Making sense of the ‘pause’ in Lansley’s Health Bill

In an excellent article Colin Leys analyses the proposed changes to the Health and Social Care Bill, and shows how we can use the pause to defend the NHS. – link to full article below.
He writes:

“Cameron now knows he has allowed a well-informed but tunnel-vision privatiser (Andrew Lansley), who is close and deeply obligated to the private health industry, to push ahead with a bill that risks major electoral penalties. He will wait to see whether Lansley can buy off enough opposition. For both Lansley and Cameron the question is whether they can keep the Lib Dem leadership in the Coalition when the Lib Dem rank and file are pressing to make the defence of the NHS a final sticking-point.

“The fact that the story has kept changing day by day shows that the task is seen as quite problematic. At first Lansley said there would be two months of ‘listening’. But he made it so clear that he meant we would be listening to him that the story then had to be changed to one in which he would do the listening, but only to health professionals; and then the idea occurred of listening only those likely to support the Bill. Cameron, accompanied by Lansley, personally announced the creation of a Listening Forum, consisting of patients as well as nurses and doctors. The Forum has since developed into a Futures Panel of five, to be assisted by a forum of 40 doctors, who in turn will listen to ‘grassroots GPs’ around England, and will be chaired by the outgoing chair of the Royal College of GPs (RCGP), Dr Field, a long-term proponent of marketisation.

What the Health and Social Care Bill will do

“The Bill removes the existing obligation on the Secretary of State for Health to provide a comprehensive health service, and does not lay that obligation on anyone else. Commissioning Consortia will be free to decide what services should be available on the NHS for their patients, and to set fees even for some of these. Patients will be free to choose private providers and private for-profit providers will be able to bid to provide any service that they can make a profit from, leaving NHS hospitals with the unprofitable remainder and forcing many of them to close. The private sector is now well placed to start doing this and has been in close contact with Lansley about the prospects. Any attempt by consortia to preserve local hospitals by giving them preference in making contracts will be open to challenge (one private company, Circle Health, has already challenged a Primary Care Trust for doing this); and the healthcare market regulator, Monitor, is mandated to promote competition.

“GPs and Consortia are free not to accept patients, and patients who are not registered with a GP will not be entitled to NHS services. Some patients who are costly or difficult, and people such as asylum seekers and undocumented immigrants, will be forced to rely on local authorities to get treatment, which will not be free. What is implied is a set of services increasingly provided either by private providers, or by NHS foundation trusts, which all NHS providers have to become by 2013, and which are nominally public but which will be forced by competition to act like private ones. Free services will be limited by what each unaccountable local GP consortium decides to pay for, with fees charged for what they consider extras – and otherwise no option but private treatment (for those who can afford it). A raft of current policies is already pushing the NHS towards the US model of care. The Bill will complete the process.”

Colin Leys goes on to summarise the various attempts to amend the bill, and points out that only the set of amendments being demanded by rank and file Lib Dems lead by the Drs Charles West, Evan Harris and Graham Winyard would have the effect of saving the NHS. The amendments proposed by other groups are at risk of being used as a fig-leaf by Lansley and Cameron. – This paragraph is mine. C.W.

Full article can be found here.

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