Health bill is ‘biggest upheaval in NHS history’
Victoria Macdonald
Health and Social Care Editor
As the NHS reform bill begins its third reading, Channel 4 News Health and Social Care Correspondent Victoria Macdonald writes that it has polarised opinion across the spectrum at Westminster.
MPs returning from their summer break have began a crucial two-day debate on the NHS health and social care bill, which is at the report stage and is on its third reading.
The government has itself submitted 1,000 amendments, although about 700 of them amount to little more than name changes, with other amendments tabled by Labour and the Liberal Democrat MPs John Pugh and Andrew George.
Mr George, a member of the health select committee, said: “The bill breaks the coalition agreement, is based upon a false claim that the NHS performs poorly in comparison with health systems across Europe, and represents the biggest upheaval of the NHS in its history at precisely the time it needs stability and certainty.”
Briefing papers
Before the debate had even begun both the government and opponents to this controversial bill had put out briefing papers to suggest that either the National Health Service will be better than ever or will become fragmented and privatised.
The Department of Health released a statement headlined Top Myths in which it denied bureaucracy will increase, that they are privatising the NHS, that private patients will take priority over other patients, that the bill has not had proper scrutiny, that NHS hospitals will be managed by foreign companies, that the NHS does not need to change, that they are introducing EU competition law in the NHS and that these plans were not in the coalition agreement.
In this briefing they did not debunk accusations that the secretary of state will no longer be held accountable for the NHS, although that was included in a later press notice.
The health secretary, Andrew Lansley, said in a statement: “The principles of our modernisation plans – patient power, clinical leadership, a focus on results, stated in the Coalition Agreement and again in last year’s White Paper – have always been at the core of the Bill – principles which are widely accepted as reported by the independent NHS Future Forum.
“They called for us now to get on and today we are getting on with modernising the NHS,” he added.
Critics unappeased
This all comes after the pause and listening exercise, led by the NHS Future Forum, earlier this year and called for by the prime minister as criticisms of the bill grew.
Those critics do not appear to have been appeased. Liberal Democrat Vice-President Dr Evan Harris said the government’s myth-busting list was “full of half truths”. Dr Harris said that it was likely that emergency motions would be tabled at this month’s Lib Dem annual conference.
But Labour’s Shadow Health Secretary John Healey issued a Lib Dem scorecard. He said that Nick Clegg’s claims that he had secured 11 of the 13 changes demanded by his party at its spring conference did not bear scrutiny.
“The reality is that he has failed on seven of their demands and fallen short on six,” Mr Healey said.
He said the promise that there would be more accountable commissioning had failed. “There will be no elected members or councillors on commission consortia boards, while Health and Wellbeing Boards are only able to give either opinion to consortia and consortia are under no obligation to abide by that opinion.”
‘Transparent’ providers
On the issue of cherry-picking, in which a private provider would be able to take on the easiest and most profitable types of treatment, Labour said the government amendments only required a provider to be “transparent” in how they chose their patients.
Mr Healey said the changes to the NHS bill had left it more complex and more costly.
And at a meeting, the campaign group Keep Our NHS Public said that little of significance had changed after the “pause”. The meeting, chaired by the former health secretary Frank Dobson, and backed by the NHS Consultants’ Association, said that it was a repeated myth that the bill was simply about putting more power into the hands of family doctors.
Speaking at the meeting, John Lister of Health Emergency said: “Giving GPs more power is not going to happen in the bill.” Mr Lister said that the National Commissioning Board would decide what services GPs could buy, and overriding all this anyway was the demand that the NHS makes savings of £20bn over four years.
It is likely that the bill will pass its third reading – with a few rebels and some abstentions. But it is also likely that it will have a far from easy passage through the House of Lords.
