By: 29 May 2012

The UK’s House of Commons revealed that an NHS Director had written to an NHS employee to say that it was “inappropriate” for him to have signed a letter highlighting his personal concerns about the Government’s Health and Social Care Bill. The employee was summoned to attend a meeting with NHS managers to explain and account for the actions he had taken.

That NHS employee is Professor John Ashton, formerly North West Regional Director of Public Health. In an essay published in The Lancet, Professor Ashton continues to oppose and raise his concerns about the Bill. He argues that the Health and Social Care Bill heralds the beginning of a return to an insurance-based system that will recreate the divide between those who can afford access to voluntary hospitals and the “undeserving poor” who will be destined for the underfunded Poor Law hospitals, but this time under the same roof.

Prof Ashton says: “One of the frightening aspects of the current UK Government’s policies is the apparent ignorance of ministers and civil servants not only of their own history, but of the body of evidence that until so recently informed social policy in this area…Nobody should be allowed to dismantle the NHS if they have not read, understood, and digested the writings of Richard Titmuss and his colleagues.”

He adds: “The Poor Law concept of the deserving and undeserving poor is alive and well, and living in 10 Downing Street and Richmond House. These ideas are sitting comfortably alongside the Orwellian doublespeak of the New Localism, at the same time as the UK’s rich tradition of local public health is being nationalised and centralised. Although there is a commitment to reducing inequalities in health, a whole raft of Coalition Government policies is taking us in the opposite direction.”

He warns: “Mass circulation newspapers feed hostile and negative propaganda in defiance of the facts about public services in general and the health services in particular, softening both them and the public up for carpet-bagging private organisations to move in to cream off profitable short term opportunities, leaving the costly areas of obstetrics, accident and emergency, psychiatry, care of the elderly – not to mention high-end, innovative surgery – to residual state provision, with massive increases in transaction costs en passant.”

He concludes: “At a time when the NHS has never been more popular and when there is increasing evidence of its cost effectiveness, we are sleep-walking into its destruction…It is time to rise up and defend an institution that was built by our parents and our grandparents and which we owe to our children and our grandchildren to maintain and pass on to them and to their guardianship.”

Dr Richard Horton, Editor-in-Chief of The Lancet, comments: “Professor Ashton is a highly respected public health leader in Britain. He has made extraordinary contributions to this country’s public health. Instead of silencing him and threatening him with disciplinary action, NHS managers and ministers should be listening carefully to his concerns. Every health professional has a duty of care to patients and the public. The notion that raising legitimate questions about the adverse impact of this government’s health reforms can be punished sends a chilling signal about the kind of NHS this government wishes to create.”