How did we end up in this mess? A majority of those who work for the NHS, at every level, and a majority of the public, believe that Andrew Lansley’s wretched NHS reform bill — technically, the Health and Social Care Bill, but more colloquially, and accurately, known as the NHS privatisation bill — should be scrapped, but the legislation appears to be unstoppable.
The latest group to oppose it was the the Royal College of Physicians (RCP), who, just last week, voted to stop the bill. 69% (6,092 respondents) rejected it in its current form, and, breaking that down, as the Guardian described it, “49% (4,386) said they wanted the RCP to ‘seek withdrawal of the bill,’ while slightly fewer — 46% (4,099) — said it should ‘continue to engage critically on further improving the bill.’” Typically, the Tories attacked the RCP findings, because only 35 percent of members had responded, but ministers should not forget that less than a quarter of the British people who were eligible to vote in the General Election in 2010 voted for the Tories, who clearly do not have a mandate for anything they are doing.
Lansley’s NHS bill was temporarily halted last spring for a “listening exercise,” after the first wave of antipathy towards it, and it has since been subjected to so many amendments that it doesn’t even make sense to healthcare professionals, but its central aim — of enforcing increased competition in the NHS — remains intact, and, as is clear from an examination of who stands to gain from it, it is not the patients, but the private companies with whom, of course, many in Parliament are far too intimately involved.
Mainly, however, the reason the bill still lives is that the Liberal Democrats haven’t finished it off, and although the party likes to claim that, in its coalition, it has been mitigating some of the worst Tory plans, in reality the Lib Dems have been facilitating the most savage assault on the fabric of the British state in living memory, a malignant ideologically driven project to attack the working poor, the unemployed and the disabled, to sell off whatever assets still remain in public control (Britain’s forests, for example), and to remove all funding for students of arts, humanities and the social sciences in our universities.
Today, the House of Lords has been given the last chance to ditch the government’s poisonous bill, and the reasons were eloquently spelled out in a short article for the Guardian on Saturday by Lord Owen, who has tabled a hugely important amendment, designed to halt the bill until the risks of the planned changes can be assessed. Helpfully, Lord Owen, in this and in previous commentary over the last week, has been pointing out how unconstitutionally the Tories have been acting, and how the Lib Dems have allowed themselves to be drawn into this damaging approach to government. This is the key passage for that:
There is a growing authoritarianism associated with this coalition government. The Conservatives did not win the 2010 election, yet they seem to forget this. Both coalition parties in the health and social care bill have gone way beyond their own agreement and in the process are defying the Liberal Democrats’ conference decision [when, last weekend, 59% of the Liberal Democrat delegates voted not to support the leadership’s position on the NHS].
Below is Lord Owen’s article, and following it, further criticism from the Labour peer Lady Thornton, and Baroness Jan Royall of Blaisdon, Labour’s shadow leader of the House of Lords.
Constitutional legitimacy has plagued the health and social care bill. The prime minister started by breaking an election pledge not to make yet another top-down reorganisation of the NHS. There is, therefore, no electoral mandate for the bill. He also pledged that there would be no further transfer of legislative powers to the EU without a referendum, but has nevertheless introduced health legislation that paves the way for unprecedented levels of EU interference in the NHS.
The coalition government objected within the Freedom of Information Act to my request to publish the latest (2006) legal advice to government on the implications for EU competition legislation of “any willing providers” competitively tendering across the board for NHS services. It was entitled to do so and the information commissioner upheld its view.
It also objected within the Freedom of Information Act to the disclosure of the transitional risk register covering the health and social care bill, but the information commissioner, supported by the first-tier tribunal, judged that this risk assessment should be published. On Monday before the scheduled debate on the third reading, the government will be asking the House of Lords to ride roughshod over these two judgments and not even give members time to read the judgment.
A whipped vote poses a direct challenge for Liberal Democrat peers who claim a proud record of championing the Freedom of Information Act. Peers know well that you cannot, with integrity, pick and choose between judgments. It is not acceptable to deprive the House of Lords before the third reading of the opportunity to read the detailed judgment of the chairman of the tribunal, Professor John Angel. Between now and the new parliamentary session on 9 May there is ample time for the detailed decision of the first-tier tribunal to be published, for the government to react, preferably by publishing the risk assessment, and also for debate on the third reading.
There is a growing authoritarianism associated with this coalition government. The Conservatives did not win the 2010 election, yet they seem to forget this. Both coalition parties in the health and social care bill have gone way beyond their own agreement and in the process are defying the Liberal Democrats’ conference decision. Meanwhile, the Royal College of Physicians, of which I am a fellow, has voted by 69% to reject the bill and only 6% to accept. A devastating verdict on the risk of going ahead with this legislation.
For the health and social care bill to become law on Tuesday, without at least the Lords and Commons knowing why the tribunal believes this particular risk assessment should be published, is a constitutional outrage.
Peers undoubtedly have different views on publishing the risk assessment, but this is not the issue in Monday’s debate. It is that members of both houses should have the opportunity to read the detailed arguments.
The way to block the bill will be to vote against the third reading, something rarely done but, in all the circumstances, fully justified.
Yesterday, another peer, Lady Thornton, Labour’s health spokeswoman in the Lords, joined in with her own last-minute appeal for the Lords to stop the bill. As the Guardian described it, she said the bill was “a triumph for Tory ministers who had seen Liberal Democrats ‘capitulate’ over the vexed issue of privatising the NHS,” adding that, “although the bill has been amended more than 300 times, its pro-market measures remain largely intact,” and the health service will, in her words, end up as “a terrible bureaucratic, expensive and fragmented NHS.”
In addition, she said, “This is an ideologically driven bill and the Lib Dems capitulated. Ministers lied to get it through. I know it’s unusually unparliamentary language but I am really horrified. They have sold us a pup.”
As the Guardian also noted:
Thornton will also put forward a motion asking peers to halt the bill. Such motions are rarely used, invoked only at times of high political drama. On the last occasion, peers were asked to oppose “that this bill do now pass” during the Blairite push to reform the House of Lords in 1998. Before that a similar vote took place during the Maastricht debates of 1993 that rocked the Major administration.
Lady Thornton said that such a vote — though rare — was justified because “it really was the last 48 hours to save the NHS”.
She was particularly angry at the Lib Dem peers Lady Williams and Lord Clement-Jones. As the Guardian also explained:
After weeks of working with the pair on defeating the government over the pro-competition parts of the bill, Thornton said the two had pulled out just before the crucial Lib Dem spring conference — where activists went on to win a motion declining to back the reforms and embarrassed the party leadership. Instead of shielding the NHS from the full force of EU competition law, Clement-Jones did a deal with the government so that ministers would offer a “strong statement” on the need to take patients’ interests into account — arguing that this would insulate the health service in court against legal challenge.
Thornton said a minister’s “strong statement” was not likely to be “worth much”, adding it would mean “the proposed protection comes when legal action starts to take place. I would prefer the protection to be in the bill to stop it ever getting to court.”
Echoing Lord Owen, she explained that the government had become “insouciant and arrogant” as the planned date for the bill to be accepted has approached.
Whether the intervention of Lord Owen and Lady Thornton will be enough remains to be seen. The clock is ticking on the NHS, as the crunch vote approaches. In another article soon, I’ll outline some of the other developments in the last week, which bring home the chilling reality of the government’s plans on the universal care of those who need it, but for now I’ll leave you with the words of Labour’s shadow leader of the House of Lords, Baroness Jan Royall of Blaisdon, who has just posted the following on the Labour Lords website:
Today is a critical day for the NHS. It is a day on which the Lords will have up to two final opportunities to have an impact on the future of the Health and Social Care Bill, a day on which because of the Coalition majority in the Commons, the fate of the NHS will pretty much be sealed.
As we know, the vast majority of health and social care professionals as well as the general public are against this Bill, as it will exacerbate the problems they are already experiencing as a result of the Nicholson challenge. But the Coalition is determined to plough its ideological furrow regardless.
It is not that the NHS will change radically overnight, because it won’t. We are already seeing the steady increase in waiting lists, more pressure on overburdened front line staff and, in some places, concerns that there will be a lack of health bureaucrats to cope with the new system. The most profound changes will be seen in a few years time when services have been fragmented, when hospitals will be competing rather than collaborating and caring, and when private companies — including foreign multinationals — will be making money from what should be a public service.
So I believe that we in the Lords have a duty today to firstly, support the motion by Lord Owen, which would ensure that the 3rd Reading would be deferred until Parliament has seen the Health Bill’s risk register. And if that motion should fail, we have a duty to what would essentially be a vote against 3rd Reading of this potentially damaging legislation.
In the Lords valiant efforts have been made to change the Bill and some remarkable changes have been made, for example in relation to education, training and research, but the most important changes were not agreed to and the Bill as it stands will lead to the break-up of what Crossbench peer Lord Hennessy has called “the closest we have ever come to institutionalising altruism.”
Note: It’s still not too late to contact members of the House of Lords to ask them to vote against the bill. Since last Wednesday, Dr. Éoin Clarke, on his blog The Green Benches, has been encouraging supporters of the NHS to contact members of the House of Lords to ask them to support Lord Owen’s amendment, and on Friday he also added contact details for the clergy in the House of Lords. Both calls involve an extraordinary little widget that makes it incredibly easy to contact the peers and bishops.
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, Digg and YouTube). Also see my definitive Guantánamo prisoner list, updated in June 2011, “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 new “Close Guantánamo campaign,” and, if you appreciate my work, feel free to make a donation.
In addition the the complaints above, the Guardian reported this morning:
Doctors were supposed to be at the heart of the reforms. But the British Medical Association today has come out to attack the reforms. Hamish Meldrum, Chairman of BMA Council, put out a statement asking for a rethink:
“Even at this late stage a number of peers are raising very serious concerns about this bill, which are shared by the BMA. Today is the last chance for peers to stop it and we would urge them to do the right thing — it is still not too late. The health and social care bill is not fit for purpose and it would be far better for the NHS if it were withdrawn. We want the government to work with healthcare professionals so an alternative solution can be developed, one which has the support of NHS staff and the public.”
On Facebook, Pauline Kiernan wrote:
Thank you Andy. Am sharing.
Thanks, Pauline. Good to hear from you — and thanks to everyone else who’s paying attention to this hugely important topic.
Lord Owen’s amendment has been defeated, but Andy Burnham has secured an emergency debate in the Commons tomorrow. More on this soon.
Pauline Kiernan wrote:
Andy – have posted your up to date post.
Thanks, Pauline. Another article will be along soon.
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