NHS reform: savage, callous, a godsend

The government's proposed reforms to the NHS have aroused much public debate. Would the Health Service benefit from increased competition? Emily Hohler reports.

To Labour, Andrew Lansley's Health Bill is "savage, callous, and a godsend", says Michael Deacon in The Daily Telegraph. The party watches delightedly as GPs vote against it and protesters shout "codswallop". Over 100,000 people signed a petition calling for the bill to be withdrawn. The lesson here for the government, albeit too late to learn, is: if you want to reform the NHS, "don't let on". When a Tory says NHS reform', many people hear: "your mother will be tipped out of her hospital bed and made to perform her own hip operation in the car park".

What "agitates" opponents most is competition, says The Daily Telegraph. But new research by the London School of Economics shows that measures introduced six years ago by the last government to encourage competition between hospitals have worked. Their study of two million patients found it reduced costs and increased efficiency.

Four separate studies have tested the effects of competition in the NHS, say Julian le Grand and Zack Cooper in the FT. The findings are clear and consistent: patient outcomes are better. Yet as opposition mounts and Lansley's proposals look like being "emasculated", there is a "real risk" that this evidence will be ignored. Caving in would be a mistake.

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Competition is vital, agrees Stephen Bubb in The Times, but there is more common ground between the coalition and the opposition than one might think. "Most politicians agree that the system can't cope." There are 18 million people with long-term health conditions in Britain and more than 20% of the population is over 60. Both figures are growing. "Medical advances, lifestyle changes and demographic shifts mean increased demand for NHS services that cannot be matched by a rise in money."

Observers agree that to make the necessary changes especially shifting spending towards preventative, community-based services to avoid spending 70% of funds on long-term conditions the NHS must let "new providers with new ideas break the bureaucratic stranglehold on delivering services". Politicians must build on common ground to enact sensible reform.

Yes, the NHS needs modernising and would benefit from more competition, but Lansley's reforms are still a "disaster", says Philip Stephens in the FT. The surviving good elements of the bill will be "buried" in "organisational upheaval", cost billions to implement and officials fear "meltdown" as the shake-up "collides with a ferocious squeeze" on the NHS budget.

It is not too late to turn back. However, David Cameron may think it is, says Max Pemberton in The Daily Telegraph. A retreat risks being seen as a "show of tremendous weakness". Cameron is "putting political pride before the welfare of the nation".

Emily Hohler

Emily has extensive experience in the world of journalism. She has worked on MoneyWeek for more than 20 years as a former assistant editor and writer. Emily has previously worked on titles including The Times as a Deputy Features Editor, Commissioning Editor at The Independent Sunday Review, The Daily Telegraph, and she spent three years at women's lifestyle magazine Marie Claire as a features writer for three years, early on in her career. 

On MoneyWeek, Emily’s coverage includes Brexit and global markets such as Russia and China. Aside from her writing, Emily is a Nutritional Therapist and she runs her own business called Root Branch Nutrition in Oxfordshire, where she offers consultations and workshops on nutrition and health.