Despite the unctuous assurances from the Government, repeated again yesterday at the Report stage of Lansley’s bill, that the NHS would be preserved, on 5 key counts the content of the bill flatly belies their pledges:
First they said that private patients should not be able to jump the queue. Yet clause 168 of the bill abolished the private patient income cap, so that hospitals can treat any amount of private patients they like, even if this is to the detriement of NHS patients. In the new cut-throat system, hospitals will prioritise those that bring in extra income over ‘free’ NHS patients in the face of relentless pressure to make £20bn cuts over 5 years. NHS patients will be pushed to the back by an ever lengthening queue by the rich, foreign or British, who can pay.
They said that as a result of the ‘pause’, the competition promoted by Monitor, the economic regulator, would be dropped. In fact it will now “prevent anti-competitive behaviour”, which is simply another way of saying ‘promote competition’. It will enforce competition law exactly as regulators do in the privatised utilities and railways which is completely inappropriate for the NHS. There are altogether an extraordinary 64 pages and nearly 100 clauses of the Bill devoted to setting up a full-blooded market system.
They said a larger role for the private sector was precluded. In fact many GP consortia will, and many already are, bringing in private companies like KPMG and United Healthcare for commissioning purposes, despite the manifest conflict of interest. The government’s Any Qualified Provider policy will inevitably increase private providers, and the bill’s Right to Provide and Right to Challenge will also disadvantage existing public providers. Just in case there might be any doubt about it, the bill puts a legislative block on the NHS being the ‘preferred provider’ of services in future.
They said the Secretary of State would continue to promote a comprehensive health service. In fact clause 10 makes explicit that it is not the Secretary of State, but rather the new GP consortia, that must arrange for the provision of health services. Clause 11 says a GP consortium will determine what constitutes the lealth service “as it considers appropriate”. There is still no direct duty of comprehensiveness on GP consortia. All of this undermines the accountability of the NHS to Parliament.
They said they would improve the openness and transparency of GP consortia. However there is a get-out clause: “except where the consortium considers that it would not be in the public interest to permit members of the public to attend a meeting”. Similarly clause 155 allows foundation trusts to exclude members of the public from a meeting “for special reasons”, without explaining what these special reasons are.
This is surely the most dishonest and mendacious bill ever introduced into Parliament in modern times.
