Intended for healthcare professionals

Rapid response to:

News Roundup [abridged Versions Appear In The Paper Journal]

Reform group calls for shake up in NHS funding

BMJ 2006; 332 doi: (Published 06 April 2006) Cite this as: BMJ 2006;332:813

Rapid Response:

Re: NHS funding

I wish to repond to some of the misrepresentation that has followed
your news article about Doctors for Reform (DfR).

1. The Steering Committee of DfR are all NHS doctors committed to
equity of provision and access to health services according to clinical
need which should be free at the point of use. I myself have worked for 23
years in the NHS and have never seen private patients under my own care.

2. We are not calling for co-payments by patients at the point of use
of healthservices, but rather an examination of alternative compulsory
social insurance schemes as operate in Europe (particularly those of
Switzerland, Germany and France)

3. We do this because the European systems have proven better
clinical outcomes to the NHS (which came 18th out of 19 in a recent study
- France was number one), cost no more in GDP than the NHS now does and do
not have rationaing by waiting lists (The NHS still has a million people
waiting for procedures even if the longest waits have gone).

4. We are totally opposed to the introduction of a US styled
healthcare system, where many remain uninsured.

5. The Wanless report considered European systems only to immediately
dismiss them without proper consideration of their clinical,
administrative, economic and political success. Wanless appeared to many
to argue to a pre-destined conclusion, but it did comment on the real lack
of equity in today's NHS, that is also acknowledged by Government and
Healthcare academics.

6. All political parties remain in thrall to the tax-funded NHS,
Labour because they brought into existence, the Tories because they think
they can never change it without disasterous political consequences and
the Liberals because they believe they invented it (Beveridge). This kind
of intellectual & political cowardice produces exactly the chaotic
circumstances we now see playing out in the NHS right across England,
(while the Celtic nations shut up shop and hope the problem will not come
their way - Scotland 20% more funding than England, Wales ignoring
deficits and N. Ireland not implementing the details of the new

The principles of the NHS are clear on equity and access to care,
that it has to be tax funded is not necessarily one of those principles.
When we compare the clinical outcomes of real patients in the UK's system
to those in the systems of similarly sized and wealthy European nations it
is incredible that the arguments have not even been properly debated
before. Everyone should stop hiding behind the Wanless report its central
conclusions and comparisons are blatantly flawed.

David Wrede

Consultant in Obstetrics & Gynaecology, Taunton & Somerset NHS Trust.

Member of the Steering Committee of Doctors or Reform.

Competing interests:
None declared

Competing interests: No competing interests

11 April 2006
C. David H. Wrede
Consultant in O&G
Taunton TA1 5DA