Andrew Lansley and his colleagues assure us that under their plans to privatise the NHS, “services will still be free at the point of use”. But they fail to add a key proviso: provided the services are still available. In reality, a growing list of services won’t be available, and so won’t be free.
Of course, some services that the NHS originally provided, such as long-term care for frail older people, have long been officially withdrawn; and others, like prescriptions and dentistry, are still provided but subject to charges. Under the health and social care bill there will be further contraction of what is provided free on the NHS. Local clinical commissioning groups, not the secretary of state, will decide what services it is “reasonable” to provide out of the budgets they are given, and the package will gradually contract.
This process has already begun under the pressure of the so-called productivity savings recommended by McKinsey. NHS services are being withdrawn in an unannounced, piecemeal and unaccountable way.
In 2006, Croydon primary care trust drew up a list of 34 procedures that would not be paid for in cases where they were judged ineffective or “cosmetic”. But the list also included cataract surgery and hip and knee replacements, on the grounds that their benefits were minimal in “mild” cases. Obviously, what is considered a mild case is liable to be modified by financial pressures. By 2010, the Croydon list was being used widely by other PCTs as a means to save money. In some areas, one commentator noted, “only ‘urgent’ treatment – cancer, fractures and A&E – are funded, and all other procedures are either delayed or the patient is denied funding”.
So a new postcode lottery for treatments has developed, largely unreported. NHS North Central London has a relatively short list of 36 treatments it won’t pay for unless there are special circumstances. South West Essex has a list of 213. In effect, people who need these treatments have to pay for them privately and if they can’t pay for them, they have to do without.
On top of this, GPs are being prevented from referring patients to specialists. In some areas indebted primary care trusts have simply limited each GP to a maximum of four referrals a week, regardless of how many patients need specialist attention. In other areas GP referrals are being intercepted by referral facilitation services (a name that might have been invented by Orwell himself), also called “referral gateways”, run by private firms. One of the first was in west London, where the American health insurer UnitedHealth has a contract to override GPs’ judgments and tell patients to have physiotherapy or use more painkillers instead of seeing a specialist.
A patient with good communication skills and determination may manage to overcome this obstacle. One west-London patient whose NHS surgeon had previously told her she needed a new knee, but who was denied it by UnitedHealth, had to pay over £1,000 and spend a year getting a scan and other surgeons’ opinions to finally prove she needed it, and get back onto the NHS waiting list. But for many this is not possible. For them, free specialist services turn out not to be available.
Related articles
I can’t believe this is happening. Goodbye NHS. The nails being pounded down in the coffin lid.
stop pissing about with our health service you torrie bastards !
when you lie you got to have a very memory but these buggers get away with it daily not only do they want our benefits they now want us to buy insurance from people like unum for cover for hospitals but hold on they dont cover it they get out off paying bills as of in america thrown out with boot up the backside big fines .but torys do not want us to be going to be treated for free its going to kill the nhs and thats the truth the bloody hippocrites with their fingers in the till and mouths in the trough feeding off the many whilst they rule the roost unbeleavible doing most damaged before they thrown out jeff3
I’ve been trying to warn people about this for over a year.
Using Unum Insurance as ‘gvt advisers’ we are little more than another US state masquerading as the UK, with an NHS that remains free at the point of need – always asuming the NHS will still be providing the service.
This has been planned for a long time. Most MPs are unaware, so perhaps it is time to tell them.
Lobbying Lib Dem MPs on mass, in advance of their party conference, may help to wake them up but would require Lib Dems to stop the coalition and bring about another general election.
I doubt they’ll be willing to step down from their seat at the top table as they see every Lib Dem policy dismantled.
OH HOW I HATE THE TORY BASTARDS
The Lib Dems would put their hand up an elephant’s anus to get power. As for the Tories, they don’t seem to know that if they destroy the NHS the public will throw them out. Everyone ecept for the very rich depends on the NHS, be they disabled or not.
This article should make clear that Lansley is making these changes to the NHS in England, not in Wales or Scotland. We’ve had free prescriptions in Wales for many years now.
I have Asperger’s Syndrome so either could not get insurance or it would be stupidly expensive.
I feel sick reading this. What else are they going to take from us?