It appears that all is not well following the recomendations of the future forum and the acceptance of its recommendations by the ConDem coalition government. Many NHS news articles highlight the fact that despite the many changes to the Destroy the NHS bill the privatising elements remain intact. The bill is still on course as the first stage of transforming the NHS into a restricted, privatised, insurance-based model of care.
It is clear that the revised Abolition of the NHS Bill does not satisfy the demands of the Liberal-Democrat Spring Conference due to the reliance on private providers. It is recognised that the Liberal-Democrats are facilitating the destruction of the NHS.
- Conservative election poster 2010
A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
The NHS Future Forum, while having uncovered many faults throughout the legislation, was never asked to consider the ideological foundations behind the Bill.
This leaves Field between a rock and a hard place, having ensured new safeguards are applied while at the same time adding legitimacy to a significant departure from the founding principles of the NHS.
The Health and Social Bill remains a real threat to the NHS as a comprehensive service free at the point of use.
All this means that the threat to NHS services and staff remains a clear and present danger. The Future Forum did little to assuage the fears of NHS staff who still face losing nationally determined pay, terms and conditions and will have little confidence in their job security which has been a hallmark of our National Health Service, established over 60 years ago by a Labour government.
The Health and Social Care Bill will now return to a public Bill committee of MPs of which I will be one.
How the coalition implements the NHS Future Forum recommendations in legislation and to what extent these recommendations change the direction of travel charted by the Bill will be known shortly.
One thing is certain – the Bill does far more than the coalition’s stated aims. Otherwise we would not need a Bill at all.
As I said in the Commons earlier this week, the changes set out by government this week are largely cosmetic. “You could put lipstick on a pig, but at the end of the day it was still a pig.”
Grahame Morris is Labour MP for Easington.
On Monday, the Future Forum unveiled its long-awaited report on the Coalition’s NHS bill. Having now agreed to implement the majority of its recommendations, the Conservatives are keen to portray the episode as an example of a government willing to “listen” and improve “where it hasn’t got things right”. The reality is that their initial bill was a transparent attempt to privatise the NHS. Only the prospect of the Lib Dems voting it down forced any change. This was not a “listening exercise”, it was a last ditch attempt to push the bill through with the minimum concessions necessary. The primary function of the bill remains in place: to introduce private sector provision throughout our health service.
The argument for Andrew Lansley’s NHS bill has been tenuous from the outset, encountering continual and vocal opposition. Recognising that the bill’s defeat would be catastrophic for his premiership, Cameron has desperately tried to repackage it whilst keeping the fundamentals in place. It has been a master class in the rhetoric and evasions of privatisation. But with minor tweaks there lies a danger that the bill will be accepted, both in the legislature and by the public, on the basis that it is less destructive than Lansley’s original proposals. This mentality of concessions and minor victories must be avoided. Instead, what must be continually asked is whether the bill is acceptable and legitimate in its current form – does it leave the NHS as a nationalised, coherent health service, and did the public vote for it?
Lansley will tell his backbenchers that the fundamentals of the bill remain in place: GP Consortia commissioning services, and the private sector brought in through competition requirements. The involvement of private health firms has always been at the centre of these proposals and nothing in today’s report will worry them overly. In years to come, any niggling public safeguards can be slowly eroded.
The bill still represents a fundamental change to our NHS; it is a programme for widespread privatisation. Private services will expand, the truly national part of our health service will shrink, and incidents like Southern Cross could become more and more common. John Redwood’s claim on Question Time that providers must put “patients first” was typically disingenuous; corporations have a legal obligation to maximise shareholder value. They will be obliged to seek the maximum revenues and prices possible, and incur the minimal costs possible. They are profit maximisers, not charities, and a patient’s worth is measured in pound sterling.
GMB today set out its position on the recently published NHS Future Forum Recommendations.
Rehana Azam, GMB National Officer Public Services Section said “ The report and recommendations on the face of it appears that significant progress has been made. In reality there is much to be concerned about and until the details emerge as to what the amended Bill will look like the GMB remains of the view that Bill should be scrapped. The Bill in its current format will lead to the break up of the NHS and this break up continues to be the most significant threat to the NHS.
Earlier this week, the Government announced it would be changing many of the initiatives that were to be implemented, following recommendations from the NHS Future Forum. According to Mercer, despite the proposed changes, companies should continue to prepare for further increases in corporate healthcare costs. GP consortia will work with healthcare professionals to ensure the most effective multi-professional involvement in the design and commissioning of services.
Consortia will also not take on the full range of responsibilities by April 2013, but when they have the right skills, capacity and capability to do so. Despite these changes, Mercer believes that giving these consortia control over budgets may still affect the quality of care and the length of waiting lists.
According to Naomi Saragoussi, principal in Mercer’s health and benefits business: “The devil is in the detail. While the Government has accepted the criticism of its policies and the plans to make the NHS more competitive appear to have been watered down, some areas lack clarity. It may be difficult for the consortia not to take a more commercial approach and prioritise more cost-effective treatments, despite their good intentions. We will have to wait and see.”
According to all accounts Captain Cameron and second mate Lansley have listened to the weather warnings of the Future Forum, have duly altered course and are now steering the SS Health Service into a bright new future.
Or are they? Closer examination of the small print suggests that we are in reality still heading into stormy waters and are the victims of a massive PR trick by the government who have managed to stay on course while persuading us that they have significantly altered the Health and Social Care Bill.
Lansley has reassured backbenchers that no red lines have been crossed and that the core principles of the Bill are untouched. On the same day that the papers were reporting Cameron’s “explicit rejection of further private sector involvement in the NHS” Lansley himself was addressing a conference of private companies eager to get involved in commissioning and providing NHS care.
One of the core principles of the Bill is to facilitate private involvement in commissioning and delivering NHS care (and anyone who still doesn’t believe that this is advised to read Colin Leys and Stewart Player’s compelling book The Plot against the NHS). All the policy levers for this – in particular GP commissioning and any willing provider, – remain in place. The emphasis of the role of Monitor has been altered but can easily be redirected once the well orchestrated political dust has settled.