Kitchen cabinet aide says charging improves service and NHS should be shown 'no mercy' in drive for reform
A senior adviser to David Cameron says the NHS could be improved by charging patients and will be transformed into a "state insurance provider, not a state deliverer" of care.
Mark Britnell, who was appointed to a "kitchen cabinet" advising the prime minister on reforming the NHS, told a conference of executives from the private sector that future reforms would show "no mercy" to the NHS and offer a "big opportunity" to the for-profit sector.
The revelations come on the eve of a major speech by the prime minister on the future of the NHS, during which he is expected to try to damp down widespread fears that the reforms proposed in health secretary Andrew Lansley's health and social care bill will lead to privatisation of the service.
It has been suggested that Cameron may even announce the extension of a pause in the progress of the bill through parliament until after the party conference season, amid growing tensions on the issue within the ranks of the coalition government.
The deputy prime minister, Nick Clegg, has insisted that the Liberal Democrats will not support any reforms that allow the "profit motive to drive a coach and horses through the NHS".
Backbench Tory MPs, however, have called for the government to stick to the reforms and open up provision of services to the private sector. Britnell's comments will inevitably raise the temperature of the debate.
Britnell, a former director of commissioning for the NHS, who is now head of health at the accountancy giant KPMG, was invited to join a group of senior health policy experts, described by the respected Health Studies Journal as a "kitchen cabinet", in Downing Street earlier this month. The group, which includes former NHS executives and the former Department of Health permanent secretary Lord Crisp, was assembled by Cameron's new special adviser on health, Paul Bate.
In unguarded comments at a conference in New York organised by the private equity firm Apax, Britnell claimed the next two years in the UK would provide a "big opportunity" for the for-profit sector, and the NHS would ultimately end up as a financier of care similar to an insurance company rather than a provider of hospitals and staff.
According to a glossy brochure summarising the conference held last October, Britnell told his audience: "GPs will have to aggregate purchasing power and there will be a big opportunity for those companies that can facilitate this process … In future, the NHS will be a state insurance provider, not a state deliverer." He added: "The NHS will be shown no mercy and the best time to take advantage of this will be in the next couple of years."
Writing in the Health Studies Journal, Britnell also suggested that the NHS would be better served by breaking with the mantra that all services should be free at the point of delivery by allowing co-payment, where patients share the costs of care and drugs.
"It is no good pretending that the health sector can simply turn over and have its belly tickled to produce the scale of savings required for healthcare reinvestment," he wrote. "It appears that countries that have a mixed blend of public and private provision, co-payment and social insurance, are possibly more capable of providing resilient healthcare systems."
The shadow health secretary, John Healey, said: "This revelation comes direct from Cameron's inner circle and gives the game away on the government's NHS plans. It confirms the Tories' true purpose is to set up a free-market NHS and open up all parts of the health service to private companies."
In a move that will pile more pressure on Lansley, the Department of Health last week released the latest Mori poll on satisfaction levels with the NHS. It shows that 66% of people questioned believe the NHS was the best health service in the world, while 37% of the public expect services to deteriorate following the reforms.
However, nearly three-quarters of the British public admit they know "not very much" or "nothing at all" about changes the government plans to make to the NHS, despite claims by the Conservatives and Liberal Democrats that the majority of the reforms were contained in their manifestos.
Health experts have voiced concerns about a threat by Lansley to scrap funding for future public opinion surveys on the NHS, including the British Social Attitudes Survey and Mori polls.
Last night Sir Michael Scholar, the chairman of the UK Statistics Authority, demanded a rethink of the halt on funding for the General Lifestyle Survey, which is run by the Office for National Statistics.
Scholar said abandonment of the survey would make it more difficult to judge opinion on the success or otherwise of the NHS reforms. "If government is planning a major reform of the NHS, people will want to know if it is worse afterwards or not," he said. "These statistics are very important in reaching a rational view."
Labour sources said that the only explanation for the cuts in funding was that the government expected a hostile reaction to the reforms that do proceed and ministers were "planning how best to keep that from view".
A Downing Street spokesman said the government's views on NHS reform had been set out clearly in the Commons and declined to comment on the advice provided to the prime minister by Britnell or others.
--
Source: http://www.guardian.co.uk/politics/2011/may/14/david-cameron-adviser-health-reform
~
Manage subscription | Powered by rssforward.com
Tidak ada komentar:
Posting Komentar