NHS is on brink of collapse, say consultants

The NHS is on the brink of collapse and cannot be saved unless Gordon Brown intervenes when he becomes prime minister to give doctors the authority to organise a recovery, the leader of Britain's 33,000 hospital consultants will claim today. Jonathan Fielden, chairman of the British Medical Association's consultants committee, will tell Mr Brown: "Political meddling has brought the NHS to its knees. Unshackle the profession, give us back the health service, and we will rebuild it. Fail to do so and you will rightly be condemned for destroying the best piece of social capital the country has ever had."

Dr Fielden will make his plea as Patricia Hewitt, the health secretary, announces the NHS's financial results for the year to March. She is expected to confirm a report in the Guardian last week that it made a surplus of about 500m. Dr Fielden will blame the Department of Health for cutting services too aggressively last autumn, when ministers panicked about the possibility of another deficit. "It takes weeks to cut, but years to rebuild trust," he will tell the BMA consultants' conference in London. "We are angry with the government for a woeful dereliction of duty - towards patients, towards the profession and towards the future. We have lost all confidence that the government can solve the problems it has created."

The service suffered from too little strategic direction and too many ministerial policy initiatives. It had become "a distorted skeleton". The government diverted billions of pounds from improving efficiency to create an internal market in which hospitals competed for patients. "The excessive use of private firms to provide NHS services has been costly, disruptive and has fragmented care. The independent sector should only be used where the NHS needs it, not thrust into its midst like a carelessly placed hand grenade."

Mr Brown should work with doctors, patients and other healthcare professionals to stem the loss of trust and collapse in morale. "We will not stand by and see the Trojan horse of the independent sector rolled in to take over the health service from within."

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Outrage over NHS cutbacks and bookkeeping fiddles

Patricia Hewitt was accused yesterday of aggravating regional inequalities in NHS care to meet her promise to stem health service deficits in the last financial year. The Health Secretary faced a barrage of criticism from economists and health professionals over her stewardship of the NHS after disclosing that it had underspent its budget by 510 million pounds last year. The figure fulfilled a government pledge to avoid a third year in the red, but provoked outrage over "excessive" cuts and their impact on waiting lists. The latest unaudited data show that more than one in five NHS bodies in England are still in debt, with about one in ten classed as facing long-term financial challenges.

Jonathan Fielden, of the British Medical Association, described the cost-cutting strategy as "wreaking havoc on the NHS and return[ing] it to boom and bust health economics". The combined debt of the 22 per cent of NHS organisations who failed to break even in 2006-07 was 911 million. In the previous financial year the NHS ran up an overall deficit of more than 500 million, and the gross deficit - the total of all those organisations which ran up debts - was 1.3 billion.

However, the NHS, which had a budget of over 70 billion for 2006-7, has only managed to balance the books by taking money from elsewhere. A leaked e-mail, reported yesterday by The Times, suggested that in addition to lost jobs and raids on training budgets, the climate of cost-cutting has stalled progress on the flagship policy to ensure no patient waits longer than 18 weeks for hospital treatment........

Peter Carter, general secretary of the Royal College of Nursing, said that yesterday's budget figures "expose the tragedy and farce of NHS finances". He condemned the Government's refusal to give nurses their 2.5 per cent pay award immediately instead of staged over the year. "With a NHS surplus of more than half a billion pounds and the threat of industrial action on the horizon, it is surely time for ministers to do the decent thing and give nurses the fair pay deal they deserve," he said. "Stop-go economics is no way to run the NHS." NHS Trusts have been spending more than œ1 billion a year on agency nurses due to poor planning, a group of MPs said. The Public Accounts Committee said that the bill grew by 40 per cent in the five years to 2005 - despite the number of permanent nurses in the health service rising by one fifth over the same period.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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