Battle is joined – for the future of your NHS


This week the Labour Party will be launching its formal defence of the National Health Service, after the Coalition government stealthily slipped a “negative resolution” to enforce privatisation onto the books before the Parliamentary recess.

The resolution, as mentioned in a previous Vox article, will force clinical commissioning groups (CCGs) in England to introduce competition to provide all services for which it is practical (in other words, almost everything), whether or not they believe it to be in the best interests of all concerned.

Its arrival means either the government lied when it gave the promise that neither the Health Secretary nor Monitor would be allowed to force health commissioners to put services out to competition, or it has decided to break firm, formal promises, written by Andrew Lansley in a letter and spoken on the record in Parliament.

Labour’s Shadow Health Secretary, Andy Burnham, has announced that the party will ‘lay prayers’ against the resolution in both Houses of Parliament, and will fight “tooth and nail” to defeat it.   He has repeated his firm, unambiguous commitment to repeal the 2012 Health and Social Care Act as a priority once Labour is back in government, and to restore the lead on the commissioning of health services to local government.

If Labour win the next General Election, he will reintroduce a preferred provider policy that will allow genuine NHS organisations to be named as the providers of choice, thus ensuring that the NHS remains, at its core, a public institution. This will restore the NHS to leadership of health service provision, alongside local government as the commissioning lead.

But by that time much irrevocable damage will have been done, so concerted interim action is needed – and it is heartening that CCGs in Haringey and Bristol are already leading the way.

In Haringey, the CCG has been persuaded by campaigning organisation 38 Degrees to adopt amendments to its constitution, ensuring that they will only invite competition to buy services where “necessary or appropriate”. Contractors/providers must be “good employers” – be reputable, meet tax and NI obligations and keep to EO legislation. Other amendments exclude companies convicted of offences, and   prohibit companies that use improper tax avoidance and off shore schemes.

That is just the start of the battle for the NHS – but it’s a good one, and an example that can be taken forward.

Haringey has accepted that there is a case for arguing that awarding tenders to private providers will cause genuinely public structures to atrophy as funds are taken out of the public health economy and turned into private profits. This would be to the long-term detriment of the NHS, meaning an award to a private bidder is worse value, even if the headline price is lower.

If you are in England and concerned about the decline that the government’s negative resolution will instigate, why not get in touch with your own local CCG, ask them to examine the actions of their colleagues in Haringey, and politely request that they go and do likewise?

Expect much more on this issue in the future. It will be published here as it becomes available.

6 thoughts on “Battle is joined – for the future of your NHS

  1. Duncan McLean (@A_D_McLean)

    “Other amendments exclude companies convicted of offences, and prohibit companies that use improper tax avoidance and off shore schemes.”

    That clause would have ruled out the last Labour Government, which indulged in such ridiculous schemes as selling the HMRC property estate to an offshore company. No wonder there is now an embedded culture of tax avoidance in UK companies – they are taking their signal direct from the tax authorities.

    It is regrettable that voters in England can only choose between various shades of privatisers. Fortunately, here in Scotland people have the option of voting for a party, the SNP, that is genuinely committed to the a publicly-run NHS free at the point of need. I understand even Labour in Wales is trying to hold the line on the rightward drift of the UK Labour party on health.

    I wouldn’t depend on holding the rump of Labour’s Blair/Brown generation to their pre-election promises on health or anything else.

    1. Mike Sivier

      I disagree with your last paragraph (but then I would – I wrote the article on the understanding that Andy Burnham’s words were in good faith).

      I do agree that a lot of stupidity has happened since the 1970s (at least), perpetrated by both main parties. Mr Burnham is signalling an end to that kind of nonsense with regard to health services, if Labour are returned to office in 2015.

      You are correct that the Labour administration in Wales is running a public service NHS, but I would not say that this was any attempt to halt a rightward drift on the part of the Labour Party as a whole. It seems to me that UK Labour has gone about as far right as it’s going to, and is on its way back to more wholesome ground.

      In all honesty, I think the NHS is an institution that ALL parties (other than the obvious exception) could get behind. Let’s forget our other differences and work TOGETHER on this. If we allow our political differences on other matters to divide us, the Tories and their private corporate backers will be laughing all the way to the (offshore) bank.

  2. skarp

    “, formal promises, written by Andrew Lansley in a letter and spoken on the record in Parliament.”

    can you please give chapter and verse for these promises? – i’ll write to my tory mp. he’s bullshitted before about this so i don’t hold out much hope but he’s in a marginal seat…

    1. Mike Sivier

      From :

      ‘In response to concerns raised about the risk of coercion to introduce competition, Lansley sent out a letter to prospective commissioners that included the following, very clear statement:

      ‘”I know many of you may have read that you will be forced to fragment services, or to put services out to tender. This is absolutely not the case. It is a fundamental principle of the Bill that you as commissioners, not the Secretary of State and not regulators, should decide when and how competition should be used to serve your patients’ interests. The healthcare regulator, Monitor, would not have the power to force you to put services out to competition.”

      ‘The new regulations, which will force almost all services to be put out to competitive tender, show this assurance to have been a shameless lie.’

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