Health boss resigns to fight NHS reforms

The former regional director of public health for the South West has accused the Government of using the current economic crisis to break up the NHS.

In a scathing assault on Whitehall, Dr Gabriel Scally has lashed out at Health Secretary Andrew Lansley's reforms over what he describes as the privatisation of the NHS. And he claims there is a "deliberate policy" to roll back public sector achievements made over the past 70 years.

Dr Scally, 57, stepped down from his post at the end of March and this week gave his first interview since parting ways with his former employers at the Department of Health.

He told The Guardian: "The time had come for me to step outside the formal system and do things in a different way. My job is helping people live healthier lives in healthier communities, and there are better ways of doing it than participating in the changes that are taking place in the public sector in England.

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"Since 1993, I've been restructured and reorganised eight times, I think, and that's enough really.

"Throughout these restructurings I've seen a loss of talent, of momentum and of coherence, in both the NHS structures and public health structures.

"This one [by Andrew Lansley] was the final straw."

Mr Scally lives in Bristol with his family and is an associate fellow at the Institute for Public Policy Research thinktank as well as a visiting chairman at Bristol University and the University of the West of England.

The former grammar schoolboy, who went on to study medicine at Queen's University, Belfast, said: "I think there's a very deliberate policy across all of the public sector to roll back the achievements that have been made in this country since the Second World War – including the NHS – and that financial austerity is being used to pursue an agenda aimed at dismantling the state.

"At the end of the war this country was hugely indebted, but within a couple of years had free healthcare and free education for everyone – what an achievement.

"This Government is putting a huge price on education, especially young people seeking to go to university, and is in the process of dismantling the NHS."

He said the NHS could be destroyed in the wake of the abolition of primary care trusts, strategic health authorities (SHAs) and the handing-over of £60 billion of patient treatment budgets from next April to clinical commissioning groups (CCGs).

He said: "What we're going through now is a systematic downgrading, if not destruction, of civil society in England with a de-layering of structures and organisations and, at the same time, a huge amount of responsibility being handed to the local level, especially to local authorities, at the same time as their budgets are being cut. The abolition of regional development agencies, government offices in the regions and SHAs is all part of the same process.

"To many people that sounds great, like we're getting rid of bureaucracy.

"But this is a very big country and cannot be run by a very much smaller civil service in London and a huge, disparate patchwork quilt of local authorities all pulling in different directions."

According to the article, Dr Scally views the creation of the new NHS Commissioning Board, which will oversee the local GP-led commissioning groups, as part of "another worrying trend": the centralisation of power in the hands of political appointees.

He said: "I trained as a GP and I know that it's no part of a GP's training to deal with tens, and in some cases hundreds, of millions of pounds' worth of commissioning budgets. It's not what most GPs want to do, so handing them a huge amount of commissioning power doesn't bode well for the future of the NHS."

He said he believed current NHS policy was deliberately assisting what he called "the circling birds of prey of the private sector" seeking to make big profits out of healthcare. "That's less money for patients," he added.

His solution for the NHS's woes is to inject massive investment in prevention, rather than treatment, of illness and an overhaul of primary care to increase the number of GPs in the most deprived areas.

Mr Lansley's health reform bill is weathering a somewhat stormy voyage through Parliament with strong opposition.

Dr Scally said that, ultimately, the NHS would only be ruined if the public allowed it, and spoke of an "awakening" to the idea that it was under threat.

"The task over the next couple of years is to use all of that concern, interest and commitment as part of a rich debate about how we put the NHS back together again, when the opportunity arises.

"The NHS will only be destroyed if the people of this country let it be destroyed."