Last week appeared to be another good week for those opposing the Tory-led coalition government’s disastrous and entirely unwanted NHS reform bill, although no one should be fooled, as the government is still determined to press ahead with its terrible plans, even though wrecking the NHS will almost certainly cost them the next election.
First up was the matter of the e-petition launched by Dr. Kailash Chand OBE, a GP and chair of Tameside and Glossop Primary Care Trust. Simply entitled, “Drop the Health Bill,” the e-petition “[c]alls on the Government to drop its Health and Social Care Bill,” and, at the time of writing, it has been signed by 172,483 people, and is open for signatures until May 16.
This is good news, of course, although in order for it to count for anything, the Labour leader Ed Miliband — and shadow health secretary Andy Burnham — had to force David Cameron to honour a promise he made to the British people, and to Parliament. As Jonathan Reynolds, the Labour MP for Stalybridge and Hyde, and parliamentary private secretary to Ed Miliband, explained in an article four days ago:
In the run-up to the last general election, David Cameron promised that Parliament would debate and vote on any issue if it had the backing of more than 100,000 people. But that promise was broken in February — when I was refused parliamentary time to debate the future of the government’s Health and Social Care Bill.
An e-petition – calling on the government to drop the controversial bill – was started by respected health professional Kailash Chand OBE, who lives in the Stalybridge and Hyde constituency. When I stood before Backbench Business Committee, the e-petition had already been signed by more than 162,000 people. Yet despite widespread backing — including members of the Labour Party, the Green Party, the SDLP, the DUP and the Liberal Democrats — the application for the debate was refused. […]
David Cameron made his promise to devote parliamentary time to any issue that was backed by 100,000 people because he wanted to show that he would listen; he wanted to show that he was in touch. But his determination to railroad through the Health and Social Care Bill shows that he will not listen – not to the Royal Colleges, not to the patients, not to the healthcare unions and not to the tens of thousands of people who have signed the petition.
Of course David Cameron made another important promise in the run-up to the general election — he promised that there would be no more top-down reorganisation of the NHS. Despite his reassuring words, the Health and Social Care Bill marks the biggest reorganisation of the NHS since its launch in 1948.
On Thursday, the voices of Dr. Chand, and over 170,000 others, were finally acknowledged by the Prime Minister. As Pulse reported, “pressure from shadow health secretary Andy Burnham has secured a slot for the Drop the Bill debate and vote next Tuesday (March 13th). It will effectively form a last-ditch attempt by Labour and rebel Liberal Democrats to delay the bill, currently before the House of Lords and expected to reach the statute book on March 20th.”
In response to the news, Dr. Chand said he was “delighted” because the public was “sleepwalking into a disaster.” As Pulse described it, he said the debate “was necessary to make people aware of what would happen to the NHS under the bill.” As Dr. Chand explained, “It’s a recipe not just for a postcode lottery but for a taxcode lottery in that the treatment you get will depend on how wealthy you are. It will be down to what insurance you have.” He added that the issue was “not about party politics,” and pointed out that he was “a long-term critic of the Labour party — as well as a supporter.” As he noted, “I’m a socialist — but it’s not necessarily about party politics.”
Andy Burnham had spoken about Dr. Chand’s e-petition — and the 170,000 people that the Prime Minister proposed to ignore — at a “Save our NHS” rally at Westminster Central Hall on Wednesday, attended by “[t]housands of nurses, midwives, doctors, physiotherapists, cleaners, porters and other NHS workers,” as the Guardian explained, also noting:
Speaker after speaker stressed their love and admiration for the NHS and its unique place in national life. “It’s more popular than the BBC and more popular than the royal family,” said Dave Prentis, the general secretary of Unison. Kailash Chand … demanding the scrapping of the bill, said it was “the finest achievement of the 20th century”.
Vikki Mills, who is experiencing plenty of NHS care as she is pregnant with twins, said she had been told that her babies may be born prematurely and need special care. “My care is based on my needs,” she said, before warning that the coalition’s plan to let NHS hospitals raise as much as 49% of their income from private patients could lead to a two-tier NHS, with some patients getting better care than others simply because they were paying for it. […]
Nye Bevan’s famous dictum that the NHS would survive for as long as there was people left to fight for it was invoked over and over again, gaining applause every time.
On Thursday evening, there was further bad news for the government, when, by 101 votes to 70, the Royal College of Surgeons agreed that the bill would “damage the NHS and widen healthcare inequalities, with detrimental effects on education, training and patient care in England,” although, as the Guardian described it, ”members held back from the dramatic step of backing its withdrawal. While 76 agreed that the college should ‘publicly call for withdrawal of the health and social care bill’, 99 disagreed.”
On Friday, there was further bad news for the government, when it lost an appeal against the release of its own risk assessment regarding the proposed NHS reforms. In November, as I explained at the time, the Information Commissioning Office (ICO) found that the Department of Health “had twice breached the Freedom of Information Act in not disclosing the document and the strategic risk factor associated with the NHS reforms contained therein,” as the website Practice Business explained.
Although the Information Commissioner, Christopher Graham, ordered the release of the strategic risk register in November, the government appealed, but has now lost its appeal, rejecting claims made by representatives of the Department of Health, at a two-day hearing last week, at which witnesses for the Department of Helath argued “for it to be kept private lest it set a precedent that would undermine government departments’ ability to assess the risks of pursuing particular policies,” as the Guardian explained.
As the Guardian also noted, “Campaigners — including Labour and key medical bodies such as the British Medical Association and the Royal College of Nursing — have argued that it must be released so that peers debating the health and social care bill can have the full information needed to scrutinise it properly.” In addition, Labour MP John Healey, who first sought publication of the register in 2010 when he was shadow health secretary, wrote a follow-up article for the Guardian in which he debunked the government’s claims about publication of the risk register establishing a dangerous precedent. As he explained:
Despite the apocalyptic arguments made in court in defence of the government, this is not a decision that will bring the civil service system of risk management to a full stop, nor will this lead to the routine disclosure of government risk registers. The tribunal’s judgment, and the information commissioner’s earlier decision, is based on my argument that the transition risk register for the NHS reorganisation is a case apart. The scale and speed of such a huge NHS upheaval is unprecedented, and the public interest in understanding the risks is exceptional.
Risk has been at the heart of the concerns surrounding the NHS reforms from the outset. Lack of evidence and confidence about how well the government was prepared to manage the risks of the biggest reorganisation in NHS history during the tightest financial squeeze on health funding since the 1950s was a major cause of growing professional, public and parliamentary alarm at the plans in November 2010, when I first made my FoI request.
The failure of ministers to provide a fuller explanation and reassurance has fuelled the chorus of criticism and opposition ever since. They simply can’t see what the NHS means to people, how much it matters. We all need the NHS; we trust it when we are most fearful. We utterly depend on it when we are most vulnerable. This is why the public interest in such massive NHS changes is so strong.
Unfortunately, despite the ever-increasing opposition to NHS reform, the Liberal Democrats have failed to seize the initiative presented to them, and have refused to demand an end to the bill at their spring conference this weekend, even though more than 270 delegates voted in favour of an emergency motion to “kill the bill.”
How significant is this? Well, as Ben Goldacre, the doctor and journalist, explained succinctly in a comment on Twitter today, “is this a F*CKING PLAYGROUND? … Senior LibDem sources say if party votes to drop the health bill it would be ‘a Labour win.’”
In a blog post, Goldacre also highlighted how close we are to the death of the NHS as we know it, introducing an important article in the British Medical Journal (PDF) by Allyson Pollock, a professor at the Centre for Primary Care and Public Health, Queen Mary, University of London, David Price, a senior research fellow at QMUL, and Peter Roderick, a public interest lawyer, with the following urgent request:
I strongly recommend you read this … You may possibly begin to understand why the Royal College of GPs, the Royal College of Physicians, the Faculty of Public Health, the Royal College of Nursing, and the rest, are all against the bill. They believe it will harm patient care. They’re correct.
I may be biased, since my political affiliation is “floating voter”, but I really don’t think this is an issue on which it’s okay to simply be politically partisan, and worry about whose party is whose. This bill stands out alone as something very important, life changing for all of you, and it really does need to be stopped if at all possible. I honestly don’t think you can afford the alternatives.
You can find your MP here, and write to them.
In conclusion, here’s the opening paragraph of that BMJ article, in which experts — as opposed to the ideologues in the government — present the main problems with the bill:
Entitlement to free health services in England will be curtailed by the Health and Social Care Bill currently before parliament. The bill sets out a new statutory framework that would abolish the duty of primary care trusts (PCTs) to secure health services for everyone living in a defined geographical area. New clinical commissioning groups (CCGs) will arrange provision of fewer government funded health services and determine the scope of these services independently of the secretary of state for health. They may delegate this decision to commercial companies. The bill also provides for health services to be arranged by local authorities, with provision for new charging powers for services currently provided free through the NHS (clauses 1, 12, 13, 17, and 49), and it will give the secretary of state an extraordinary power to exclude people from the health service. Taken together the measures would facilitate the transition from tax financed healthcare to the mixed financing model of the United States.