Intended for healthcare professionals

Observations Future of the NHS

Why the Queen’s Speech on 19 May should include a bill to reinstate the NHS in England

BMJ 2015; 350 doi: (Published 29 April 2015) Cite this as: BMJ 2015;350:h2257
  1. Allyson M Pollock, professor,
  2. Peter Roderick, barrister and senior research fellow
  1. 1Global Public Health Unit, Centre for Primary Care and Public Health, Queen Mary University of London, London E1 2AB, UK
  1. a.pollock{at}

US healthcare “solutions” are the death knell for the NHS

The Health and Social Care Act 2012 marked the end of the NHS in England. But you wouldn’t know it from the election debates, as cries for more funding compete with differing claims about privatisation. Politicians seem to be deliberately avoiding the elephant in the room.

This isn’t surprising. At the last election the Tories remained silent about their plans to break up the NHS, knowing full well that most people would reject them. The coalition agreement reneged on its promise to protect the NHS. Labour is still in denial about the consistent Blairite embrace of the market, which provided the platform for the 2012 act to take the commercial thinking to its logical conclusion.1

What do we have now? NHS trusts struggling with deficits triggered by the private finance initiative (PFI) and reductions in NHS funding.2 A health secretary with no legal duty to provide hospitals, community services, ambulances, and doctors and nurses throughout England. Local clinical commissioning groups (CCGs) with no duty to provide, only to contract and tender in the marketplace—but not for everybody in their area, only for “persons for whom they are responsible” (except for emergency care). Compulsory market tendering diverting billions of pounds of NHS …

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