If you had been on Twitter on Wednesday night after the vote on NHS reform, you might have got the impression from the vitriol of the miscellaneous lefty masses that the coalition government had just asset-stripped hospitals, privatised cancer wards and thrown grandmothers out on the streets to sell off the beds. ‘It’s a Tory Privatisation!’ ‘The Liberal Democrats have sold out!’ - #lowerthanvermin was the hashtag of choice.
Of course all of that is complete tosh.
No party or ideology has a monopoly on the NHS. A free at the point of use, national and public health service is something Labourites, Liberals and Conservatives alike passionately believe in and that is something the NHS reforms will not change. If you don’t believe me, read the explanatory notes yourself here.
The Bill's aims are to restructure the NHS; abolishing Primary Care Trusts and setting up Commissioning Boards, which will have much more local accountability, give GPs more autonomy over local services and allow much more transparency than the existing setup. They will also encourage efficiency and give NHS providers new freedoms to improve quality of care.
It will not, as online campaigning portal 38 Degrees and others have suggested, allow the secretary of state for health to ‘wash their hands’ of the NHS, lead to privatisation, or subject the NHS to new aspects of UK or EU Competition Law.
38 Degrees' assertions are particularly misguided as they contradict the legal advice they commissioned themselves.
Where 38 Degrees told their members that ‘the bill will remove the duty of the secretary of state to provide’ (Sections 1 and 3 of the 2006 act) their legal advice states: The duties set out in Sections 1 and 3 of the 2006 Act are executed on behalf of the Secretary of State by Primary Care Trusts … Thus, there is no change at all. Incidentally the Bill itself retains the wording ‘The secretary of state has the duty to promote a comprehensive health service’ - something retained from the original 1946 Act.
Where 38 Degrees told their members the Bill will ‘make it almost inevitable that UK and EU competition law will apply as if it were a utility like gas or telecoms’, their legal advice states: ‘The current procurement law contained in the Public Contracts Regulations 2006, which derives from European law, has always applied to NHS purchasing … As regards the applicability of domestic and European competition law to the NHS, it is likely that… competition law already applies to PCTs and NHS providers. ‘
Apart from the fact that Labour’s 2006 NHS act delegated the duty to provide to Primary Care Trusts and exposed the NHS to European competition law, the charge that the Liberal Democrats somehow ‘sold out’ is risible.
It was a motion at the Liberal Democrat Spring Conference led to the Bill being paused and a massive rewrite taking place that guaranteed no privatisation of the NHS, no special favours to the private sector, retained the legal requirement that services be free of charge, ensured continuous improvement in the quality of services and put in place a clause to reduce health inequalities – all of which, incidentally, is the duty of the secretary of state.
I note the cries of ‘privatisation’ ‘shame’ and ‘sellout’ come from the same Labour party that financed new hospitals using expensive private finance initiatives, created ‘private’ foundation hospitals and paid the private sector £250m for operations that weren’t carried out.
There are complaints you can make about the bill – it's rushed, it’s a top-down reorganisation and it’s not what’s in the coalition agreement – but it is not privatisation through the back, or any, door.
Of course the art of politics is about presentation, something the coalition is relatively poor at, but it is important to get the facts right, and not scaremonger as 38 Degrees and Labour have. We received an email in the office this morning from a member of the public worried about paying for healthcare and asking whether they were going to have to start paying for their healthcare.
The very clear and understandable answer is no: the NHS will remain free at the point of use – I’m saddened to learn that you have been misled.
Comments
Rebecca Taylor / September 09 2011 10:14am
Very good article Martin. I am also amazed at the comments of some Labour supporters given all that their party did to bring in private sector involvement in the NHS.
For anyone not aware of such activities, I wholeheartedly recommend the book "NHS PLC" by Allyson Pollock (Professor of Public Health Research at Queen Mary University of London).
PeterC / September 09 2011 12:55pm
"The very clear and understandable answer is no: the NHS will remain free at the point of use - I'm saddened to learn that you have been misled."
Strangely your personal assurances fail to lift my doubts which are concerned with future developments not just todays presentation. If you think the doubters are misguided perhaps the House of Lords debates and outcome may enlighten you. Tosh Martin ,Tosh.
PeterC / September 09 2011 12:55pm
"The very clear and understandable answer is no: the NHS will remain free at the point of use - I'm saddened to learn that you have been misled."
Strangely your personal assurances fail to lift my doubts which are concerned with future developments not just todays presentation. If you think the doubters are misguided perhaps the House of Lords debates and outcome may enlighten you. Tosh Martin ,Tosh.
Thomas Maher / September 10 2011 3:39pm
Simplistic blogs like this just shows how liitle you Tory-LibDems know or understand the NHS..
See the BBC Panorama September 5th 2011, the Bill was even denounced by Gerry Robinson who gave dire warning about its consquences.
I have worked for nearly 30yrs in NHS Mental Health Services.
I have always worked in front line usually acute/crisis Clinical areas.
The NHS basically worked because the NHS Health Workers were devoted and believed in it. No longer.
We now have Temporary Staff, Temporary Contracts, a bullying managerial regime that puts its own bonuses and intrests before anything else, attacks on pensions and general dumbing down of all service quality.We have a farcical, light touch regulator and a rampant Corporate Sector which cannot wait to do to the NHS what they did to Elderly Care, sack, assett strip, loot and run.
Or look at Dental Services and weep! back to the 1930s with a 3 tier Health System. Private, Charity and DIY.
This change to the NHS will be like nothing you have ever seen , the amount of bureacrats necessary to begin to run this sytem is staggering, administration costs will be rising sharply. Driven by the accountants,consultants and Corporate looters LibDems -Tories have let loose. GPs will be awarding themselves big bonuses whilst cleaners loose pension, worker rights and get minimum wages.
Remember the Railways after Privatisation, all the Tory guff about investment, choice, quality? Now look at it , how much the Tax Payer subsidises the wealthy who own the Railways. Look at the profiteering, the accidents, prices travellers now have to pay.
Look at the withdrawl of services,overcrowding etc.
A Poll Tax on Wheels it was called and all shoved through by good old Leader of House, LibDem-Tory, Young.
Well imagine this debacle, but this time in our vital National Health Services. Imagine A/E closing or Mental Health Services axed, because Trusts have lost other service contracts and cannot afford to keep them running. Things like this are already happening.
You dont know or understand what you have done to the NHS.
I can tell you that the LibDems have colluded with the Tories in a Bill that breaks the back of the Public Service, Co-operative NHS and leaves it wide open to privatisations.
What we now recognise as a National Health Service will be sold off bit by bit, to Tory-LibDems wealthy pals. Like the Companies paying for Lansleys Shadow Health Office, the Foreign Companies being encouraged by the Tory-LibDems to take over hospital and services see recent leaked DOH emails in Independent
and as the remnants fail this will be used as further proof it needs breaking up.
Already in Mental Health Services see a dumbing down and loss of senior , experienced, well trained staff . In their place low cost, temporary staff, poorly paid, poorly trained are used to compete on price with "any willing provider" Profit before quality being the mantra
delivered by managers breaking up the NHS.
Our NHS was built on sharing, cooperation, devoted, well trained Health workers, low pay and long hours. This is what made it effective and effecient. Health Workers, who are the NHS, morale is very low, pay cuts , usually pay freezes in a 5% inflation per year, attacks on pensions , attacks on trade Union Rights and absoloutely no free speech allowed in the workplace. They will leave or stop the unpaid devorted, caring, overtime, Health is not like making sausages but you Tory-LibDems dont understand that.
I will never trust the LibDems again, never. You have colluded with the Tories in destroying one of the most important safety nets and one of the most effecient and effective Health Systems in the world. You did this in order to maintain a shoddy coalition with the servants of the Neo Liberal wealthy.
You lied to the electorate, the students and now you have destroyed the NHS.
I hope and believe you will pay a very, very, heavy electoral price
I for one live in a LibDem seat and , not previously active, will do anything to ensure your MP is not re-elected .
Thomas Maher / September 10 2011 6:41pm
Simplistic blogs like this just shows how liitle you Tory-LibDems know or understand the NHS..
See the BBC Panorama September 5th 2011, the Bill was even denounced by Gerry Robinson who gave dire warning about its consquences.
I have worked for nearly 30yrs in NHS Mental Health Services.
I have always worked in front line usually acute/crisis Clinical areas.
The NHS basically worked because the NHS Health Workers were devoted and believed in it. No longer.
We now have Temporary Staff, Temporary Contracts, a bullying managerial regime that puts its own bonuses and intrests before anything else, attacks on pensions and general dumbing down of all service quality.We have a farcical, light touch regulator and a rampant Corporate Sector which cannot wait to do to the NHS what they did to Elderly Care, sack, assett strip, loot and run.
Or look at Dental Services and weep! back to the 1930s with a 3 tier Health System. Private, Charity and DIY.
This change to the NHS will be like nothing you have ever seen , the amount of bureacrats necessary to begin to run this sytem is staggering, administration costs will be rising sharply. Driven by the accountants,consultants and Corporate looters LibDems -Tories have let loose. GPs will be awarding themselves big bonuses whilst cleaners loose pension, worker rights and get minimum wages.
Remember the Railways after Privatisation, all the Tory guff about investment, choice, quality? Now look at it , how much the Tax Payer subsidises the wealthy who own the Railways. Look at the profiteering, the accidents, prices travellers now have to pay.
Look at the withdrawl of services,overcrowding etc.
A Poll Tax on Wheels it was called and all shoved through by good old Leader of House, LibDem-Tory, Young.
Well imagine this debacle, but this time in our vital National Health Services. Imagine A/E closing or Mental Health Services axed, because Trusts have lost other service contracts and cannot afford to keep them running. Things like this are already happening.
You dont know or understand what you have done to the NHS.
I can tell you that the LibDems have colluded with the Tories in a Bill that breaks the back of the Public Service, Co-operative NHS and leaves it wide open to privatisations.
What we now recognise as a National Health Service will be sold off bit by bit, to Tory-LibDems wealthy pals. Like the Companies paying for Lansleys Shadow Health Office, the Foreign Companies being encouraged by the Tory-LibDems to take over hospital and services see recent leaked DOH emails in Independent
and as the remnants fail this will be used as further proof it needs breaking up.
Already in Mental Health Services see a dumbing down and loss of senior , experienced, well trained staff . In their place low cost, temporary staff, poorly paid, poorly trained are used to compete on price with "any willing provider" Profit before quality being the mantra
delivered by managers breaking up the NHS.
Our NHS was built on sharing, cooperation, devoted, well trained Health workers, low pay and long hours. This is what made it effective and effecient. Health Workers, who are the NHS, morale is very low, pay cuts , usually pay freezes in a 5% inflation per year, attacks on pensions , attacks on trade Union Rights and absoloutely no free speech allowed in the workplace. They will leave or stop the unpaid devorted, caring, overtime, Health is not like making sausages but you Tory-LibDems dont understand that.
I will never trust the LibDems again, never. You have colluded with the Tories in destroying one of the most important safety nets and one of the most effecient and effective Health Systems in the world. You did this in order to maintain a shoddy coalition with the servants of the Neo Liberal wealthy.
You lied to the electorate, the students and now you have destroyed the NHS.
I hope and believe you will pay a very, very, heavy electoral price
I for one live in a LibDem seat and , not previously active, will do anything to ensure your MP is not re-elected .
john oakes / September 10 2011 8:24pm
If Martin Shapland is correct -and the quotes seem to support his thesis up to the hilt,- then Facebook pressure group 38 Degrees should hang their heads in shame for misleading many thousands of people over the latest NHS legislation .Including me. Caveat scriptor.
Cole / November 04 2011 1:53am
Seems the LibDem peers now agree with 38 Degrees on the danger of the State 'washing his hands' of the NHS.
Shapland should be ashamed of himself for lifting great chunks of his article from a round robin written by a Tory MP.