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How to respond when your MP says “I am deeply committed to the NHS”

House of Commons correspondence

I recently received a letter from my local (Conservative) MP and comparing it with letters from other MPs posted at 38 Degrees it appears that there are several common themes. Here are rebuttals to those themes. If you decide to write back to your MP it will have more impact if you use plenty of local examples.

"I am deeply committed to the NHS"

All MPs start with this platitude; however, none of them explain what "the NHS" is. It could simply mean that they are committed to the principle of "free-at-the-point-of-use". At the moment there is no suggestion this is in danger. However, Any Qualified Provider will mean that NHS hospitals will not be protected.

"The Government is increasing investment in the health service by £11.5 billion over the next four years."

MPs have stopped telling us there will be real term increases (as was promised at the election and in the Coalition Agreement) and have started throwing around a figure like this. No MP explains where this figure comes from.

The Spending Review (Table 1) gives the funding for the NHS in England over next four years. The £11.5bn is the aggregate of the "increases" over the four years. However, the Spending Review shows that the "cumulative real growth" over four years will be a mere 1.3% (0.3% per year). Compare this to the increases over the last decade which averaged 5.7% per year.

The Chancellor decided to fix the funding in October 2010 based on the predictions for inflation provided by the OBR. The OBR have since increased their predictions yet NHS funding has not been increased. Recent calculations (March 2011) by Prof John Appleby using the OBR's figures show that real term increases are very small (for 2011/12 it is £24m).

The figure of £11.5bn is the cash increase over four years and almost all of this money is an inflationary increase, not a real terms increase. (Incidentally, the last Darling budget pledged inflationary increases to NHS funding for two years.) Thus £11.5bn is not a real terms increase, and cannot be described as an "investment".

"the two biggest demands on the NHS – of an ageing population and of rising costs of new treatments and technologies – meant that reform of the NHS was needed"

Prof Steve Field says the following in the summary of the Future Forum report:

"A greater proportion of NHS funding will need to be targeted at the increasing numbers of frail older people. The NHS must also meet the costs of sophisticated but expensive new drugs and technologies."

This says that the NHS needs more funding, but as I have outlined above, any increase in funding is purely inflationary. Germany spends 11.6% of GDP on healthcare and the UK spends just 9.8% (OECD, 2009 figures). A recent paper in the Journal of the Royal Society of Medicine reported that the NHS is one of the most cost-effective healthcare systems in the world. Since the NHS is more cost-effective and clinically effective than Germany, we can afford to address the greater demands of the frail and elderly by increasing our funding to German levels.

"the changes we are now making have attracted broad support."

Many of the royal colleges have registered objections to the health bill. The Royal College of GPs, the Royal College of Nursing and the Royal College of Midwives are the most vociferous. Dr Clare Geralda Chair of RCGP (representing 39,000 GPs) sums up their objections thus:

"As a College we are extremely worried that these reforms, if implemented in their current format, will lead to an increase in damaging competition, an increase in health inequalities, and to massively increased costs in implementing this new system. As independent research demonstrates, the NHS is one of the most efficient healthcare systems in the world and we must keep it that way."

"This is not an attempt to privatise the NHS for profit"

It is. In the East of England £300m of care pathways (including diabetes, muscular-skeletal and elderly care) have been put out to competitive tender to the private sector. The winner of this contract will be performing all the care in the contract and patients will not even have the choice to use an NHS provider.

Richard Blogger writes about the NHS and social policy at NHS Vault.

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