A private member’s bill that proposes undoing the worst excesses of Andrew Lansley’s unpopular NHS reforms has caught a mood
Former health secretary Andrew Lansley. If the bill to repeal his reforms went through it would be ‘a parliamentary mea culpa of historic proportions’. Photograph: Stefan Wermuth/Reuters
This week the same MPs who voted Andrew Lansley’s unpopular Health and Social Care Act through parliament, despite the warnings that it would distract, weaken and potentially even wreck the NHS, have a chance to undo at least some of the damage that both Westminster and the NHS’s equivalents of the dogs in the street know it has done. On Friday they will debate and vote on Labour MP Clive Efford’s National Health Service (amended duties and powers) bill, a private member’s bill which will receive its second reading.
Among what Efford regards as the many ill-advised, reckless or self-evidently negative changes the 2012 Act involved, he has one key target – the huge expansion in competition it brought to the NHS, with a concomitant expansion in the privatisation of clinical services previously provided by the NHS.
“The bill wouldn’t repeal the entire Health and Social Care Act. But it cuts the heart out of it. It would repeal some of the worst elements of it that impose market forces on the NHS,” explains the MP for Eltham in south-east London, who is better known as the shadow sports minister. For example, it would replace the health sector regulator Monitor’s duty to promote tendering with an obligation to promote integration of services.
Its 14 clauses would also repeal “section 75”, the clause in Lansley’s legacy that enforces the compulsory tendering of all NHS contracts, which came into force last year. It removes the ability of hospitals to earn 49% of their income from private patients. New figures last weekend showed that such income has risen 10% overall since 2010 with, for example, the specialist Royal Brompton and Harefield trust growing its revenue from that source from £24.3m in 2010-11 to £33.6m in 2013-14.
It would also exempt the NHS from the EU-US trade treaty, currently being negotiated in secret, known as the Transatlantic Trade and Investment Partnership (TTIP), which could open up NHS services to competition permanently, including from US healthcare firms. The coalition’s refusal to seek such an opt-out would be trumped by the new law specifying that TTIP does not affect the NHS. And it would restore the health secretary’s responsibility for the NHS, something Lansley watered down. Crucially, says Efford, his bill would reassert parliament’s sovereignty over the NHS.
The Royal College of Nursing, a persistent critic of Lansley’s “unnecessary and chaotic reorganisation”, has welcomed the bill as an opportunity to undo the damage. Lord Owen, the ex-Labour health secretary who tried to pilot two similar bills through last year, praises its “imaginative and constructive proposals”. The British Medical Association is broadly supportive, though worried that an over-powerful health secretary could introduce even more political interference in the NHS.
If it became law – few private member’s bills ever do – Efford’s bill would amount to a parliamentary mea culpa of historic proportions. If the coalition had made meaningful rather than cosmetic changes to Lansley’s law at the time, Efford’s effort would not be needed. But the admission by an unnamed cabinet minister last month that the act was this government’s greatest folly (quoted on the front page of the Times) and the fact that 44% of the public think the NHS is under threat from private health companies suggests Efford’s bill has caught a mood.
Efford says: “There will be plenty of Labour MPs in the Commons on Friday [a day MPs are usually in their constituences rather than Westminster] and I’ve got no indication that there’s a whipping operation to stop it, so the government has accepted that it can’t win the vote”.
Are any coalition MPs who backed Lansley’s bill likely to now back Efford’s? “Not so far. I suspect that they are all too embarrassed that they supported this incredibly unpopular piece of legislation that people want repealed,” he says.