As public health doctors and specialists, we are concerned about the Health and Social Care Bill. The Bill will do irreparable harm to the NHS, to individual patients and to society as a whole.
It ushers in a degree of marketisation and commercialisation that will fragment patient care; aggravate risks to individual patient safety; erode medical ethics and trust within the health system; widen health inequalities; waste much money on attempts to regulate and manage competition; and undermine the ability of the health system to respond effectively to communicable disease outbreaks and other public health emergencies.
While we welcome the emphasis placed on establishing a closer working relationship between public health and local government, the proposed reforms will disrupt, fragment and weaken the country’s public health capabilities.
The Government claims that the reforms have the backing of the health professions. They do not. Neither do they have the public’s support. The Health and Social Care Bill will erode the NHS’s ethical and cooperative foundations and will not deliver efficiency, quality, fairness or choice. We ask the House of Lords to reject passage of the Health and Social Care Bill.
The important words here are \”public health\”. They\’re all \”public health\” professionals, the signatories. Public health being:
Public health is \”the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals\” (1920, C.E.A. Winslow).
Now, don\’t get me wrong, public health has almost certainly done more for the lifestyle and lifespan of the average human being than any other area of human endeavour. Vaccines, sewage treatment (taking \”public health\” to be widely drawn), the basic study and control of epidemics and pandemics has done more for us all that any amount of surgery or, indeed, pretty much anything else with the possible exception of abundant food for all.
However, the profession has gone on to other things:
Since the 1980s, the growing field of population health has broadened the focus of public health from individual behaviors and risk factors to population-level issues such as inequality, poverty, and education. Modern public health is often concerned with addressing determinants of health across a population. There is a recognition that our health is affected by many factors including where we live, genetics, our income, our educational status and our social relationships – these are known as \”social determinants of health.\” A social gradient in health runs through society, with those that are poorest generally suffering the worst health. However even those in the middle classes will generally have worse health outcomes than those of a higher social stratum. The new public health seeks to address these health inequalities by advocating for population-based policies that improve health in an equitable manner.
Well, yes, so public health nowadays is simply the health care wing of the Labour Party. It\’s all inequality innit? The Spirit Level, Professor Marmot etc. And, of course, the people who cook up those studies lying about smoking bans reducing heart attack rates, about salt being a killer, who want to ban sugar from processed foods, who would ban Marmite from being advertised to children, who have caused the HP recipe to be changed, who bleat about the entirely made up \”safe drinking guidelines\”. Fake charities galore telling us all how we should live in order to make sure than no one, anywhere, can be accused of enjoying themselves.
So, the reorganisation of the NHS is going to reduce their power is it? Dig them out of their comfy niches where they can propagate their prejudices?
Bring it on say I.