The editors of three leading healthcare publications in the United Kingdom warn that the National Health Service (NHS; London United Kingdom) will need another overhaul in five years time, and call for a public debate on its future to “salvage some good” from the government’s “damaging” reforms.

Published simultaneously on January 30, 2012, as an editorial in BMJ, Health Service Journal (HSJ), and Nursing Times, the editors warn that the NHS is “far too important to be left at the mercy of ideological and incompetent intervention,” and argue that “we must make sure that nothing like this ever happens again.” As part of this process, they suggest that parliament should establish an independently appointed standing commission “to initiate a mature and informed national discussion on the future of our national health system.”

BMJ Editor Fiona Godlee, HSJ editor Alastair McLellan, and Nursing Times editor Jenni Middleton argue that “through a combination of poor political judgment and reluctance to engage with criticism, a set of (mostly) reasonable objectives morphed into an old fashioned top down reorganization. It also resulted in a bloated and opaque piece of legislation, whose goals could have largely been achieved by other, more effective, means.”

“Rather than relying on policy makers to build brave new worlds in back rooms, we need a broad public debate on the principles that should underpin the NHS, how decisions on priorities should be made in a cash-limited system, and what role clinicians and private sector organizations could and should play,” they added. “This debate will require restraint on behalf of all involved if it is to escape being characterized yet again by polarized views, (often disguised) vested interest, political point scoring and conspiracy theories to the benefit of none.”

The Health and Social Care Bill proposed by the Conservative-led coalition government on January 19, 2012, represents the biggest shake-up of the NHS since its inception 64 years ago, and it will be implemented against the backdrop of the biggest financial challenge in its history. Following the reform, most of the NHS budget will be go to general practitioners (GPs), through GP consortia, who, as independent contractors, will be responsible for commissioning treatment and care for patients in line with guidance set by the newly proposed national NHS commissioning board.

 

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