Counting the cost of NHS reorganisations | Letters

Exhausted and traumatised NHS professionals who have given more during this pandemic than any of us could have imagined or asked for will undoubtedly feel badly let down if the government’s “gratitude” is to be expressed now by embarking on another ill-timed and questionable NHS reorganisation (Matt Hancock lays out plan for reorganisation of NHS in England, 11 February).

The catch-up workload is going to be immense and NHS staff need a period of calm and support to enable them to recover psychologically and physically, not the stress and pressure of more change. The government needs to put the needs of the workforce above misplaced, opportunistic and unproven ideology. If they don’t, the exodus of staff from the NHS will itself hit epidemic proportions. Think again, Matt Hancock – doctors still haven’t forgiven your predecessor for his treatment of their contracts and this government has used up any remaining goodwill.
Joy Morgan
Leek Wootton, Warwickshire

• Most of the changes to the NHS proposed in the government’s white paper (NHS and social care blueprint: key points, 11 February) are sensible and welcome, but there should be no illusion that they will make the slightest impact on the two major problems affecting health and social care: the neglected social determinants of health, and a depleted workforce. If people can’t afford to eat healthily, for example, no amount of information on food packaging will reduce rates of obesity. Only lifting people out of poverty will make a difference to the obesity epidemic. Integrated care systems are desirable, but only pooled NHS and local authority social care budgets combined with greatly increased funding will enable the workforce to become fit for purpose.
Prof Philip Graham

• Polly Toynbee points to the failure of the private sector to make major inroads into NHS spending (The Tories’ massive NHS U-turn won’t undo the damage they inflicted, 8 February). What she doesn’t point out is the huge collateral cost: millions spent on tendering costs, plus money siphoned off to shareholders that could have been spent on care. Add to that the operational cost of time and effort diverted from other tasks, and the human cost: the failure of Hinchingbrooke hospital was not just a financial shambles, it was a catastrophe for staff and patients.

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This is not going to stop: the draft white paper still sees an important role for private providers and expresses no intention of bringing services back in house. Polly Toynbee aptly comments that the health secretary’s proposed Henry VIII powers will free him “to follow political foibles and to favour cronies”. There is nothing to suggest that the NHS of the future will be protected against private profiteering, particularly given the bonanza of corruption that has characterised the Covid era.
Anna Ridehalgh

• The most iniquitous element of the reorganisation of the NHS 10 years ago was the moving of funds from poor areas to rich areas. The NHS had been a redistributive system since its inception, with a funding formula base on need. The Cameron reform reversed that, taking from the poor to give to the rich, imposing a new formula based on per capita funding. We have seen the consequences of embedding health inequalities as people dying with Covid are the victims. The proposed restructuring will not reverse the plundering of health resources from poorer communities.
Frances Crook



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