This was the Week the NHS Died, and No One Cares

Save the NHS: A Protest Outside Parliament, and a Public Meeting in Lewisham, a set on Flickr.

On Wednesday April 24, the House of Lords voted by 254 votes to 146 to dismiss a motion, proposed by the Labour peer Lord Hunt of Kings Heath, a shadow health minister, to prevent the passage of regulations relating to Section 75 of the Health and Social Care Act (the Tories’ wretched legislation for NHS reform, passed last year), which was sprung on an unsuspecting public back in February.

The reason I call this the week that the NHS died is because the regulations enforce competition on almost all NHS business, paving the way for private companies to swiftly and effectively dismantle it, cherry-picking services they can easily make profits out of, and cowing the newly appointed Clinical Commissioning Groups (the GPs responsible for 80 percent of the NHS budget), who will be afraid of ruinously expensive legal challenges if they dare to take on the private sector.

It is not strictly true, of course, that no one cares, but I stand by the necessity of such a provocative headline. In fact, a 38 Degrees petition was signed by over 360,000 people, but millions should have been on the streets since the Tories first announced their intentions to destroy the NHS. That, however, has never happened. On the night of the Section 75 motion last week, despite furious lobbying of peers, and some great speeches in support of the NHS (by Lords Hunt and Owen in particular), the last chance to block the legislation was lost.

This was a particular betrayal by the Lib Dem peers, not one of whom voted to save the NHS. As the Daily Mirror explained, “The move to throw out the regulations was backed by 114 Labour peers, 23 crossbenchers, six others and the Bishops of Bath and Wells and Bristol. The Government was supported by 173 Tories, 63 Lib Dems, 15 crossbenchers, the Bishop of Exeter, Ulster Unionist Lord Empey and Labour’s former health minister Lord Warner. Later analysis of division lists showed there were no Government rebels.”

Disgracefully, the Daily Mirror was one of the few media outlets in the UK that even bothered to cover the debate, quoting from Lord Owen (David Owen), an independent crossbench peer who was a foreign secretary in the Labour government in the 1970s, who, as the Mirror put it, warned that “the regulations were part of the erosion of the traditional NHS,” and that they “would leave the NHS unrecognisable within 20 years.”

As he told peers, “Don’t think this is a minor step. If this goes through the National Health Service as we have seen it, as we have believed in it, as we have persuaded the electorate that we support it, will be massively changed. It will take five, 10, 15, maybe 20 years, but unless we pull back from this whole attitude there will be no National Health Service that any of us can recognise.”

He added, “I for one feel tonight one feeling only — overwhelming sadness.”

Lord Hunt told peers that the regulations “could not be in the interests of patients,” as the Mirror put it. “Every day up and down the country a market is unfolding in the NHS,” he said, adding, as the BBC put it (in one of the only other reports in the British media) that the problem is that “they hold open the door to a competitive, marketised service in which I am afraid that … the interests of patients will be not first but last.” The Mirror also described how he “warned of the ‘fragmentation’ of NHS services and said the regulations removed the ‘discretion’ of commissioners to decide when to offer services out to tender.”

As he explained, “I believe we face the prospect of NHS services being placed in the middle of a costly bidding war with private companies, discrete services cherry-picked for profit while the NHS is left to run the more complex and expensive services but with less money.” He added, “How can that possibly be in the best interests of patients? It cannot — I believe we should reject this order.”

In response, health minister Earl Howe tried to claim that the law relating to competitive tendering had not changed “one iota,” and said that the regulations were designed to provide “safeguards,” and Lord Clement-Jones of the Liberal Democrats accused Lord Hunt of promoting “conspiracy theories,” but their protestations are unconvincing. Shamefully, far too many Lords have interests in the very companies that stand to make a financial killing from the privatisation of the NHS, and cannot be trusted. As the investigative journalist Andrew Robertson asked on Open Democracy on Wednesday, “Why, considering their extensive conflicts of interest, are many of these Lords not barred from voting?” The same question should also be asked of MPs.

Despite the apologists for Section 75 trying their best to hoodwink the public, the medical profession and their colleagues, the BMA (the British Medical Association) is one of numerous organisations that are unconvinced. Before the vote, the BMA stated that the regulations need to be replaced with new rules that “unambiguously reflect Government assurances that commissioners will not be forced to use competition when making their commissioning decisions.”

After the vote, Andy Burnham, the shadow health secretary, said, “It is sad that in this, the 65th anniversary year of the NHS, the unelected House has voted to undermine its founding principles and plant the free market at the heart of the NHS. David Cameron promised to put GPs in charge, but has instead forced them to carve open the NHS to full competition. He has put the NHS up for sale — without the permission of the British public. Labour will never give up this fight for the NHS and serves notice tonight on the Prime Minister that we will continue to oppose his NHS privatisation plans on the ground in every community. He cynically used the NHS to get into Downing Street but it becomes clearer by the day that it is simply not safe in his hands.”

Unfortunately, there is, as yet, no guarantee that, even if the Labour Party wins the next election, they will reverse the Tories’ butchering of the NHS, although I fully believe that, ravaged by the Tories — and by senior NHS management — in the years running up to the next election, the NHS will be a huge campaigning issue in 2015 as the cuts begin to bite.

*****

On Thursday, the day after the Lords vote, campaigners in Lewisham delivered an antidote to the bad news from the Lords, with a public meeting in the Great Hall of Goldsmith’s College, in New Cross, put together by the Save Lewisham Hospital campaign. The meeting was packed out, with hundreds of local campaigners turning up to have their say, and to listen to the speakers, Professor Colin Leys, an expert on the NHS and the co-author of The Plot Against the NHS, Dr. John Lister (of Health Emergency), Dr. Louise Irvine, the chair of the Save Lewisham Hospital campaign, Rachel Maskell of Unite, and Pat Smith of the Labour Party, who got a resolution to save the NHS passed at the Labour conference in October, and whose conference speech is here.

Despite health minister Jeremy Hunt approving plans to severely downgrade Lewisham Hospital in January this year, as part of outrageous proposals to bail out a neighbouring NHS trust, two judicial reviews challenging the legality of the decision are underway — one launched by Lewisham Council and the other by the Save Lewisham Hospital campaign. Further actions are also planned — the Hunt for Hunt, a trip to Jeremy Hunt’s Surrey constituency on June 15, and A Lewisham People’s Commission of Enquiry on June 29, chaired by Michael Mansfield QC.

Before that, however, there is a London-wide demonstration in support of the NHS taking place on Saturday May 18, which I hope people will attend. The demonstration begins at 12 noon in Jubilee Gardens (by the London Eye), followed by a march to the Department of Health and Parliament (sign up on the Facebook page here).

Note: For other opinions on Section 75, see these articles by Dr. Kailash Chand and Randeep Ramesh in the Guardian, and the concerns of a number of charities here on the website of Marie Curie Cancer Care. I hope to have time to look into other aspects of healthcare reform, but if I don’t get the opportunity, please check out this article on GP Online about how other existing legislation might help GPs defeat Section 75, and this Guardian article about the failings of Serco, a private contractor that has £300m worth of contracts in the health sector, which raises important questions about accountability.

Andy Worthington is the author of The Guantánamo Files: The Stories of the 774 Detainees in America’s Illegal Prison (published by Pluto Press, distributed by Macmillan in the US, and available from Amazon — click on the following for the US and the UK) and of two other books: Stonehenge: Celebration and Subversion and The Battle of the Beanfield. To receive new articles in your inbox, please subscribe to my RSS feed — and I can also be found on Facebook, Twitter, Flickr (my photos) and YouTube. Also see my definitive Guantánamo prisoner list, updated in April 2012, “The Complete Guantánamo Files,” a 70-part, million-word series drawing on files released by WikiLeaks in April 2011, and details about the documentary film, “Outside the Law: Stories from Guantánamo” (co-directed by Polly Nash and Andy Worthington, and available on DVD here — or here for the US). Also see my definitive Guantánamo habeas list and the chronological list of all my articles, and please also consider joining the “Close Guantánamo campaign”, and, if you appreciate my work, feel free to make a donation.