are fully in place, such vocal opposition is unlikely to die down for some time yet.