Andrew Lansley mobbed by angry NHS campaigners

Another day, another debate about the controversial NHS Bill. Only this time, the prime minister neglected to invite the growing number of health professional bodies who have expressed their opposition to the bill.

Doctors, nurses and members of the public staged a protest outside Downing Street against the bill and their exclusion, and heckled Health Secretary Andrew Lansley as he tried to enter No.10 to attend the summit.

The health secretary stopped to talk to one woman who said: “I’ve had enough of you and Cameron.” Mr Lansley denied that the bill would result in privatisation, but she responded angrily: “You are privatising – don’t you dare lie to me.”

The health secretary told protesters that their concerns were based on a “complete misrepresentation”. He was booed and protesters started chanting “greedy” as he fought his way through the crowd.

He keeps saying it’s about giving power to doctors and nurses, but he’s excluding the people who he’s supposed to be handing power to. We in our great majority are totally opposed to this bill. Dr Louise Irvine, Lewisham GP

Since the original white paper was published in July 2010, the coalition government has made several changes recommended in the NHS Future Forum.

And earlier on Monday, Downing Street denied the exclusion of all the health unions and eight medical colleges was an attempt to freeze out opposition. “The purpose of today’s meeting is to hear first-hand from people who are implementing the reforms about how the process is going,” said a spokesman.

But Dr Louise Irvine, a Lewisham GP, told Channel 4 News that failing to invite representatives for around 500,000 medical representatives was “pathetic”.

“I think it shows how desperate Cameron is getting,” she added.

The medical colleges left in the cold:
Royal College of GPs
Royal College of Radiologists
The Faculty of Occupational Medicine
Royal College of Psychiatrists
College of Emergency Medicine
Faculty of Public Health
Royal College of Pathologists
Royal College of Ophthalmologists

The unions not invited:
Royal College of Midwives (RCM)
Royal College of Nursing (RCN)
British Medical Association (BMA)
Unite
Unison

A member of the Royal College of GPs, as well as the BMA, Dr Irvine said the decision was hypocritical. “He keeps saying it’s about giving power to doctors and nurses, but he’s excluding the people who he’s supposed to be handing power to,” she said. “We in our great majority are totally opposed to this bill.”

Of the medical colleges who have been invited, the Royal College of Physicians has called a general meeting for February 27, and will finalise its approach to the bill after hearing frm its members.

The summit comes as a Yougov survey found that six times as many people trust health professionals over the prime minister and the health secretary on the NHS reorganisation. So what would these excluded health professionals tell David Cameron if they were there?

Patient care

Opponents of the bill have many concerns, but privatisation, resulting in a decline of patient care, is among their greatest fears. The bill proposes opening up the NHS to private companies – both to provide healthcare and commission services, which many health professionals are worried will lead to fragmentation of services.

In addition, hospitals will be allowed to gain 49 per cent of their income through private care – something that critics have said will lead to two-tier patient care. “This is not just a reform – it’s a fundamental denationalisation and repeal of the founding act of the NHS,” Dr Irvine told Channel 4 News.

“Hospitals are in such difficult financial situations and there is a finite amount of space in hospitals – NHS patients will have to wait longer for their care, and private patients will be able to jump the queue. People will be tempted to take out health insurance and those who don’t will suffer.”

The royal colleges invited:
Royal College of Paediatrics
Child Health Royal College of Surgeons
Royal College of Obstetricians and Gynaecologists
Royal College of Anaesthetists
Royal College of Physicians

Speed of change

Labour leader Ed Miliband has recently launched a Save the NHS campaign, calling for the bill to be scrapped.However politicians and commentators argue that it is now too late – the question was raised during the forced consultation period last year, but the wheels are already in motion.

The government on Monday pointed out that handing more power to doctors has already resulted in positive change – Department of Health figures show a 0.5 per cent decline in emergency hospital admissions in 2011, compared with a 36 per cent increase between 2001 and 2010.

The clinical commissioning groups is an idea that could have benefits for patients, but the way the government is putting it forward, will result in increased private competition. BMA spokesman

But the BMA, who called their non-invitation “odd”, say that the timetable for reform has been over ambitious, and that major changes are taking place on the ground before the Bill has been passed is dangerous.

“It’s also been put through at a time when NHS is being asked to save £20bn in reforms,” a spokesman told Channel 4 News.

And while some amendments have been conceded, they don’t go far enough, according to the Royal College of Nurses (RCN) Chief Executive Dr Peter Carter.

“In particular, the amendments do not fully address the key areas of competition, nurse involvement, the private income cap and health inequalities,” he said. “The bill continues to damage the NHS as we know it and combined with the need to save £20bn in England by 2014, we fear that the health service is facing an extremely difficult future.”

Role of GPs

In its easily digestible summary of the bill, the government has outlined its main points as handing over more power to GPs, and reducing bureaucracy.

Involving GPs more has been on the cards for years, and its not one that the BMA is opposed to in itself. But the idea of forming clinical commissioning groups, which GPs will be heavily involved in running, is not the way to do it, a spokesman told Channel 4 News.

“It’s an idea that could have benefits for patients, but the way the government is putting it forward, will result in increased private competition,” said a spokesman.

As a GP with 20 years experience, Dr Irvine is not keen on a change in her role. “Other GPs have got very involved in trying to get the commissioning thing working,” she told Channel 4 News. “I think it distracts GPs from their real work, and looking afrer their patients. We’re not equipped to becoming NHS bureaucrats. I don’t want that to change.”