Health and Social Care Bill

Memorandum submitted by Dr Leonard Fagin (HS 57)

I have recently retired as a Consultant Psychiatrist working for the NHS for over 35 years. I have observed with increasing concern the development of a market approach to health care over the past 10-15 years, with multiple re-organizations that have impacted on the standards of health care and on the morale of dedicated health providers. My commitment to the NHS was based on my belief that health care should be provided with best and most efficient use of often limited resources, with equal access irrespective of means, but despite serious limitations, especially in mental health care, there have also been important and useful developments. In my view the current proposals in the above Bill are very likely to scupper the achievements of the past 10 years, by opening up the parts of health care that can be cherry picked by willing providers with the only intention of financial gain, and with scant evidence of competence, only gaining contracts by undercutting other services. GPs are unwilling scapegoats in this process, having to decide where the axe must fall, rather than dedicating themselves to front line patient care. With all the will in the world, GPs are not ready , or frankly willing, to make overall public health decisions that affect large communities.

I recently participated in a local meeting discussing these issues, addressed by Lord Nicholas Rea and Dr Jonathan Tomlinson, a GP in Hackney. The meeting was very well attended, and the sense of outrage and militancy was palpable in the audience. I expect that the public will be prepared to make increasingly vociferous demands to kill this Bill, which in my view will lead to the death of the NHS.

February 2011