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GUARDIAN Tue, 20 Mar 2012 21:00:02 GMT
The prospect of the health and social care bill soon becoming law fills us, as people professionally concerned with health and social care policy, with a profound sense of failure and foreboding. We have failed, over more than two decades in which successive governments have prepared for the introduction of a market in healthcare, to get what was happening understood by the public at large. That failure has been compounded by the failure of mainstream media to report the direction of policy in an accessible and balanced manner. And the democratic process has failed to disclose what was really intended and to evaluate it in a proper, evidence-based manner. Party interests have been put before the public interest. All the evidence shows that the longer-term consequences of marketisation, typified in the latest plan to privatise children's services in Devon (Report, 16 March), are detrimental to the provision of safe, high-quality and sustainable health and social care. Like the outsourcing of hospital cleaning in the 1980s, and the outsourcing early this year of translation services for the courts, the fundamental rationale of such outsourcing is to cut costs. And always with the same depressing result: fewer, less qualified staff, on lower terms, offering a more restricted and lower-quality service. In the case of the NHS, this means loss of security, loss of quality of life, and even loss of life. What the longer-run consequences add up to is the loss of what the US-based Commonwealth Fund has shown, in its annual surveys, to be one of the two high-performing healthcare systems in the world. Instead of the freedom from fear that the NHS provides, we will be returned to the insecurity and health inequality that existed before 1948, and that exist in other market-based health systems today. This is not the modernisation we are repeatedly told is necessary for the survival of the NHS. The government is turning the clock back while at the same time wilfully ignoring the widespread opposition to its proposals from all quarters. Is this what democracy has come to in 21st-century Britain? Yusuf Ahmad University of the West of England Dr John Ashton Director of public health, Cumbria Prof Clare Bambra Durham University Prof Sarah Banks Durham University Dr Christopher A Birt Liverpool University Prof Carol Brayne Cambridge University JP Boswell Director of Assist Social Capital Ellie Byrne Cardiff University Liz Cairncross Oxford Brookes University Dr Gideon Calder University of Wales Newport Prof Mick Carpenter Warwick University Dr Harriet Clarke Birmingham University Prof Derek Cook St George's, University of London Dr Iain Crinson St George's, University of London Dr Daniela D'Andreta Warwick University Dr Rachael Dobson Leeds University Prof Elizabeth Dowler Warwick University Dr Peter Draper Health policy consultant Prof Ros Edwards Southampton University Prof David Evans University of the West of England Richard Fielding University of Hong Kong Dr Julie Fish De Montfort University Debra Fox Liverpool University Prof Caroline Glendinning York University Dr Ann Gray University of Ulster Prof Stephen Harrison Manchester University Dr Chris Holden York University Prof Walter Holland University of London Prof David Hunter Durham University Dr Judith Ibison St George's, London University Dr Maggie Ireland North Tyneside Prof Harry Keen King's College London Rose Khatri Liverpool John Moores University Veronica Killen Northumbria University Dr Derek Kirton Kent University David Lawrence London School of Hygiene and Tropical Medicine Ben Leaman NHS Yorkshire and the Humber Prof Colin Leys Goldsmiths, University of London Dr John Lister Coventry University Prof Alison Macfarlane City University, London Paul Madill NHS South of Tyne and Wear Dr Tony Maltby Sheffield University Prof Russell Mannion Birmingham University Dr David McCoy University College London Prof Ruth McDonald Nottingham University Neil McHugh Glasgow Caledonian..
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 Tuesday, 15 May 2012 07:35:09 UTC/GMT

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