No economic justification for Lansley's reforms
From Prof Maureen Mackintosh and others.
Sir, Sarah Neville notes ("Timing, implementation and lack of clarity taint NHS reform", February 11) that health secretary Andrew Lansley has been unable to explain how his NHS reforms will make life better for patients. He has failed equally to answer a second important question: how do they benefit the broader economy in time of crisis? A cost-effective and universal health service that does not impose on individual employers' health insurance costs for their staff is an important contributor to UK competitiveness and economic rebalancing, supporting labour market flexibility and labour productivity. Mr Lansley's reforms not only impose huge transitional costs, they also drive escalating unit costs by: extending fee-for-service mechanisms in mental health and community services; multiplying contracts and purchasers; shifting commissioning from primary care trust staff to private suppliers used to much higher levels of remuneration; and, perhaps most serious, undermining the (already fragile) cohesion of community services essential to reduce hospitalisation of those with chronic illness.
External assessment showed that the heath system inherited by this government was both cost-effective by international standards and had high patient satisfaction. Other governments, including the 1945 UK government and the 1997 South Korean government, have used universal and redistributive healthcare to reinforce social solidarity and economic efficiency at times of economic crisis. We have not seen an economic justification for this government's move in the opposite direction.
Maureen Mackintosh, Professor of Economics, The Open University Pam Smith, Professor and Head of Nursing, Edinburgh University Mariana Mazzucato, Professor of Economics and R.M. Phillips Chair, University of Sussex Anne Sassoon, Emeritus Professor of Politics, Kingston University Diane Elson, Emeritus Professor, University of Essex Susan Himmelweit, Professor of Economics, The Open University