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| Senior doctors assess government’s record on NHS – letter in full | Senior doctors assess government’s record on NHS – letter in full |
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| After five years of a government which pledged to protect the NHS, this election campaign makes it timely to assess its stewardship, since 2010, of England’s most precious institution. Our verdict, as doctors working in and for the NHS, is that history will judge that this administration’s record is characterised by broken promises, reductions in necessary funding, and destructive legislation, which leaves health services weaker, more fragmented, and less able to perform their vital role than at any time in the NHS’s history. | After five years of a government which pledged to protect the NHS, this election campaign makes it timely to assess its stewardship, since 2010, of England’s most precious institution. Our verdict, as doctors working in and for the NHS, is that history will judge that this administration’s record is characterised by broken promises, reductions in necessary funding, and destructive legislation, which leaves health services weaker, more fragmented, and less able to perform their vital role than at any time in the NHS’s history. |
| In short, the coalition has failed to keep its NHS pledges. | In short, the coalition has failed to keep its NHS pledges. |
| The 2012 Health and Social Care Act is already leading to the rapid and unwanted expansion of the role of commercial companies in the NHS. Lansley’s Act is denationalising healthcare because the abolition of the duty to provide an NHS throughout England abdicates government responsibility for universal services to ad hoc bodies (such as clinical commissioning groups) and competitive markets controlled by private-sector-dominated quangos. | The 2012 Health and Social Care Act is already leading to the rapid and unwanted expansion of the role of commercial companies in the NHS. Lansley’s Act is denationalising healthcare because the abolition of the duty to provide an NHS throughout England abdicates government responsibility for universal services to ad hoc bodies (such as clinical commissioning groups) and competitive markets controlled by private-sector-dominated quangos. |
| In particular, the squeeze on services is hitting patients. People may be unaware that under the coalition, dozens of Accident & Emergency departments and maternity units have been closed or earmarked for closure or downgrading. In addition, 51 NHS walk-in centres have been closed or downgraded in this time, and more than 60 ambulance stations have shut and more than 100 general practices are at risk of closure. | In particular, the squeeze on services is hitting patients. People may be unaware that under the coalition, dozens of Accident & Emergency departments and maternity units have been closed or earmarked for closure or downgrading. In addition, 51 NHS walk-in centres have been closed or downgraded in this time, and more than 60 ambulance stations have shut and more than 100 general practices are at risk of closure. |
| The core infrastructure of the NHS is also being eroded with the closure of hospitals and thousands of NHS beds since 2010. | The core infrastructure of the NHS is also being eroded with the closure of hospitals and thousands of NHS beds since 2010. |
| Mental health and primary care are faring no better – with both in disarray due to funding cuts and multiple reorganisations driven by ideology, not what works. Public health has been wrenched out of the NHS, where it held the ring for coordinated and equitable services for so long. | Mental health and primary care are faring no better – with both in disarray due to funding cuts and multiple reorganisations driven by ideology, not what works. Public health has been wrenched out of the NHS, where it held the ring for coordinated and equitable services for so long. |
| In September 2014, the Royal College of General Practitioners said that the wait to see a GP is a “national crisis”. | In September 2014, the Royal College of General Practitioners said that the wait to see a GP is a “national crisis”. |
| In England the waiting list to see a specialist stands at 3 million people, and in December 2014 NHS England estimated that nearly 250,000 more patients were waiting for treatment across England who are not on the official waiting list. | In England the waiting list to see a specialist stands at 3 million people, and in December 2014 NHS England estimated that nearly 250,000 more patients were waiting for treatment across England who are not on the official waiting list. |
| Throughout England, patients have been left queueing in ambulances and NHS trusts have resorted to erecting tents in hospital car parks to deal with unmet need. | Throughout England, patients have been left queueing in ambulances and NHS trusts have resorted to erecting tents in hospital car parks to deal with unmet need. |
| A&E target waiting times have not been met for a year, and are at the worst levels for more than a decade; and elderly, vulnerable patients are marooned in hospital because our colleagues in social care have no money or staff to provide much-needed services at home. | A&E target waiting times have not been met for a year, and are at the worst levels for more than a decade; and elderly, vulnerable patients are marooned in hospital because our colleagues in social care have no money or staff to provide much-needed services at home. |
| Funding reductions for local authorities (in some places reductions as high as 40%) have undermined the viability of many local authority social care services across England. This has resulted in more patients arriving at A&E and more patients trapped in hospital as the necessary social care support needed to ensure their safe discharge is no longer there. | Funding reductions for local authorities (in some places reductions as high as 40%) have undermined the viability of many local authority social care services across England. This has resulted in more patients arriving at A&E and more patients trapped in hospital as the necessary social care support needed to ensure their safe discharge is no longer there. |
| The NHS is withering away, and if things carry on as they are then in future people will be denied care they once had under the NHS and have to pay more for health services. Privatisation not only threatens coordinated services but also jeopardises training of our future healthcare providers and medical research, particularly that of public health. | The NHS is withering away, and if things carry on as they are then in future people will be denied care they once had under the NHS and have to pay more for health services. Privatisation not only threatens coordinated services but also jeopardises training of our future healthcare providers and medical research, particularly that of public health. |
| Given the obvious pressures on the NHS over the last five years, and growing public concern that health services now facing a very uncertain future, we are left with little doubt that the current government’s policies have undermined and weakened the NHS. | Given the obvious pressures on the NHS over the last five years, and growing public concern that health services now facing a very uncertain future, we are left with little doubt that the current government’s policies have undermined and weakened the NHS. |
| The way forward is clear: abolish all the damaging sections of the Health and Social Care Act 2012 that fragment care and push the NHS towards a market-driven, “out-for-tender” mentality where care is provided by the lowest bidder. Reversing this costly and inefficient market bureaucracy alone will save significant sums. Above all, the secretary of state’s duty to provide an NHS throughout England must be reinstated, as in Scotland and Wales. | The way forward is clear: abolish all the damaging sections of the Health and Social Care Act 2012 that fragment care and push the NHS towards a market-driven, “out-for-tender” mentality where care is provided by the lowest bidder. Reversing this costly and inefficient market bureaucracy alone will save significant sums. Above all, the secretary of state’s duty to provide an NHS throughout England must be reinstated, as in Scotland and Wales. |
| As medical and public health professionals our primary concern is for all patients. | As medical and public health professionals our primary concern is for all patients. |
| We invite voters to consider carefully how the NHS has fared over the last five years, and to use their vote to ensure that the NHS in England is reinstated. | |
| Dr Sheila Abdullah general practitioner (retired)Dr Sheila Adam former deputy chief medical officer for EnglandDr Gwen Adshead consultant psychiatristProf George Alberti emeritus Professor of Medicine, University of NewcastleDr James Anderson consultant psychiatristProf Sabarantnam Arulkumaran former president Royal College of Obstetrics and GynaecologyProf John Ashton retired director of public healthDr Ashok Atrey GPDr Helen Bailey physician in Sexual Health and HIVDr Arun Bakshi emeritus consultant physician, Isle of Man Dr JS Bamrah consultant psychiatrist Mr Dipak Banerjee retired consultant opthalmologistDr Roger Banks psychiatrist in intellectual disability, former vice-president Royal College of PsychiatristsDr Helen Bantock senior lecturer and consultant paediatricianDr David Bareford retired consultant haemotologistDr Vijay Bathla GPDr Naomi Beer GP partner Prof Richard Bentall professor of clinical psychology, University of LiverpoolDr Morris Bernadt retired consultant psychiatristDr Naureen Bhatti GP and associate dean, London Professional Support UnitProf Dinesh Bhugra consultant psychiatrist and former president Royal College of PsychiatristsDr Christopher Birt University of Liverpool and Christie hospital, ManchesterDr Kambiz Boomla GP and former chair City and East London Local Medical CommitteeDr Carol BrayneDr Raymond Brown consultant paediatricianDr Laurence Buckman GP and former chair UK General Practitioners CommitteeDr Chris Burns-Cox emeritus consultant physician, BristolDr Marta Buszewicz GP and senior lecturer in general practiceProf Simon Capewell professor of public health, University of LiverpoolDr Lucy Carter GPDr Lyn Challands retired GPProfessor Sir Iain Chalmers coordinator, James Lind InitiativeDr Kailash Chand GP and former NHS trust chairDr Connie Chen GP clinical lead for prescribing and child health, Central Manchester CCGProf Carolyn Chew-GrahamDr Jonathan Coates GPDr Tom Coffee GPProf Michael Coleman professor of epidemiologyProf Peter Crome emeritus professorDr Richard Cunningham consultant microbiologistDr Jack Czauderna retired GPDr Jonathan Dare retired consultant child and adolescent psychiatrist, Maudsley hospitalDr Susan Davies consultant histopathologistDr Paquita de Zulueta honorary senior clinical lecturer, Imperial College LondonDr Nicholas Dennis retired, clinical geneticsDr Harpal Dhingra GP, AlbrightonProfessor Paola Domizio pathology educationDr Edgar Dorman consultant obstetrician and gynaecologist, LondonDr Ross Dyer-Smith clinical lead, Lambeth CCG directorDr David Elliman consultant, community child healthDr Katrina Erskine consultant gynaecology and obstetrics, Homerton University hospital, LondonDr George Farrelly GPDr Katherine Fielder GPDr Miriam Fine accident and emergencyDr Peter Fisher retired consultant physicianDr Paul Fleming consultant anaesthetistDr Lindsay Forbes senior lecturer in cancer and public healthProf Robbie Foy professor of primary care, University of LeedsDr Andrea Franks consultant dermatologist, ChesterDr Robert Galloway accident and emergencyProf Linda Gask emirita professor of primary care psychiatry, University Of ManchesterDr Clare Gerada GP and former chair, Royal College of General PractitionersDr Colin Godber consultant old age psychiatryDr Michael GopfertDr Marilyn Graham general practitionerProf Trisha Greenhalgh professor of primary care, University of OxfordDr Rex Haigh consultant psychiatrist in medical psychotherapyDr Phil Hammond associate specialist paediatric chronic fatigue service, BathDr MG Harrington consultant geriatricianDr David Hawkins consultant physicianDr Iona Heath GP and former president, Royal College Of General PractitionersDr Robert Hugo consultant psychiatristDr Christopher Jenkins GPProf Roger Jones editor, British Journal of General Practice, emeritus professor of general practice, King’s College, LondonDr Coral Jones GPDr Fred Kavalier GPDr Mohammed Salah Khalifa GPDr Surendra Kumar GPDr Dianne Levevre consultant psychiatristDr Jasvinder Singh Lidder consultant psychiatrist Prof Karina Lovell professor of mental healthDr Simon Lowes specialist registrar clinical radiologyDr Sahira Mahmood locum GPDr Nick Mann GP and NHS osteopathDr Chris Manning convener Action for NHS WellbeingProf Martin McKee professor of European public healthDr Helene McKeon GPDr John Middleton independent public health physicianDr Sally Mitchison retired consultant psychiatristDr Roger Neighbour GP and former president, Royal College of General PractitionersDr Julia Nelki child psychiatrist Cheshire & Wirral Partnership TrustDr David Nicholl consultant neurologistDr Maureen O’Leary retired consultant psychiatristDr Tony O’Sullivan consultant paediatrician, Kaleidoscope – Lewisham Centre for Children & Young PeopleDr Sophia Osbourne GPDr David OwenDr Tim Paine former president, National Association for Patient ParticipationProf Allyson Pollock professor of public healthProf Hilary Powers professor of nutritional biochemistry and head of oncology, University of SheffieldDr Umesh Prabhu consultant paediatricianDr Braham Prashara GPDr Shibley Rahman academic in dementia, Primrose HillDr Dan Rainbow GP and locality commissionerAnne Read consultant psychiatristDr Paul Revell consultant haematologistDr Brian Rossiter retired consultant physicianDr Yvette Saldanha GP trainerDr Alex Samuel senior lecturer in public health, University of LiverpoolProfessor Wendy Savage retired senior lecturer in obstetrics and gynaecologyDr Gabriele Scally public health consultantDr Parveen Sharma consultant psychiatristMr Virender Sharma consultant ENT SurgeonDr Caroline Shulman GP for homeless and inclusion health, Kings Health PartnersDr Kamal Sidhu GPDr Martin Siebert GPDr Brian SilkDr Ian Sinclair general practitioner (retired)Dr Surinder Singh GPDr Francis Skiffington retired consultant community paediatricanDr Alison Smailes GPDr Donatella Soldi community paediatricianMr Virender Soni ophthalmologist Dr Miranda Splitt consultant geriatricianDr John Sweeney consultant physicianDr RL Symonds consultant psychiatristProf Raymond Tallis emeritus professor of geriatric medicine, University of ManchesterDr Jonathon Tomlinson GPDr Charlie Tomson consultant nephrologistDr David Tomson GPDr Norman Traub former consultant haematologist, Southend hospitalDr Asha Umrawsingh emergency care doctor, Lewisham University hospitalDr Devaraja Vedakkalur GP Dr Ian Walton GPDr Fiona Watson GPDr Eric Watts retired consultant haemotologist and clinical directorProf Jonathon Weber professor of infectious diseases, Imperial College LondonDr Tara Weeramanthri GPDr Sian Williams consultant in occupational medicineDr David Wrigley GPDr Luke Zander retired GPDr Patrick Zentler-Munro retired consultant physician |