Tory free-market hurricane will blow our NHS apart

[CHIMO]

This week's NHS bill is such a monumental upheaval that it has more pages than the original 1946 act. David Cameron's speech about it today wrapped his support for "the public ethos" in a glow of warm words, but nothing will disguise what is about to happen. The public will soon see for itself the dangers warned of by the medical profession, the Tory-led Commons health select committee, the royal colleges and the independent King's Fund.

The government has skilfully focused all attention on what seems most patient-friendly and easy to understand. Your trusted GP will be in charge of an £80bn budget for your care. Faceless bureaucrats in unknown primary care trusts will be swept away, half of all NHS managers sacked and replaced by your wise GP buying whatever you choose, with no diktats from above.

In reality those commissioning services will be more distant from patients, as local PCTs are replaced by far larger clusters of consortiums – some run by the same managers expensively sacked and re-employed, but more by private companies. A survey by Pulse magazine found six out of 10 of the first consortiums are negotiating with private companies to run their referrals. It may or may not hold together, but at a time of famine the price tag is £2bn-£3bn: the real cost of these political re-disorganisations is never fully computed.

GPs are camouflage for the true Cameron revolution. Consortiums must now commission services from "any willing provider". Naive GPs who fondly imagine they can choose where to send patients may get a nasty shock. Monitor, whose role was limited to scrutinising foundation hospitals, has been re-born as a regulator whose first task is "to promote competition". For the first time the NHS is opened to EU competition law. If a consortium keeps a relationship with a trusted local hospital, it may find itself challenged in court by any private company claiming the right to outbid. Neither GPs nor patients will control who is treated where: the law will decide.

http://www.guardian.co.uk/commentisfree/2011/jan/17/free-market-bill-blow-nhs-apart