Only a few weeks to go until the most unpredictable election in years and polls show that the NHS tops the list of voters concerns. Not surprisingly, politicians, of all persuasions are committing to promises about the service—details of extra funding and what they will offer patients in future. The Conservative manifesto, for example, pledges an extra £8 billion by 2020, same day appointments with GPs for those over 75, and an NHS leading the world in fighting the scourges of cancer and dementia—what’s not to like?
But those who have been paying attention may ask why should we trust politicians who have such a poor record on the NHS?
The answer of course is that we shouldn’t and the evidence is in a new book—NHS For Sale, Myths Lies and Deception. The book is based on a myth busting formula, and examines the pledges made before the last election, the myths created to excuse the massive Coalition “reforms” and the promises that accompanied those reforms. It compares the myths with the reality, providing an evidence based narrative that will shock even the most cynical and hardened NHS campaigner.
The promises made before the 2010 election were clear and a matter of public record. Billboards featured David Cameron promising to “cut the deficit not the NHS,” and there is footage of him a few years before promising an audience of nurses that there would be no more of those “pointless reorganisations that aim for change but instead bring chaos.” There was thus not only no hint of a reorganisation, that the chief executive of the NHS later said was, “so big it could be seen from space” (4), but there was a specific promise that it wouldn’t happen.
Within weeks of taking power, Andrew Lansely produced his plans for the health service—and the Health and Social Care Bill. The Coalition developed myths to justify the broken promises. Statistics were cherry picked and rearranged to persuade us that the NHS was a failing service with poor outcomes, and what’s more was costing too much money. The bill would solve all these problems by giving power to patients and money to GPs, who would be free to make the best decisions on their patients’ behalf.
Lansley promised that his reforms would reduce bureaucracy, which was “stifling” the NHS, and would save money. The NHS would be more transparent and accountable, and there would be no privatisation of the NHS despite the obvious incentives for the private sector to bid to deliver NHS care. There would be more choice for patients and more voice for local communities. As many said at the time, it was motherhood and apple pie.
The book devotes a chapter to each of these myths and promises, and comprehensively demolishes them with carefully researched evidence. Many of the examples given will be familiar—the failures of the private sector on so many counts, from falsifying data to abandoning unprofitable contracts, private companies hiding their costs, profits, and outcomes behind a wall of “commercial confidentiality” that even the Health Select Committee cannot penetrate, the terrible waste of money and clinical time resulting from the introduction of compulsory tendering. But above all one is left asking—what has this done for patients? The answer based on the evidence in the book has to be that it has made things much worse, as patients face a fragmented NHS and staff try to do their best as their jobs and services are cut and outsourced.
This is a must read for anyone who is interested in the fate of the NHS. It is both accessible for those who are new to the subject (each chapter is preceded by a short summary explaining the background) and yet contains enough material to be useful for campaigners and NHS watchers. It should be read by any voter who wishes to cast their vote for the NHS, which, judging from the polls, is most of us. If the question is whether or not we trust pre election promises on the NHS the answer based on the evidence in this book must be a resounding “no.” We have been warned.
Clare Gerada is a Lambeth GP and medical director of the NHS Practitioner Health Programme. She is co-chair of The Founders’ Network, a group of organisations and individuals committed to creating a healthier NHS.
Competing interests: Clare Gerada is a member of UK Labour Party.