The House of Lords has backed regulations promoting privatisation of NHS services in England. An Opposition attempt to overturn the NHS (Procurement, Patient Choice and Competition) (No. 2 Regulations 2013) was defeated by a ruling Coalition majority of over a hundred votes. Holders of NHS budgets are likely to be forced to put more services out to tender, giving lucrative opportunities to private firms even if this harms patient care.
The House of Lords has backed regulations promoting privatisation of NHS services in England. An Opposition attempt to overturn the NHS (Procurement, Patient Choice and Competition) (No. 2 Regulations 2013) was defeated by a ruling Coalition majority of over a hundred votes. Holders of NHS budgets are likely to be forced to put more services out to tender, giving lucrative opportunities to private firms even if this harms patient care.
The government originally made out that its reforms would give more power to GPs, who have a leading role in new clinical commissioning groups, and patients. But many were unconvinced, fearing that commissioners would be increasingly be forced appoint providers through competitive bidding.
When the Regulations were published, many reacted strongly, and ministers promised to amend them. As a House of Lords Secondary Legislation Scrutiny Committee warned in February 2013, “Rather than the more generalised duty not to be anti-competitive that the health sector evidently expected, these regulations require the wider use of competitive tendering in the procurement of most services.”
Competition could be avoided if only one provider could adequately deliver a particular service. However the Committee pointed out that “Any supplier who has not been awarded the contract will have a clear incentive to challenge the procurement process.” There were fears that “focusing on competition, particularly price competition, will make quality standards a secondary consequence and may lead to inequalities in provision… Almost every one of the submissions received conveys the belief that the provisions of these Regulations are at variance with ministerial statements made during the passage of the then Health and Social Care Bill”.
The government, while claiming that critics of the Regulations were wrong, modified these slightly. However, according to David Lock QC, who provided legal advice to campaign group 38 Degrees, “The changes between the first and second version of the Regulations will not materially affect the impact of these Regulations in practice. These Regulations play fast and loose with the NHS by turning it into a giant experiment for those committed to a certain right wing ideology.”
Clare Gerada, Chair of the Royal College of General Practitioners, warned that: “The new reforms of which these regulations are a key part remove the legal framework for a universal, publically provided, publically managed, publically planned, democratically accountable health service.”
NHS services valued by local communities now risk being destabilised and patient interests overridden by those of healthcare firms. The changes to the healthcare system, and how they have been introduced, raise serious moral questions about the type of society that is being created.
While NHS as well as private providers can offer a poor service, this can be even harder to identify and correct when contractors are involved, while profits can take money away from care. A recent National Audit Office report on the provision of the out-of?hours GP service in Cornwall by private company Serco revealed serious problems that had not been picked up until whistleblowers raised the alert. In addition “there is only a weak link between financial incentives and achieving the requirements. The clinical commissioning group has questioned whether the contract will give it sufficient ability to challenge Serco as robustly as it might wish as the commissioner of the service.” Such problems are likely to become increasingly common.
However opponents of privatisation are unlikely to give up. Over 300,000 people signed a petition against the Regulations. Resistance is likely to grow as the cost of putting profits for a few over health for many become clearer. Justice cannot be suppressed for ever.
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(c) Savitri Hensman is a regular Christian commentator on politics, social justice, welfare and religion. She works in the care and equalities sector and is an Ekklesia associate.