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.