Our view on the NHS reforms – evolution or revolution?

MPs are debating the Government's health reforms

The Coalition Government’s flagship health reforms were discussed in Parliament yesterday, as the 2011 Health and Social Care Bill had its Second Reading.

The discussion focused on the bill’s general principles. It will next be discussed clause-by-clause by a committee of MPs.

We’ve emailed our thoughts on the Bill to all MPs, outlining our views and sharing a number of concerns – you can read these in detail in this PDF document.

We’ve not taken an ideological view of the Bill. We neither support nor oppose its entirety – we simply want the UK to have cancer outcomes that match the best in the world. And whilst there has been significant improvement in survival rates – with rates doubling over the last forty years – we still lag behind the best performing countries in the world.

So we’ve tried to view all of these proposals through a simple prism – will they help or hinder efforts to improve things for cancer patients in England?

The government needs to keep a close eye

Looking at the bigger picture, the proposed scale and pace of reform is indeed risky – and could have an impact on cancer services in the short to medium term. As organisations are recalibrated and services reconfigured, there is likely to be some disruption.

So, crucially, we want the Government to keep an extremely watchful eye on the reforms’ impact and act quickly if it appears that cancer services are suffering.

MPs must scrutinise the legislation

We’re also asking MPs to raise seven issues for discussion in the Parliamentary debate – these are the issues where we want more information and clarity from the Government:

1) Research

To improve cancer outcomes, the health service must encourage and support cancer research. Patients treated in hospitals that do more research tend to fare better.

We would like assurances that the health reforms will provide incentives for decision-makers and budget-holders (i.e. GP-led consortia and the NHS Commissioning Board) to promote cancer research.

2) Commissioning expertise

The commissioning – i.e. the planning and buying – of cancer services is not currently as good as it could be. But in recent years the service has improved, and these efforts are being led by the Cancer Networks – the bodies responsible for organising cancer treatment and care in specific geographic areas.

We believe it will be essential that those with proven expertise in commissioning cancer services are able to use this expertise. The government must guard against a ‘brain drain’ of experts in cancer commissioning from the health service.

3) Integrated care

If we are to match the best in the world, it is critically important that all parts of the health service work together to get cancers diagnosed earlier. We believe the key reason that England has worse survival rates than the best performing countries in the world is that we often diagnose cancer late in this country.

So we need reassurance that Public Health England (the new organisation that will take responsibility for public health and some early diagnosis activities) and the NHS will work closely together to ensure that cancer is diagnosed as early as possible.

4) Information

High-quality information about cancer services – such as details about local health needs, and data about cancer survival and mortality – must be made available to the commissioners of cancer services, to the public and, importantly, to patients themselves.

We want the Health Bill to ensure this becomes a reality in cancer, and we want to know how this will be achieved.

5) Inequalities

We know that some significant – and unacceptable – inequalities exist in cancer services. Where you live, and how much you earn, still make too much of a difference.

We need assurances from the Government that their planned reforms will make these inequalities better, not worse.

6) Patient involvement

The public and patients must have a strong voice in the design of the country’s cancer services. For example, when and if services like chemotherapy or radiotherapy units are being moved or reconfigured, patients should be consulted and involved in the decision.

Does the Health Bill make sufficient provision for this? We are asking MPs to probe on our behalf.

7) The status of quality standards

The Government is developing a new type of guidance for health professionals – quality standards – across a range of health conditions. We are asking MPs to get assurances that cancer quality standards will be developed quickly and will have enough clout to make a real difference.

We’ll be monitoring the passage of the Health Bill through Parliament very closely, and will be working with parliamentarians to ensure we get the right assurances.

It’s essential that cancer services do not suffer as a consequence of this reform.

Henry

Image courtesy of Graeme McClean via Wikimedia Commons