Bury the bill

This week I’ve spent some time in meetings that have made it clear how damaging the cack-handed management of the NHS reforms has been. I’m exhausted by the complexity of the changes, the range of opinions expressed in every corner, and above all with the uncertainty of everything.

The editorial in the BMJ last week summed up my feelings about the Health and Social Care Bill. Tony Delamothe, Edward Davies and Fiona Godlee make the case to “sweep the bill’s mangled remains into an unmarked grave and move on”. They state that we don’t need it to achieve change and yet we are promised even more bureaucracy.


Primary care trusts could still be reformed to put the GPs in the driving seat, as was originally intended, thus obviating the need for vastly more disruptive, and costly, structural change. Choice of any qualified provider could still be limited to services covered by tariffs to ensure that competition is based on quality.

We didn’t need legislation to achieve these aims. Whatever happens now it is crucial we see some progress – it feels like the NHS has been completely hamstrung. There are still monumental gaps in everyone’s understanding of how the NHS will work. No one can plan any care and organisations are unravelling before our eyes with no clear idea of the next step.