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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.