NHS: A battle is won but the war goes on

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The government has agreed to withdraw and re-write the controversial Statutory Instrument 257 regulations, that would have led to the privatisation – in practical terms – of most National Health services in England.

The regulations were being brought in under section 75 of the hated Health and Social Care Act 2012, under a process known as ‘negative resolution’. This meant there would be no debate or vote; they would become law 40 working days after they were introduced, leading to the demise of the English NHS as anything other than a brand name.

The government claimed the regulations were drawn up because previous guidance on procurement was set to become obsolete, as they applied to organisation that will not exist after April 1.

But concern was raised by Parliamentarians and more than 1,000 doctors, who wrote to the Daily Telegraph to point out that the legislation would make “virtually every part” of the NHS open to private contractors.

It is notable that the climbdown was announced by Liberal Democrat Health Minister Norman Lamb, rather than the Secretary of State, Jeremy Hunt. At Health questions in the House of Commons last week, Mr Hunt had maintained an attitude that there was nothing wrong with SI 257, but Mr Lamb responded to concerns from a fellow Liberal Democrat by agreeing that “clear assurances” had been made in the House of Lords while the Health and Social Care Act was passing through Parliament, and “it is important that they are complied with in the regulations”.

The amendments include clauses to make it clear that clinical commissioning groups (CCGs) of GPs will decide when and how competition should be sought; clearer rules about the exceptional circumstances when only one organisation can tender for a service without competition for the contract; assurances that CCGs do not have to tender all services, and cannot be forced to do so by the regulator (Monitor); and an insistence that competition must not be at the expense of “integration and co-operation”.

In all cases, the regulations would be based on standards adopted by the previous Labour government, when the now shadow health secretary Andy Burnham was in charge of the health department, according to Mr Lamb.

The turnabout has triggered a wave of derision from opponents including Labour’s Health spokesman Andy Burnham, who said Coalition policy on competition was “in utter chaos”, and Stephen Dorrell, Conservative chairman of the health select committee, who said it showed that “the cloud of rhetoric that surrounded the passage of the Health and Social Care Act was so much hot air”.

This is a victory for those who wanted to keep healthcare-for-profit out of the National Health Service. But it is only a battle that has been won – not the war.

We do not know what the new regulations will be. Just because the Coalition says they will be drafted in a certain way does not mean that is how they will end up – we have plenty of experience to show that what the Coalition says and what it does are two entirely different things.

At most, this is a reprieve. Those of us who want services protected must remain vigilant.

And we must hold Labour to its promise to repeal the Act altogether, if that party gains office in two years’ time.

8 thoughts on “NHS: A battle is won but the war goes on

  1. Phil The Folk

    As you say, a battle won but not the war Mike. It good news though. Just need good news on the Atos front now!

  2. Brittle

    1000 doctors write in the Daily Telegraph and all they could say was that they were “concerned”. Is that it? They are only “concerned”. What about? If you read the rest of this very short letter it doesn’t come across that they are “concerned” about privatisation, but how much privatisation. What are they saying – yes let us make all the money instead?

    Here is the letter
    http://www.telegraph.co.uk/comment/letters/9901077/Doctors-concerns-over-NHS-contracts-being-put-up-for-sale.html

    Clare Gerada is herself heavily involved with a private commissioning company. But I suspect they don’t call it that officially.

    The other oddity around all this is the Government claiming they are not trying to privatise by stealth. They are perfectly entitled to say this, after all they are doing it openly.

    1. rainbowwarriorlizzie

      Doctors’ concerns over NHS contracts being put up for sale
      The Government has proposed legislation to open up the NHS to the private sector

      6:58AM GMT 01 Mar 2013

      Comments19 Comments

      SIR – As doctors and health-care workers, we are concerned about the Government’s proposed secondary legislation (under Section 75 of the Health and Social Care Act) to force virtually every part of the English NHS to be opened up to the private sector to bid for its contracts.

      These regulations were proposed on February 13 and will become law on April 1 unless MPs first insist on a debate and then vote them down.

      Parliament does not normally debate or vote on this type of regulation, but it is possible. We urge parliamentarians to force a debate and vote on this issue to prevent another nail in the coffin of a publicly provided NHS free from the motive of corporate profit.

      Dr David Wrigley

      Dr Clare Gerada

  3. katrina

    I have to agree with Brittle, already there are many operations that are available privately that people are been turned down for on the NHS. Although this may not always include life saving ops and treatments they often involve operations that have a serious impact on quality of life. I am witnessing this with my partners condition which is seriously reducing his mobility, some consultants who offered treatments both privately and on NHS claimed that they could not help. My Mother could also not get the treatment she wanted unless she paid and was offered a less effective alternative on the NHS. This already suggests that there are better alternatives if people have the money to pay. There have also been complaints against GPs who are harassing patients who are in receipt of benefits and receiving free prescriptions..I also do not agree with consultants been able to offer both private and NHs work in any other profession this would be classed as moonlighting, especially when they are carrying out private operations in NHs facilities. Although I am grateful that we still have an Nhs and access to free health care it is a very worrying concept that Doctors may become more concerned with profit and savings than fulfilling their promise to do no harm. I will continue to support the Nhs because it would be devastating to loose this vital service.

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