Ones and Twos - the Nail in the NHS's Coffin is Still There

In March, the eagle eyed Dr No wrote this blog post on what he termed 'the secret nail in the NHS's coffin'. This was a reference to a change in wording from the 2006 National Health Service Act Section 1. Section 1(1) and (2) of the 2006 Health Service Act reads as follows;

1 Secretary of State's duty to promote health service

(1) The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement—

(a) in the physical and mental health of the people of England, and

(b) in the prevention, diagnosis and treatment of illness.

(2) The Secretary of State must for that purpose provide or secure the provision of services in accordance with this Act.

Under the new wording originally proposed by the Health and Social Care Bill, it would look like this;

1 Secretary of State's duty to promote health service

(1) The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement—

(a) in the physical and mental health of the people of England, and

(b) in the prevention, diagnosis and treatment of illness.

.

(2) For that purpose, the Secretary of State—

(a) has the public health functions conferred by this Act, and

(b) in exercising functions in relation to a body mentioned in subsection (2A), must act with a view to securing the provision of services for the purposes of the health service in accordance with this Act.

Now, we have been banging on about this 'act with a view' phrase for the past while. It has got to be changed. We said so to the government. And the government via the DoH's Future Forum report has come back with this;

"The role of the Secretary of State

The policy is that the Secretary of State will be responsible – as now – for
promoting a comprehensive health service. The wording of section 1(1) of the 2006 NHS Act will remain unchanged in legislation, as it has since the
founding NHS Act of 1946. This will be underpinned by the new duties that
the Bill already places on the Secretary of State, around promoting quality
improvement and reducing inequalities."

Section 1(1) will remain unchanged. That's very good of them, seeing as they had not changed Section 1(1) in the first place. But what about Section 1(2), where the weasel phrase 'act with a view' cropped up? Are they going to go back to the original wording 'must for that purpose provide or secure the provision of services' ?

Guess what. It doesn't say. I think our dear government is hoping that we get our ones and twos mixed up and not notice that they have made a promise to keep precisely the same wording that they had for Section 1(1) anyway, while not promising to change the wording of Section 1(2).

The nail is still in the NHS's coffin. We must act and get the word round as quickly as we can and make it as public as we can. We are at the most dangerous moment in this debate, because Labour and the Lib Dems are in a position where they can say that the government has agreed to reforms under pressure and support the Health and Social Care Bill, rather than having to go back to the drawing board again. We have to anticipate that and make sure that there is no hiding place for the opposition on this issue and that they cannot walk by on the other side. This is serious. This is fundamental. This is the end of our health service if we don't manage to prise this nail out of the wood. Let's get to work now.

Allyson Pollock Speaks Out

Do read Allyson Pollock's excellent article on the government's response to the Future Forum.

Face Palm..

What We Should All Be Telling Nick and Dave

Came across this video of David Nunn, orthopaedic surgeon at Guy's hospital, giving the third degree to the prime minister's entourage, who hadn't rolled up their sleeves and washed. There's something lovely about a professional talking to Dave and Nick like they're a bunch of naughty boys. Which is exactly what they are. Give that man a medal..

With thanks to Dr Aust and Dr Zorro..

Kill the Bill

No use. Absolutely no use at all.

The time for talking, listening and acquiesing is over. The government has listened and has basically produced the same Health and Social Care bill with a few vague promise to 'safeguard' services and 'act with a duty to promote' the health service. It is a total utter insult.

This bill needs to be stopped. I understand on one level why the BMA and others felt obliged to at least consider and analyse what the government proposed instead of rejecting it outright. Doing that would have lead to accusations of being unreasonable. The trouble with doing that however, is that we are now being lured into a dialogue. Instead of scrapping competition we are being asked how much we will accept just now. Instead of keeping in place the primary care trusts and rejecting deregulation, we are talking about how much time we will need to abolish them and set up consortia. Instead of a clear unequivocal statement of the health secretary's duty to provide or secure services, we have got 'a duty to promote' health care.

We have been had. The BMA needs to get off its backside and call a strike now. We don't want to talk about what parts of the bill we accept and don't. The whole, stinking, weasel worded mass of this needs to be ditched now. Nothing less will suffice.

We need to Kill the Bill.

One out of Bed, Three from the Canteen..

Have you heard of Carmarthen County Council? Nope? Well, as the devil said to the damned, ye ken noo. A blogger called Jacqui Thomson fell foul of the aforesaid council, for filming an angry debate on the closure of an elderly day care club on her mobile phone. She was asked to stop filming and when she wouldn't, four, yes four policemen were sent to arrest her. You never know with these bloggers after all; they're fiends with subordinate clauses and semi colons..

She was handcuffed and kept in a cell for two hours, after which time she was asked to sign an undertaking not to film any more meetings. Joking apart, this is outrageous. This is a public meeting; she was not causing disruption or danger to anyone. And where on earth do you rustle up four police these days to arrest one person? As one commentor said on the Telegraph article,' It'll be one policeman out of bed and three from the canteen. The overtime charge'll be enormous.'

Jacqui's Thomson's blog is here. I've joined her followers in support. I recommend that everyone does the same, because otherwise this will come to us all. With thanks to Dr Grumble for the story.