This is a wake-up call to the people of England. If we do not rouse ourselves we are going to find that when we or our loved ones, friends and family, neighbours or colleagues fall ill it will be too late to ensure that medical help is available. The universal service that has lifted fear and insured our health for three generations since the Second World War will be in the hands of international corporate 'providers' who profit from scarcity and privileged access to Ministers and administrators.

Anyone who even slightly believes the government rhetoric about health care “reform” — that “We are committed to an NHS that is free at the point of use”, that it’s about giving “patients the power to choose the treatments that are best for them”, and “strengthening the power of doctors and nurses as patients’ expert guides” — might take just a few minutes to read a deeply shocking and rigorous exposé in the current edition of The Lancet (republished here on OurKingdom and downloadable as a PDF).

The authors of “How the Health and Social Care Bill 2011 would end entitlement to comprehensive health care in England” include public health academics Professor Allyson Pollock and David Price of Queen Mary, University of London, public interest lawyer Peter Roderick and barrister Tim Treuherz. They leave no doubt that the NHS in England is being destroyed. There is no question about that.  

If enacted, this legislation would increase inequality in service access, provision, and uptake. It would radically impair or destroy outright the capacity to plan health services by monitoring needs, access, service use, and health outcomes.

The authors offer some insight into the moral swamp from which the Health and Social Care Bill has grown. The Bill notoriously removes the health secretary’s legal duty to provide comprehensive health care in England. (Amendments have made only weasel rewordings to the clause by which the government abdicates its legal duty.) Yet Earl Howe, the Leader of the House of Lords, told Peers: “Let me be clear: the Bill's provisions would in no way dilute the Secretary of State's overarching duty. Indeed, they are intended further to reinforce the promotion of a comprehensive health service rather than to undermine it.”

In the absence of honest and effective parliamentary opposition — both Labour and the Liberal Democrats are neutered by complicity — the medical profession has been left to fight the Bill.

They cannot succeed alone.

Their weapons — hard work and evidence — have proved unequal to the well-funded armoury of government and commercial interests so close you cannot see the join. Health minister Andrew Lansley’s top policy adviser Bill Morgan is a former private health company lobbyist. Lansley and Morgan last year ran a secret campaign with health outsourcing group Tribal (£150 million of government contracts) to corral apparently ‘independent’ GPs to give public support to the government’s plans.

The BMA, the Royal College of Nursing and the Royal College of Midwives have all called for the Bill to be withdrawn. The College of Emergency Medicine has “significant concerns . . . and is not able to support it in its current form” and is “deeply concerned that the upheaval caused by changes proposed by the Bill will distract the NHS from the huge task of meeting the efficiency savings that have been proposed.”

But the profession is coming under increasing political pressure to shut up, as evidenced by the Academy of Medical Royal Colleges dropping plans to publicly criticise the Bill. Ask any medic who has spoken out. From the top down they are being warned to leave this Bill alone.

Medics are not just embattled, but dangerously isolated. Despite the Bill’s catastrophic consequences for children with complex health needs, children’s charities have failed to speak out. (It’s a familiar pattern: small feisty underfunded charities are working hard against the Bill, big influential government-friendly charities are strangely silent).

Despite the suffering and social division entailed by widening health inequalities, anti-poverty charities and faith groups have failed to mount the kind of united, relentless and coherent opposition that might actually defeat this Bill. Student activists, perhaps overwhelmed by battling the attack on education, have not risen up to defend the NHS.

Government propaganda cannot take full credit for the shockingly weak public awareness of the true consequences of its planned ‘reforms’. Many of the journalists on this beat are apparently sleeping at their desks. Where is the BBC? The extraordinary disclosures mentioned above came, not from mainstream media organisations, but from The Bureau of Investigative Journalism and from Spinwatch.

By the time we, the people, experience the consequences of this Bill, it will be too late for popular revolt to make a difference — the NHS will be gone and we will never get it back.

It is time for journalism to interrogate and expose the multiple conflicts of interest upon which these ‘reforms’ have been built — insurance industry and private equity interests, the parliamentarians who've been bought. It is journalism’s duty to alert the public to what is going on.

It is time for faith groups and big charities urgently to come together with honest parliamentarians and the medical profession in a strong and effective alliance against this anti-democratic Bill. It's not too late.

See also: Allyson M. Pollock, David Price, Peter Roderick, Tim Treuherz, David McCoy, Martin McKee and Lucy Reynolds, 'The end of the NHS as we know it'