Kailash Chand: ‘The agenda of the Tory party is to wash its hands of the NHS’

Dr Kailash Chand’s passion for the NHS is rooted in personal experience, not just principle. Chand, 67, came to Britain from India in 1978 as a young doctor to work and study. Months later he was joined by his wife and two sons, one of whom – Amit – had Down’s syndrome and a hole in the heart, and later died. “There was a huge difference in the care he received for his Down’s syndrome compared with India, where there was still a lot of stigma around it,” recalls the veteran campaigner for the NHS, whose OBE is for services to it. Chand’s surviving son is the campaigning cardiologist, Dr Aseem Malhotra.

“When I came here I was so fascinated by the whole concept of the NHS. In India, the health system was very, very primitive in those days and 90% of people didn’t have access to healthcare. In Britain I was flabbergasted to find universal access: that everyone was treated irrespective of age, sex or income. That was a hugely revolutionary idea to me and a big inspiration,” Chand recalls.

Initially he intended to return home and campaign to create an NHS-style system there. Instead he stayed, worked as a GP for 25 years in Ashton-under-Lyne in Greater Manchester, once being named “GP of the year” by the Royal College of GPs. His outspoken denunciations of government NHS policy, and articulate defence of the country’s most cherished but visibly ailing institution, have made him a regular debater on the airwaves and writer on health policy.

For the last four years he has had a ringside view of all the big NHS controversies as the deputy chair of the British Medical Association. As he prepares to step down on Thursday at its annual conference how does he assess the health of the doctors’ union, especially given the huge challenge posed by the ongoing junior doctors’ dispute? He does not want the BMA’s dual role as trade union and professional body to change. But, he adds: “We need to be better at representing our broad membership. We need to empower those in our outer communities rather than concentrating ourselves in the BMA House ivory tower ,” a reference to its sumptuous London headquarters. “Though we are there for members, many of them feel we have not had a coordinated campaign to highlight the plight of the NHS. That’s been a disappointment to me. Our huge resources have not been put to good enough use in influencing politicians.”

Chand sees the recent surge in BMA membership among young doctors, off the back of the dispute, as a double-edged sword. More recruits is good for “the voice of doctors”. But there is also a risk, he cautions. “Junior doctors are battered and bruised. They remain concerned about their contracts. We have to meet their aspirations. But if people feel that the BMA won’t protect their interest, that the BMA has let people down, then Johann Malawana’s position as chair of the BMA’s junior doctors committee could be untenable and there could be a new leadership of the JDC.” He dismisses the fear in the BMA that a “no” vote by England’s junior doctors on the health secretary Jeremy Hunt’s final offer of new terms and conditions could lead to an internal split and formation of a new, rival trade union.

“These are very anxious days for the BMA because the whole profession is so demoralised, not just junior doctors. GPs are even more demoralised than junior doctors because of workload, demand and young doctors not choosing to be GPs any more,” Chand says. “In the 35 years I’ve worked in the NHS, I’ve seen 20 reorganisations. They demoralise NHS staff because they are always expected to deliver more for less. Doctors are also demoralised because of the politicisation of the NHS. It started with the introduction of the internal market in 1990. In my view the process of getting rid of the NHS began with that. In fact, it’s a known fact,” he says with calm conviction.

Chand says publicly what some senior NHS managers fear privately: “The government is deliberately setting up the NHS to fail, that’s clear. The whole agenda of the Tory party is to wash its hands of the NHS. The biggest evidence is that they are starving the NHS of the funding it needs so that eventually they will say that it’s unaffordable.” He sees the service’s increasingly visible failure to keep up with growing demand for care – the strain on GP, A&E, mental health and ambulance services – as part of an undeclared Tory plan.

“Ministers are also kicking the medical profession all the time, antagonising them by picking so many fights. The junior doctors’ dispute is part of that. They are trying to use the dispute to undermine the NHS. If you put talented young people off becoming doctors, how are you going to run the NHS?” he asks.

Chand sees the push for a seven-day NHS in England – the government’s key health policy for this parliament – as part of the same agenda. “It’s a political gimmick aimed at middle England that panders to demand, not need. We already have a seven-day service for things that matter most, such as A&E and heart-attack care. They want to expand all these services but without putting in proper extra money. How can you stretch an already stretched five-day workforce across seven days? The whole seven-day project is a total con.”

For Chand, the endgame of the Tory plan is privatisation or the NHS’s replacement with a US-style social insurance system. After all, Hunt, co-edited a pamphlet of essays by Tory MPs in 2005 arguing for the latter. As we are talking in the lobby of Manchester’s Midland Hotel, with delegates to last week’s NHS Confederation annual conference milling around, the chief executive of NHS England, Simon Stevens – the boss of the service Chand fears is endangered – spots him, greets him warmly and proceeds to have his ear bent, albeit in a friendly fashion.

Despite stepping down from his BMA role, Chand is unlikely to disappear from view. He has been approached by all three contenders vying to be Labour’s candidate as the mayor of Greater Manchester. He has sided with Andy Burnham, the ex-health secretary and an old friend, who has offered him a key role in influencing health policy in a region which in April took control of its combined £6bn NHS budget through a new body made up of local councils and clinical commissioning groups. This is the Devo Manc experiment that may inspire others in England to do the same.

“Andy wants me to lead his health team to realise his dream in which Greater Manchester stops topping the league table of poor health. He wants the city to become healthier and fairer through using new approaches. Public Health England data shows that we are at or near the bottom for things like the under-75 mortality rate for all cardiovascular diseases and mortality for cancer among under-75s that is considered preventable. Huge health inequalities also exist within Greater Manchester. A boy living in the poorest part of my patch, Tameside, can expect a life 17 years shorter than that of a boy in the most affluent part of south Manchester,” he says with feeling.

Initially a Devo Manc sceptic, Chand has become a convert. “It is the most promising option for realising my long-held passion to truly integrate health and social care and develop a different, more holistic model,” he says. “The current model of healthcare – the hospital model – needs to switch to the priority being prevention of illness and early intervention where required. Devo Manc could bridge the gaps between health and social care and bring some of the services under the same umbrella. Locality teams offer the chance to have teams without walls. It also offers us a good way of ensuring that appropriate funds can be allocated to pressure areas, such as general practice.”

Integration of public services could even extend beyond health and social care and see NHS funding directed elsewhere, Chand suggests. “We know, for example, that mental health problems cross criminal justice, housing, employment, health, and social care boundaries,” he says. “The consequence of this might be to move resources from health services to other public services that have greater potential to improve mental health.”

Age: 67.

Lives: Stalybridge, Greater Manchester.

Family: Married, with one son.

Education: Cantonment Board high school, Ambala Cantt, Haryana, India; Punjabi University, bachelor of medicine; Liverpool University, diploma in tropical medicine and hygiene; Family Planning Association, diploma in family planning; Royal College of General Practice, GP qualification.

Career: 2009-13: chair, NHS Tameside & Glossop primary care trust; 1982-2009: GP, Ashton-under-Lyne, Greater Manchester; 1978-81: junior doctor, various Greater Manchester hospitals; 1975-78: medical officer, Kurukshetra University, India.

Public life: deputy chair, British Medical Association; chair, Healthwatch, Tameside; OBE, services to the NHS and healthcare.

Interests: Poetry, reading, writing, cooking and politics.