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Broken pledges and the crisis in the NHS

There was the fanfare, not exactly trumpets, but soothing, calming, reassuring...reassuring. The date is Monday January 4th 2010. A week is a long time in politics, three years is an age, so we may not remember; and if we do we may be inclined to ask so what, who believed them anyway?

It was the day Mr Cameron, launched the Tory party's draft manifesto for the NHS. It was that speech in which the then Leader of the Opposition pledged there would be no top down reorganisation of the NHS. It  was also a speech in which he said the Tories would not make the sick pay for the debt crisis.

Three years on we have major top down reorganisation, £20 billion cuts in NHS funding through 'efficiency savings' which all health bodies including the BMA say have pushed the NHS to a crisis point. NHS England inform us that unless funding levels are increased the NHS in England is heading for a shortfall of £30 billion by 2020. That translates into real cuts that will affect the ability of the NHS to meet patients needs.

In making his pledge David Cameron said that "With the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS." This pledge was reiterated as part of the Coalition agreement.  The Liberal Democrats and the Tories have reneged on this pledge; they have failed to listen to the concerns of leading bodies representing health care professionals; they have failed to listen to the concerns of patient bodies.

Privatised provision has created a problem for commissioning bodies with many serving on the new bodies being potentially compromised through pecuniary interest. This problem is of great concern to the doctors organisation the British Medical Association. The potential for diverting funds from 'in-house' services provided by the NHS is also a concern leading to more private provision as the in-house service is allowed to deteriorate. 

It is no surprise that coupled with creeping privatisation of provision the issue of payment at the point of delivery is brought into question for initially some services. The divisive question is raised, why should the taxpayer pay for your therapy, hearing aids, or whatever it is? It is the same kind of divisive question applied to the changes in welfare provision. The attack on universal benefits turns to an attack on universal health care provision. Let's not say we cannot heed the warning signs. 

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