The vote to pass the S75 Regulations was very similar to the many previous votes.  Warm words from the Minister taken to be more important than the words in the actual legislation; bogus and distracting arguments missing the key point; passion from those that defend the NHS; confusion from some; vested interests protected shamelessly –  then the LibDems trooping through to support the government.  The wider public struggle to understand the real issue, and the media gives it little or no coverage.

The Regulations just fill out what was already in the Act – a one way journey to a very different NHS – starting through the mechanism of using market competition to allow greater entry of private providers, ending with a full economic market for our healthcare and a two tier service with top ups, charges and insurance; division and fragmentation. Along the way the NHS, as a public service based on the founding principles we all support, is destroyed.

Now is not the time to stop our opposition.  The intention is clear to all but the Act is complex and even with a positive environment for change it would take many years to have any major impact.  But the background is very unfriendly to implementation and we can and should challenge every step along the way.  The Act opens up many opportunities for us to become active within the system. We should take them.  We should do this alongside the local campaigns that we know will spring up to fight cuts, closures, restrictions and steps towards privatisation.

Our strategy within the SHA should remain the same.  We develop and argue for an alternative policy, which we persuade the Labour Party to adopt then implement.  We do all we can to slow down implementation of the Act – and the Regulations debate gave us more ammunition to challenge any commissioner who starts to examine putting services out to tender.

We can work with the natural resistance of the NHS to change and the undoubted hostility to the changes from many within the system to ensure that over the next two years as few services as possible are subject to Any Qualified Provider regimes or put out to tender.  And we hold the Labour Party to its commitment to repeal the Act.

There are opportunities for public involvement all over the NHS.  They may be tokenistic, but they present opportunities to gather information, to agitate, and to question what is going on.

Individual GP surgeries often have some sort of patient participation group. Though GPs are very wary of them, they are paid extra to set them up. GPs are sensitive to what their patients think about them.  The National Association for Patient Participation promotes and supports patient participation in primary care.  They can help.

Each of the 211 Clinical Commissioning Groups has to have some sort of public and patient involvement mechanism, and they have to hold board meetings in public. The detailed arrangements are down to local decision.

Every local authority has to set up a local Healthwatch – though some are a bit slow to get going.  The local Healthwatch has a seat on the council’s Health and Well-being Board.  For the first time since 1974 elected local councillors have a direct voice in the NHS, and are responsible for the health of their population.

The 145 Foundation Trusts each have a membership scheme. Some only have local members, but many offer specialised services to a wide area and have a category of members for the “Rest of England and Wales”.  The members elect the majority of the Governing Body.  The Governing Body appoint, and can dismiss, the  Chair and the Non-Executives.

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7 Comments

  1. I am unclear about some things.Listening to the debate last night,how much of the NHS services were procured from the private sector in the era of PCTs?My understanding is that by abolishing the PCTs and setting up CCGs,many more NHS services have become available to be tendered for by any provider[willing or able?].In actual fact could it be said that the so called reorganisation was exactly this:to unbundle NHS services to make them available for tendering from any willing/able provider,i.e. the private sector?
    The other thing is,Lord Owen talked about how the public services[in europe too] were exempt from the European law on competition and tendering.I dont what the score on that is.It seemed like a useful line of enquiry.
    Another thing is that if the NHS is not excluded from European law on competition and tendering,then is it not true that as soon as NHS services were made available to the private sector for tendering,then all services became subject to it- in the mode of not being able to be a little bit pregnant.
    So will any of the regulations in section 75 hold sway against the European law on competition and tendering,which it was apparently written to conform with?I cant imagine mps/lords wanting to sit on boards of tiny wee companies,They want to sit on the boards of transnationals which will eat up and obliterate the wee UK companies.Making the NHS procurement process subject to European law on competition and tendering,and the US/EU Free Trade Agreement,the privatisation of the NHS is absolutely certain and the tories know this and have meticulously planned for it.Mckinsey and Company knew how to do this.With large scale sponsorship of the tory party by the private health sector,with mps ands lords with financial interests in private healthcare,what the electorate have witnessed is the wholescale corruption of democracy,government capture and the wrecking of the NHS.
    No doubt monitor,with it’s ex-Mckinsey and company employees,can now focus on creating a level playing field by reducing the tax burden on willing providers[which can be run by people with criminal records-apparently anything goes in this brave new bs] and maybe provide them with information on which tax haven to secrete their profits.
    The NHS and the spirit that it came out of has been betrayed by our elected and non-elected representatives.End of.
    There is now an e-petition to Exempt the NHS from the US/EU Free Trade Agreement
    http://epetitions.direct.gov.uk/petitions/47102
    So now the denizens of multi-national/trans-national corporations can just move in.God,dont you love the tories.The plebs and their crappy NHS dont matter to them.Nobody but their mates and paymasters and future employers mean a damn to them.
    Their was treachery and some really sophisticated bamboozling going on in that debate last night.Some of them seemed almost too tired to speak.
    Apparently the rewritng of the Regulations was so important that three lords/ladies were involved.Obviously it was very important.
    Wonder if labour are going to have the balls to revoke/annul the Act/Bill.
    Bet you they dont

    1. Judy Breens says:

      We met Andy Burnham on Wednesday. He spoke to those of us protesting outside the House of Lords at the time of the debate and thanked us for coming. He said he has said publicy that if he is Health Secretry if/when Labour regain power he will repeal the Health and Social Care Act. He said this on stage at another public rally in Westminster Central Hall some time ago (I heard him!) He said however that if private contracts go through as a result of the regulations passing he was not sure legally that he would be able to cancel them. He also said he was on record for saying Labour went too far on privatising health when they were in power. Unfortunately media coverage is poor and these things are not often heard by the public

      1. Listening to the Debate,the degree of quoted complicity by labour in setting the foundations[good and strong]for privatisation was repugnant.I have lost all respect for parliament,and certainly labour’s understandable[in the context of their obvious complicity] wall of silence[except for Burnham and Healey] certainly moved that disillusionment along.Labour still have not[disgracefully]admitted their responsibility so they had/have absolutely nowhere to go as far as privatisation of the NHS is concerned.Their silence through much of the tory policy in devastating the plebs,and in fact more murmurs of complicity[they wouldn’t change this or that]means they are a totally compromised party.
        Burnham’s fine words’If I am Health Secretary’ is a cop out.Milleband hasn’t the balls to innovate,develop fair and equitable policy is obvious.He’ll just make Burnham,if he hasn’t rushed of into some consultancy or board[more unchecked parliamentary corruption-the honeypot of parliamentary democracy,now] a la ‘David Cameron’s former NHS privatisation adviser becomes lobbyist’
        http://www.guardian.co.uk/politics/2012/nov/23/david-cameron-privatisation-adviser-health-lobbyist
        -where’s Elizabeth Filkin when you need her:
        http://www.dailymail.co.uk/news/article-479751/Hounding-decent-woman-Labours-brutal-campaign-destroy-ethics-watchdog-Elizabeth-Filkin.html
        Milleband will just make Burnham the secretery of something else,to stop the embarrassment,and labour will walk a way,wring it’s hands a little,look for corporate sponsorship and will smell of roses-they think..
        More is required of the electorate now.Passivity just leads to the status quo,which has delivered parliamentary democracy into the hands of big business,their sponsorship and their lobbyists[the £2billion lobbying industry parasiting on ‘our’ parliamentary ‘democracy’].
        The electorate should have mps who represent their interests,ensuring that best equitable policy is developed,the hobbling of power in favour of responsibility,the means to…Whatever it my be there isn’t a glimmer in the current infestation of parliament.
        Boy did I hear some smooth operators in that debate.Awesome and profoundly scarey.A bit of roll out the lords and ladies to vote was involved.Democracy hasn’t a chance.Did/do any of those guys use the NHS?That’s how weird it all is.

  2. Mark Burton says:

    It just shows the limitations of a (purely) parliamentary strategy. Any thoughts on what an extra-parliamentary strategy might look like? (“We do all we can to slow down implementation of the Act “) It needs to radically slow down the wholesale tendering out of NHS services, and using the tokenistic provisions of the current NHS just isn’t going to give sufficient leverage (though yes, OK for intelligence purposes) – otherwise if and when labour comes to power (in typically timid ‘in government’ mode? “Wonder if labour are going to have the balls to revoke/annul the Act/Bill. Bet you they dont”) it will all be pretty much a fait accompli – remember the NHS Trusts, the utilities, rail?

    1. As a long-term iconoclast, I hate to have to admit that institutional inertia will be the best friend of radical NHS supporters.
      So will the lack of funds for CCGs that make competitive tendering an expensive luxury. Most will use every excuse not to use it as a method for improving local services.

  3. Simon Kirk says:

    I remain unconvinced that there are legions of for-profit and not-for-profit providers out there desperate to take over the bulk of NHS services, mainly because there’s not really any big money to be made – I’d need some convincing if I were a shareholder in one of these outfits. And what’s our alternative mechanism for achieving change on the part of recalcitrant NHS providers? (institutional inertia works both ways! – one of the reasons why 10 years after the Bristol scandal there’s, disgracefully, been virtually no change?) I’d be more than happy to have something other than the market mechanism, but I don’t know what it is…

  4. neil wood says:

    Adam Clifford raises considerable concerns not least about the EEC and competitive Tendering. I also watched the debate and was surprised that neither Lord Owen or any other member of the Lords knew how Scandinavia,Scotland and Wales had opted out. Could this be a case of interpreting legislation in a way that best suits the strategy. APMS contracts brought in by the previous administration used the same reasons for including the private sector in tendering.

    Furthermore for private companies entering the healthcare market on the back of APMS contracts the outcome is not always a pot-of-gold.
    The Guardian reports in the article below:
    ‘United Health Europe made its first foray into the UK health market in 2003 under the Labour government, but by 2010 it was making a loss of £13.9m on it’

    http://www.guardian.co.uk/society/2012/dec/19/when-privitisation-gp-practices-wrong

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