Health and Social Care Bill

Memorandum submitted by Elisabeth Paul (HS 92)

1. I am a GP trainee and have worked as a junior doctor, in hospital and community medicine as well as in primary care, for the past 5 years. I am looking forward to a long career as a GP in the NHS. I am very concerned about the implications that the Health and Social Care Bill has for the way I will be able to care for my patients in the future. I am also concerned about its implications for training of future generations of doctors.

2. It appears to me that the ideology behind the Bill is one of privatisation of the NHS. I do not believe that health care benefits from functioning as a free market. The cheapest provider is not necessarily the best provider of care. Patients are not a commodity from whom health care providers should be making a profit. The most at-need patients often require the most complicated, and costly, care, and these are the patients who will suffer if for-profit companies are able to compete as "any willing providers".

3. Andrew Lansley was elected on the basis of promises that there would be no more "top-down reforms" of the NHS. He made no mention of any of these proposed reforms prior to the election and therefore has no mandate to implement them.

4. The majority of GPs are either not trained to commission services, or do not wish to. This means that inevitably such a process will fall to outside professionals many of whom will seek to make a profit from the commissioning process. This, added to the costs of implementing the proposed changes, makes a mockery of the suggestion that the Bill will save the taxpayer money.

5. The Bill seems to have little recognition of the essential role of the NHS in educating the next generation of doctors. Our time at medical school provides us with a grounding, but the real education comes from working as a doctor. Our Deaneries are vital to ensure that junior doctors are receiving adequate training to enable us to continue to improve and provide the high quality of care to our patients, and I cannot see any good reason for proposing their abolition. There needs to be regional and national structures to oversee our training, without it there is the risk of geographic variations in quality and poorer standards overall. I find it hard to believe that private companies will be as well equipped to provide adequate training. The junior doctors of today (and we are the doctors that you see in the middle of the night, in A+E, the "frontline of the NHS") need to be well supported and trained so that we can develop into the excellent senior clinicians of the future.

March 2011