Andy Burnham MP recently commented,
“David Cameron used to say that his priority could be summed up in three letters: NHS. Now, it seems, he prefers not to talk about it. The word in Westminster is that, on the advice of Lynton Crosby, the Prime Minister has asked his ministers for a period of pre-election silence on the NHS. So the Queen’s Speech came and went without even a mention of Mr Cameron’s erstwhile priority.”
The NHS says 299,031 patients arrived at A&E departments last week – the highest number on record.
The NHS is set to be a key battleground at the general election and Labour intends to keep it at the forefront of the public mind in the coming months. The plan is now it will use a private member’s bill to lay out how it would repeal the coalition government’s controversial Health and Social Care Act (2012), which had a number of after shocks.
The bill, proposed by Clive Efford MP, would rewrite the rules that put competitive market tendering of services as the default option until proven otherwise. It will be debated in the Commons in November and Labour candidates in marginal seats will call on Tory and Lib Dem incumbents to back the bill, while highlighting examples of how current rules waste money and fragment care.
In fact, this legislative manoeuvre is necessary whichever party comes to power on May 8th 2015. The current legislative framework makes it very difficult for services to be commissioned which promote integration, for fear of breaching competition regulation.
The Shadow health secretary claimed the vote on the bill would “without doubt be the defining moment of what remains of this parliament”.
This private member’s bill is designed, presumably, to keep the NHS on the political and news agenda. Given the blanket reluctance of the BBC to discuss this £3bn re-disorganisation, campaigners will mainly have to resort to the social media to get their message across.
The bill is also designed to drive a wedge between the Conservatives and the Liberal Democrats. At some stage before the general election on May 7th 2015, the Liberal Democrats might wish to distance themselves from the current Conservative policy. It is nonetheless noteworthy that Paul Burstow remains adamant that opposition to hospitals suddenly closing from Labour will not work in the long run.
The Liberal Democrats, to put it simply, need this ‘differentiation strategy’ to survive. Otherwise, it will be completely annihilated as a political force. The Liberal Democrats were instrumental in getting the Lansley Act onto the statute books in both the lower and upper houses. The concept of them repealing their own legislation in a coalition after 2015 is completely unacceptable for many in the Labour Party.
And there is plenty that all NHS campaigners can unite upon, whatever political creed.
First and foremost, it would be motherhood and apple pie for the duty of the Secretary of State for Health for the National Health Service to be restored.
Secondly, it is likely that Labour will wish to see the increase in the ‘private patient income cap’ abolished. I have written about it in great detail here.
The current situation regarding the “private patient income cap” (more correctly an “income cap for non-NHS work“) in the Health and Social Care Act, through s. 164(1)(2A), is described as follows:
An NHS foundation trust does not fulfil its principal purpose unless, in each financial year, its total income from the provision of goods and services for the purposes of the health service in England is greater than its total income from the provision of goods and services for any other purposes.
In an interesting development reported this morning, hospitals are to be banned from charging patients up to £72 a day to park their cars under plans being drawn up by ministers. It is reported that some hospitals charge up to £4 an hour – and in some areas £72 per day – for parking spaces, with costs running to hundreds of pounds for those who make repeated visits for treatment.
It is also claimed that the worse-affected include cancer patients who cannot take public transport because they have reduced levels of immunity, and the parents of premature babies, whose children are often kept in hospital for several weeks.
The abolition of this lifting of the income cap for non-NHS work would go far wider than the Coalition’s targeted strike on car park charges.
A grave concern has been that competition rules ‘hold back quality‘. I first wrote about this at the beginning of January 2013 on this blog. The provision (“section 75″) puts rocket boosters into aggressive pimping of NHS services in the private sector, and the rest as they say was history.
In October 2013, it was reported that two NHS hospital trusts in Dorset would not merge on the basis of clinical need, according to the Competition Commission, an economic regulator overseeing the implementation of competition law applying to this country.
Whilst Jeremy Hunt never mentions the Lansley Act, there’s no doubt that Labour will wish to repeal it in the first Queen’s Speech of a Labour government. It appears to have appeared to have come from nowhere, though a very good description of how it came about comes from Matthew d’Ancona’s outstanding “In it together” and Nick Timmins’ outstanding “Never again”.
It’s undoubtedly a turgid piece of law, which reads like a patchwork quilt of commercial and corporate law relating to competition, regulation and insolvency. There’s only clause on patient safety, and that enables the abolition of the National Patient Safety Agency. In fact, the Draft Bill on regulation of clinical professionals, proposed by the English Law Commission, thought to be a landmark piece of legislation to promote patient safety, has been bounced into the lifetime of the next parliament.
Despite its length, the Lansley Act has three clear aims: firstly, to outsource NHS services into the private sector as easily as possibly, to bolster the functions of an economic regulator (“Monitor”), and to accelerate the managed decline of NHS units which run into financial trouble. It is indeed a result of a need to ‘liberalise the NHS market’, but as Iceland found out in their large experiment of deregulating the banks, the Lansley Act experiment may be just about to go horribly wrong. NHS campaigners, if they unite, can help to seal its fate.
