Harringay online

Harringay, Haringey - So Good they Spelt it Twice!

I joined the Lobby of Parliament against privatisation of the NHS today.  I wasn't too clued up on what was actually happening to the NHS before I went. It doesn't seem to make the news much. I'm not politically active but having heard about what is about to happen I think this issue is very relevant to Harringay (and everywhere else in England) so I'm making this post. Please delete if it doesn't comply with the rules.

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I heard a number of MPs and Lords, of several parties, along with some Unions and Local Activists, speaking about the new Regulations (S12013/500) first introduced by section 75 of the 2006 Health Act, and what this will lead to.

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At a minimum expect, in the very near future, what happened to Dentistry - charges, withdrawal of free treatments... leading to full privatisation. Furthermore the proposed EU/US Trade Agreement will enable US Companies into the UK Health Market. That'll be great.

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Despite the reassuring words of Hunt et al, a leading QC's view is the CGCs will have to put NHS services out to tender. Once services are taken over by private companies the NHS part is gone... forever.

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£3 billion has been spent in setting up the new Clinical Commissioning Groups (CGCs). And this year £2.2 billion underspent is going back to the Treasury ...while hospitals are closing, reducing services, selling land and buildings...

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Ken Loach's Spirit of '45 was recently screened for MPs in Parliament. Three Labour MPs attended.

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It's not happening anywhere else in the UK other than England. Apparently Welsh NHS management are studying the imminent problem of English Health Tourists...

Advice given at the meeting was to write to Tory, Lib and Cross Bench Peers and Tory and LibDem MPs, i.e. ignore Labour.

Last chance of stopping it here: http://www.parliament.uk/edm/2012-13/1188

Templates here http://www.keepournhspublic.com/index.php

I've written to my MP Lynne Featherstone as follows:

Dear Mrs Featherstone,

National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations SI 2013/500 – Early Day Motion 1188
I am writing to you to urge you to sign EDM (1188) which prays against the amended regulations which were published on 11 March.  The Government withdrew the earlier regulations it had laid following the outcry which took place when it became clear that ministers promises to Parliament during the passage of the Health and Social Care Act 2012  were being broken.  In particular, the regulations removed from Clinical Commissioning Groups (CCGs) the promised right to make the choices they saw fit to make in your constituency and those of other MPs.
Careful reading of and legal advice on the amended regulations tells us that these regulations , just as before, will drive the NHS to privatisation, restricting the autonomy of the new local CCGs so that they will have no choice but to go out to competition.
 What are the key differences between the old and the new regulations, and what do the changes mean?
Regulation 2 now includes reference to CCGs being enabled to make contracting decisions which facilitate integration across health and social care services, but Counsel’s opinion is that this will be subordinate to Regulation 5 which will require CCGs to use competition for each particular NHS service, and they will not be able to use Regulation 2 to justify awarding a contract to an existing provider without competition.  They are not responsible for social care services so cannot include them in the contract.

Regulation 5 of the old regulations said that commissioners could only award a contract without competition in a case of extreme urgency not created by the commissioner or for narrow technical reasons.  This has been removed from the new Regulation 5, so it appears that commissioners have more scope to award a contract without competition.  However, they are still required to demonstrate that the service is only capable of being provided by one provider, and in effect the only acceptable proof of this will be putting the service out to tender.  Catch 22.

Regulation 10 now appears to give commissioners the right to engage in ‘anti-competitive behaviour’ if it is in the best interests of patients so to do.  This appears to be giving permission for CCGs to make arrangements with an NHS trust without competition.  This power would be likely to be challenged by other providers under competition law.  But also the Commissioners’ judgement on this would be subordinate to that of the regulator Monitor, and since that body is the driver of these competition changes, it is highly unlikely that it will permit such actions.  Deeply embedded in the thinking of economists and lawyers specialising in competition law is the belief that competition empowers consumers.  This may be true when consumers are buying simple products and cost and quality are clear, but it is clearly much more problematic to apply this thinking to a complex service where professional judgement plays such a key part.  Nonetheless, their interpretation of such phrases as ‘in the interests of patients’ is that this will always be best served by competition.

Many people applauded the apparent localism in the 2012 Act, giving the people who really know the local health service the power to direct its future.  These regulations snatch localism away by forcing CCGs into a straitjacket of competition law.  I believe they should have the right to use competition, or not, as they see fit, not according to the judgement of an unelected quango such as Monitor.

Please use all your best endeavours to ensure that these regulations do not get through, and sign up to EDM1188.

 

Yours faithfully

Tags for Forum Posts: NHS

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Thank you for the the link. Really informative.

Thanks so much for posting, Eugene. Much to think about. I'm hopelessly ignorant about the impending NHS changes.

It's scary, especially if you're depending on Labour to stop it...

Hi Billy,

Sorry for not coming back to you, I've been on Easter break. Yes, it was a very interesting and informative event to go to even though I principally went to along take photographs. But I stayed to listen. Regarding your point about "a fair and balanced view of events" - well there were no Conservatives or LibDems there and it's not unexpected not to have the Governing parties speaking against their own policy. I am getting to the that stage of my life where I'll probably start making more use of the NHS so I have a selfish interest in it's well-being. And I've started digging into this issue. So, "soon" will be "soon enough" as far as I'm concerned. As to "which treatments will be going", I haven't got a clue but maybe it'll depend on how many bedrooms I've got when the time comes. As to scaremongering, I'm in good company. Read the transcript provided by the BMJ that Maggie links to below.

In the interests of some balance here is the reply (to my email as per above) that I got from Lynne Featherstone, my MP, who thinks there’s nothing to worry about:

BEGIN: Thank you for your email with regards to Early Day Motion 1188. Unfortunately, as a Government Minister, I am prevented from signing EDMs.
 
However, I do appreciate your concerns about this issue, and I understand the strength of feeling that people have. I would like to start by saying that the Liberal Democrats are against privatisation of the NHS. We will never allow it to happen whilst we are in Government. I cannot speak for the Conservative Party, but even if they did want to implement measures that would privatise the NHS, the Lib Dems would block them.
 
This does not mean, however, that we shouldn’t make some changes. The fact is that we needed to update the commissioning regulations to bring them up to date, and in line with EU law. As you have mentioned,  procurement rules mean that services have to be competitively tendered except in very limited circumstances. We have widened the exemptions much further than the previous Government, giving CCGs more opportunities to select a sole provider. Additionally, I find it unlikely that private organisations would challenge the anti-competition rules, as these have effectively been in place for some time, and it would give extremely bad press for the private firm. However, if they did so, the Government would defend the regulations vigorously.
 
Regarding your concerns about Monitor, the changes to the Regulations put through by the Lib Dems mean that Monitor can no longer force competitive tendering. They are, however, able to stop  contracts if the commissioning was not transpired, it does not secure the patients’ needs, or it does not improve the quality of service.
 
Internal competition and private providers have been part of the NHS for several decades, and there is nothing new about their involvement. Whether the healthcare provider is from the public, private, or charitable sectors, the patient will be treated by the NHS, and they will not have to pay. We are committed to a NHS that is free at the point of use (i.e. paid through tax), and available to everyone. We are therefore making sure that CCGs are free to make their decisions in the best interest of the patient, focussing on integration, without having to tender if they feel it is unnecessary.
 
Thank you again for getting in contact about this very important issue. Please do not hesitate to get in touch if I can be of further assistance on this, or any other matter.
 
Kind regards,
 
Lynne Featherstone END.

I'm sorry, but her 'cut 'n paste' answer from Lib Dem HQ from is just not a good enough reply to the points I put to her. The govt position, as trotted out by Featherstone, seems to be that the opinion of very senior legal figures is in fact wrong, and the government is right - but they have not provided any legal basis for this view, and no legal opinion has been published to support them that I am aware of.

Where she says "I find it unlikely that private organisations would challenge the anti-competition rules, as these have effectively been in place for some time, and it would give extremely bad press for the private firm."  - well, the whole point of Monitors role in all of it, is that companies won't have to take a PR hit of suing the NHS. Monitor is stuffed with and led by KPMG and McKinsey alumni - they will gladly take CCGs to the cleaner on behalf of private healthfirms. The Lib Dems don't even appear to understand the gravity of what they are enabling here. Couldn't imagine her supporting this in opposition.  Thankfully not all LibDems think like her http://www.andrewgeorge.org.uk/campaign-to-protect-nhs-wont-stop-wi...

For one example of a what the interested private organisations think, see  http://www.passprocurement.com/events/event-in-focus-selling-to-nhs-2/ 

Note where they state "The event will also highlight the routes open to contractors to challenge any action which they believe to breach the principle of fair competition and will explain the options open to them to pursue such a claim."

I have a feeling you don't read Polly Toynbee, Billy. But if you can bear it, she makes some relevant points here http://www.guardian.co.uk/commentisfree/2013/apr/01/latest-cure-nhs...

But maybe you can afford to go private?

Eugene

Hi Billy, never suggested Polly as fair and balanced, just that she made some relevant points worth reading (imo). The problem for me is not really how soon but when -  as private companies start to take over the profitable bits of the NHS it becomes slowly and irreversibly privatised albeit still "badged" as NHS. Surely you don't want even a partially US Health system here? Do you really want your Doctor deciding to treat you on the basis of how much income it'll generate for him/her? Some Doctors/Nurses views here http://www.telegraph.co.uk/health/healthnews/9901194/Scrap-NHS-comp...

Eugene

Ah well, we'll have to agree to disagree then. Keep well.

Thanks for posting this, I was there too. Unfortunately there has been little news about the forthcoming changes so that many people are unaware that this new 'Section 75' (passed through The Commons and now going through the House of Lords) will enable privatisation of the NHS.
I strongly recommend people looking at the you tube link posted above, the video is long but if you value the NHS then it is well worth the effort. The BMJ are so convinced by the arguments in the video that they have printed an edited transcript onto their website http://www.bmj.com/content/346/bmj.f1848 (The transcript is not hidden behind the BMJ paywall).
On 21/03/13 the House of Lords said about Section 75 Regulations "It cannot be good or effective policy-making to seek their immediate implementation when they are so widely misunderstood". The Lords is the last hurdle before our NHS will be turned into a market where services can be bought and sold. If you want to try and influence their decision you can write to individual peers at the House of Lords.
PS The government is already looking for a buyer for our blood plasma service!

Obviously it can't be because the new Clinical Commissioning Groups have anything to hide.

So a genuine enigma. And, as enigmas often are, wrapped in a riddle; with its head tied in a sack stamped "Confidential" and "Exempt".

As mysterious and puzzling as the gagging clauses which prevent local Council staff speaking out. And which extend to local councillors who aren't allowed to write a blog, or speak to the media without permission. Or ask public questions other than those written for them by the party's Political Assistant, challenging the cabinet member for 'Y' to tell us what amazing progress has been made in service 'X'.

(Tottenham Hale ward councillor)

Thank you for this, very moving.  So many fought to make the NHS  happen and yet it is being dismantled with such ease by those, with power, but no wider community conscience. 

Did you know that the 999 People's March to Save NHS (walking from Jarrow to London) is joining/supporting the Peoples’ Assembly’s (non-party-political group) Demo this Saturday 21? http://www.thepeoplesassembly.org.uk/national_demo_21_june

Thanks for this modest and unassuming post Eugene, this is certainly a big issue that affects us all.

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