Myths
Myth 1 The NHS is being cut.
Fact
We are increasing the NHS budget above inflation year-after-year – something which Labour opposes But this does not mean that we can continue to put up with inefficient services, because of the rising demands on the NHS due to an ageing population and better technologies. That is why we are modernising the NHS – but any savings we make will be ploughed straight back into patient care.
Myth 2 The changes weren’t in either of your parties’ manifestos
Fact
They were in both the Conservative and Liberal Democrat manifestos.
The Conservative manifesto (p. 46) promised that GPs would be given control over the health service budget. The Conservative manifesto (p. 45) promised that every Trust would be made a Foundation Trust. Both the Conservative (p. 27) and Liberal Democrat (p. 42) manifestos promised that new social enterprises would be created to deliver NHS services. The Conservative (p. 45) and Liberal Democrat (p.42) manifestos promised that all types of providers – NHS, voluntary, or independent sector – would be free to deliver NHS services. An independent NHS Board was promised in the Conservative manifesto (p. 46). Scrapping central, politically-motivated targets was promised in both the Conservative (p.46) and Liberal Democrat (p. 42) manifestos. Cutting back on unnecessary administrative costs was included in both the Conservative (p. 46) and Liberal Democrat (pp. 40-41) manifestos.
Myth 3 The NHS doesn’t need any change.
Fact
Someone in this country is twice as likely to die from a heart attack as someone in France. Survival rates for some cancers are amongst the worst in the OECD. Premature mortality rates from respiratory disease are worse than the European average. The number of managers in the NHS doubled under Labour, and productivity went down year-on-year.
Myth 4 These changes represent the privatisation of the NHS.
Fact
We will never privatise the NHS. The NHS will always be there for everyone who needs it, funded from general taxation, and based on need and not ability to pay.
Myth 5 Private hospitals will take over the NHS.
Fact
We want patients to be able to choose to be treated wherever they want to be – whether it’s an NHS hospital, or one in the voluntary or private sectors. This is because more choice and more competition will lead to benefits for patients. But we don’t want to set a target for the amount of private sector involvement in the NHS – unlike Labour – and unlike Labour we won’t pay the private sector any more than we would pay the NHS. And we will establish a powerful new regulator to enforce these rules.
Myth 6 GP consortia will be forced to use the private sector
Fact
It will be up to GP consortia to decide their own arrangements.
Myth 7 Every NHS service will need to be competitively tendered.
Fact
Our plans for ‘any willing provider’ are precisely the opposite. Competitive tendering means identifying a single provider to offer a service exclusively. ‘Any willing provider’ means being clear that a service needs to meet NHS standards and NHS costs, and then allowing patients to choose themselves wherever they want to be treated. It is designed to avoid the need for costly tendering processes, unlike Labour’s ‘independent sector treatment centres’.
Myth 8 The policy of price competition in the NHS will lead to a “race to the bottom” on quality
Fact
Patients won’t know how much a service costs, because NHS services are free at the point of use. Patients will therefore choose to be treated at the highest-quality provider. There will be competition on quality, not price.
Where prices can be reduced, in agreement with both frontline GPs and with those offering the service, we will allow it in certain cases. This is the policy Labour set out in 2009, when in government (Department of Health, NHS Operating Framework 2010-11 (paragraph 3.44), 16 December 2009).
Myth 9 Introducing competition will destroy integrated care
Fact
Allowing patients to choose the best care package for them, in consultation with their doctor, will drive integration. And there is nothing in our plans that will stop GPs working with clinicians from hospitals – or to stop hospitals working with other hospitals – to plan ways in which patient care can be improved. Indeed, the Health and Social Care Bill creates a new duty to promote integration.
Myth 10 Private providers will just cherry-pick the easiest cases, undercutting the NHS
Fact
The less complex the procedure, the less someone – including in the private sector – will be paid. Unlike Labour, we will not rig the market in favour of the private sector.
Myth 11 The NHS will cease to be a single, national organisation.
Fact
The NHS has never been a single, national organisation. It has always been made up of hundreds and thousands of different organisations and individuals – many of them from the independent sector – providing care free at the point of use and based on need and not ability to pay. This will not change.
Myth 12 These changes will cost £3 billion
Fact
The one-off cost of our changes will be £1.4 billion, of which £1 billion are the costs associated with reducing the size of the NHS bureaucracy – a reduction that is needed to honour both parties’ promises to reduce the cost of administration in the NHS. As a result, the changes will pay for themselves within two years, and go on to deliver £5 billion of savings over this Parliament.
Myth 13 Waiting times will increase.
Fact
We are not removing any guarantees which benefit patients. That’s why we’ve retained the cancer waiting time targets. It’s why we will ensure that patient experience is central to how we measure NHS performance. And it’s why we’ll allow patients to choose where to be treated, which will drive improvements in quality and waiting times. But when a quarter of patients with cancer are diagnosed only after an emergency, it’s not enough just to focus simply on waiting times. That is why we’re focusing on the actual results which matter as well, like survival rates from cancer.
Myth 14 These changes will lead to a postcode lottery.
Fact
Clear national standards of care will be set, so patients can be confident that – wherever they are treated – NHS care will be of the same high standard, wherever they live.
Myth 15 These aims could have been achieved by putting GPs on PCT boards
Fact
This would have simply allowed an additional layer of NHS bureaucracy to continue. We inherited 151 PCTs and 909 ‘practice-based commissioning groups’. Our changes are simplifying this system, cutting its costs and bringing it closer to patients.
Myth 16 Doctors and nurses will be turned into accountants.
Fact
Frontline doctors and nurses will not be turned into accountants. They will bring clinical leadership into the NHS. They will be given all the support they need to help them take decisions in the best interests of their patients, so that they have even more power to do what they do best: caring for patients.
Myth 17 These plans will result in the closure of hospitals.
Fact
There are no plans to close hospitals. Indeed, our plans will prevent the kind of top-down closures Labour made without reference to local communities. And our changes will make the NHS more efficient by cutting back on bureaucracy, ensuring that every penny spent in the NHS is spent where it should be.
Myth 18 GPs do not want to do the job you are asking them to do.
Fact
In just 12 weeks, GPs covering over half of the country have come together in groups to lead our modernisation. They have come forward voluntarily, more than two years before the formal handover of responsibility takes place in April 2013. This demonstrates the enthusiasm among frontline GPs to take advantage of the opportunities our modernisation plans offer.
Myth 19 These changes are a revolution.
Fact
Our proposals are an evolution of plans which governments of all parties have introduced over the past twenty years. Giving power to GPs has been around for the last two decades, with Labour setting up ‘practice-based commissioning’ when they realised that abolishing GP fundholding was a mistake. Foundation hospitals, and allowing patients to choose where to be treated on the NHS, have been ideas in the NHS for the best part of a decade.
Myth 20 This is a huge, top-down reorganisation.
Fact
We’re moving away from top-down organisation and control. We’re removing targets that tie up NHS staff in red tape and we’re getting politicians out of decision-making. We’re removing whole tiers of management that sit above doctors and nurses and instead giving them the power to decide what’s best for their patients. We’re giving patients more choice and control over their care, rather than managers telling them what they get. Our changes are about simplifying and modernising the NHS; not top-down change.
Myth 21 No-one has been consulted on these plans.
Fact
We received over 6,000 responses to the consultation on our plans, and we have modified our plans accordingly. For example, we have introduced the programme of GP ‘pathfinder’ consortia.
Myth 22 Primary Care Trust commissioning is in ‘meltdown’
Fact
More than 50,000 people are currently employed in NHS commissioning. We are clear that we want to reduce this number, but we are doing so in a carefully-planned manner. We are implementing our plans through a clearly-defined transition process, over a period of over two years. This process involves the creation of ‘clusters’ of PCTs, which will step back from commissioning as and when GP consortia are able to move into their place.
Myth 23 Patients with rare conditions will suffer, because GPs don’t know enough about them
Fact
Like now, the care of people with rare conditions won’t be commissioned by GPs, but by national experts in these conditions.
Myth 24 GPs will be made responsible for the rationing of NHS care
Fact
GPs are already responsible for taking decisions about NHS expenditure – when they tell a patient that they do not need a medicine; when they decide to prescribe a drug; and when they decide to refer a patient. But because they aren’t responsible for this expenditure at the moment – only for the decision – the Primary Care Trust has to ‘second-guess’ the decisions taken by all their GPs before deciding what services need to be offered. This means that the system is more complicated than it needs to be. As the NHS Confederation has said, the move to ‘GP consortia’, “presents significant opportunities to improve quality, efficiency and value for money in the healthcare system”.
Myth 25 No-one will be in charge
Fact
Ministers will remain fully accountable to Parliament for the way in which the NHS’s money is spent. But local services will be shaped to meet local needs through GP practices working together, rather than imposed by a Primary Care Trust.