After the passing of the Health and Social Care Act and the decision to introduce ‘efficiency savings’ of £20bn, it’s feared that (depending on things like where you live, what kind of healthcare needs you have, and whether your GP’s CCG is committed to upholding the principles of the NHS) you could find that:
- it becomes increasingly difficult to get referred to hospital, or to specialists for non-urgent care;
- certain types of treatment will become rationed;
- if the treatment that you need is no longer available, you will have to choose to go privately, pay a top-up fee, take out expensive insurance – or go without;
- where services are put out to tender, you will not be offered the choice of hospital or specialist that the Government has promised;
- increasingly, treatments will be provided by private companies for whom profit will be the priority;
- you have to wait longer for treatment or a hospital bed;
- you have to travel further for treatment, including A& E services;
- the quality of your care is affected by staff cuts and poor staff morale;
- if your health problem is complex, your treatment is at risk of being split between the NHS and private health companies. Your treatment will be affected if any one of the private businesses involved fails, or loses its contract.
The Act came into force in April 2013, and its effects, together with those from the government’s ‘efficiency savings’, are slowly beginning to surface. For example, in June 2014, cancelled operations reached a 10 year high, 80% of GPs fear that workload pressures will lead to poor care or mistakes, while there are signs that NHS patients needing emergency treatment are having to make way for private patients (see, for instance http://www.mirror.co.uk/news/uk-news/nhs-giving-private-patients-priority-3786478).The Chair of NHS England, among others, has raised the prospect of introducing charges for health care (see http://www.guardian.co.uk/commentisfree/2013/apr/17/nhs-charges-next-government).
For an up to date account of the effects of government changes to the NHS, see http://www.nhscampaign.org
In addition, there are signs that one of the aims behind the ‘reforms’ is to shift the NHS towards a US-style insurance-based system. The likelihood is that, over time, we will have a two-tier ‘NHS’ where, if you can afford expensive insurance, you can expect to receive treatment when you need it (providing the problem does not exist before you take out an insurance policy). However, if you cannot afford insurance, you will probably face a choice between getting into debt to pay for treatment, accepting poor treatment, or going without.