Yesterday the health and social care bill was made law. So what are my predictions for the future of our beloved NHS?
- In the short-term there will be a vacumn of authority as the old system devolves power to GPs who are learning on the job. I predict there will be a flurry of contracts awarded to private companies to take control of local commissioning and health services as GPs struggle with the enormity of the challenge imposed upon them
- In the medium-term integration between departments and hospitals will begin to splinter as hospitals concentrate on pulling punters into their doors in order to 'win' funding from GPs. (For example from my own experience Chelsea & Westminster hospital send their doctors to Brompton hospital to enable joint consultation for CF patients who also have liver disease. I can imagine such arrangements ending due to funding complications.)
Waiting lists will rise as services try to stick to budgets by rationing care and maximising the number of private patients they treat. The bill allows up to 49% of work at NHS hospitals to be given over to private patients.
More and more obese people and smokers will find themselves denied services as GPs find any excuse to limit care in order to meet spiralling costs.
National scandals will arise in which private health companies are accussed of patient neglect and care as they cut services in order to make a profit. This has already happened under Bupa.
- In the longer-term, we'll all get used to paying for some NHS services. I can easily imagine paying for evening and weekend doctors appointments as it'll be billed that you are buying the convenience of the time, not the service.
It'll become routine to take private healthcare if you can afford it.
- In the very long-term the NHS will become a safety net only for those who have no private healthcare, and people will expect only the most basic care for it.
As such the life expectancy gap between the rich and poor will continue to widen.The health and social care bill is the worst thing this Government has done while in power, and Cameron and Clegg will be hated for it by future generations far more than Thatcher ever was for her deindustrialisation drive and war on the miners.