David Cameron faces fresh calls to abandon his NHS reforms, as a group of leading public-health experts predicts that the changes will "exacerbate inequalities" in the health of the nation.
Seven former presidents of the Faculty of Public Health accuse the Prime Minister of ploughing ahead with an "unprecedented marketisation" of services, which poses a "major threat" to the integrity of the NHS.
In a letter to Mr Cameron, the group warns: "The Bill is likely to produce a 'patchwork quilt' health system that will vary hugely across the country, failing to meet the diverse needs of the population and undermining the health of vulnerable, minority groups."
Under the changes set out in the NHS Health and Social Care Bill, GPs will be handed the bulk of the £60bn health budget to buy in services for patients, with a new NHS commissioning board overseeing the process. Primary Care Trusts are to be abolished and replaced with "GP consortia", which will straddle council boundaries, raising concerns that the quality of care will vary in different parts of the country.
Andrew Lansley, the Secretary of State for Health, has denied the changes will worsen health inequalities. In an interview with The Independent on Sunday last month, he said: "What I am introducing won't make any postcode lottery worse. Actually, because we expose more information, where things aren't being done as well as they should, people are able to use that information to drive improvement."
But the seven signatories of the letter – Professor Alwyn Smith, Dr June Crown, Professor Rod Griffiths, Professor Sian Griffiths, Professor Walter Holland, Professor Alan Maryon-Davis and Professor James McEwen – say the outcome of the reforms will create a "deplorable state of affairs". They also question why the legislation is being pursued at a time when the NHS is being forced to find an unprecedented £20bn in efficiency savings. "We hope that the Government will reconsider, and withdraw it," they add.
The Department of Health said in a statement yesterday: "We simply don't agree with this group – our plans tackle health inequalities. For the first time ever, there will be a duty on all parts of the health system to reduce health inequalities, and the public health budget will be ringfenced from 2013."
However, the letter comes as Labour steps up its campaign to force the Government to drop the Bill. Andy Burnham, Labour's health spokesman, used a New Year message to NHS staff to warn that the legislation has almost completed its passage through Parliament. "The coming four months are without doubt the most important in [the NHS's] 63-year history. This is the moment of greatest threat. If we don't meet it with passion and fight, it will be too late."
He has also written to Professor John Angel, who is considering the Department of Health's appeal against the release of the risk register which sets out the potential dangers of the reforms. Mr Burnham argues that the report, requested under Freedom of Information laws, should be made available to MPs and peers before the Bill passes into law early this year.