NHS reforms 'could lead to US-style system'

The Health Bill could leave the NHS replaced by a service in which private companies compete and the government “finances but does not provide healthcare”, they claim.

Instead of having a duty to provide a comprehensive health service to patients in England, health secretary Andrew Lansley will only have a duty to “act with a view to securing” comprehensive services.

Professor Allyson Pollock, from the Barts and The London School of Medicine, and David Price, senior research fellow at its Centre for Health Sciences, say GP consortia will “not have a duty to provide a comprehensive range of services but only such services or facilities as it considers appropriate”.

The experts said patients who cannot get access to GP surgeries or consortia services “may have to default to local authorities, which would become the provider of last resort”.

Furthermore, consortia “will determine which services are part of the health service and which are chargeable, and have been given a general power to charge”.

Writing in the British Medical Journal, the authors also raise concerns about “referral management centres”, which can block hospital referrals made by GPs.

“These centres are currently rejecting one in eight general practitioner referrals and seem to operate along the lines of ‘prior authorisation’ arrangements in the United States, whereby doctors are required to obtain approval from a higher authority before making a referral for treatment or investigation.”

The authors argue the bill allows consortia to save cash from money meant for patient care and share it among staff or shareholders.

“Surpluses can be generated by selecting patients or services, denial of care, or reductions in staff terms and conditions.”

The authors concluded: “The government proposes a commercial system in which the NHS is reduced to the role of government payer, equivalent to Medicare and Medicaid schemes in the US.

“However, government belief that cost efficiency, improved quality, and greater equity flow from competition in healthcare markets is not supported by evidence, the Office of Fair Trading, the government’s impact assessment, or its experience of independent treatment centres and private finance initiatives.”

Health minister Simon Burns said: “This grossly misleading and groundless account is based on pure fabrication and a serious absence of facts.

“This government is not - and never will be - in the business of privatising or undermining the NHS.

“We are absolutely committed to a comprehensive national health service, free at the point of use and based on need rather than ability to pay - nothing in our plans changes that.

“We have protected the NHS and are ploughing in an extra £10.7bn of funding.

“But the NHS must modernise in order to keep up with the increasing demand on services, an ageing population and rising costs of new drugs and treatments.

“We are passionate about ensuring high quality, efficient services for patients.”