It beggars belief that the "top down" reorganisation of our National Health Service is implemented today. It is a cause for alarm for four reasons.
First it is a betrayal of our democracy. The Tories explicitly promised at the election that the NHS was "safe in their hands" and that there would be no "top down" reorganisation. If they didn't actually invent the phrase "top down" they certainly popularised it. Nevertheless it is happening. How can parliament have been so supine as as to vote the thing through?
Secondly, and still on the democratic theme, the re-organisation is opposed by the overwhelming majority of the population and, equally significantly, the overwhelming majority of the health professionals. Democracy is, or should be, government by discussion. This is an example of government by idealogical dictat.
Thirdly the argument to justify the re-organisation, that competition between the so-called "providers" will improve efficiency, is flawed. There is no evidence that the private sector, which will be able to "bid" to carry out functions, is more efficient than the public sector. (I should like to be able to claim that the evidence demonstrates that the public sector is the more efficient, but unfortunately that isn't true either: the research shows that both sectors are much of a muchness.) What, unfortunately, will happen, is that the private sector will "cherry pick" the lucrative functions, leaving a poorer, underfunded (because funds will be creamed off into profits) and demoralised NHS to pick up the rest.
Finally, doctors are to be put in charge of allocating provision in their areas. On the face of it this sounds a good idea, but in practice, if they are conscientious doctors genuinely concerned with curing their patients and keeping them (us) healthy, they won't have the time, and most of them won't have the expertise either, so they will "contract out" the function to profit-making management companies anxious to get their hands on the vast amount of money pumped into the health service.
For most of my active political life I have believed, against the popular impression, that the overwhelming majority of politicians of all parties are in the business because they genuinely believe that their ideas, however much I may think they are mistaken, are for the good of society as a whole. In this case it is hard to avoid the conclusion that the posh boys at the top are there to open up yet another public service to private profiteers.