Well the quick answer is yes. Back in 1989 the BMA argued in the BMJ that the then proposed health reforms that Ken Clarke was trying to implement would “lay the groundwork for the future dismantlement of the NHS”. It’s a fascinating article that also predicts:
- Individual episode pricing i.e. having a tariff, won’t happen
- That self-governing (to become NHS Trusts then FTs) would cream off all the good doctors
- That patients would no longer trust fund-holding GPs
And in the BMA’s comments on the White Paper, NHS London, their FAQs sheet the word ‘fragmentation’ is du jour. This is sounding quite familiar! And for all the criticism of Andrew Lansley pushing through un-piloted changes (though if GP Consortia were still called practice-based commissioners it might feel more evolutionary), Ken Clarke refused BMA calls for pilots in 1989 because he thought their doctors would sabotage them!
As we’ve written here before we do have concerns about the Health Bill, but ‘fragmentation’ is a scary word that is disingenuous, not least while we have a tax-payer funded universal healthcare system. Maybe the BMA should listen to Michel de Montaigne:
“My life has been filled with terrible misfortune; most of which never happened.”