Repealing the Health and Social Care Act
by Mke Squires
Mon 13th May 2013
The last ditch attempt by the House of Lords to stop wholesale privatisation of the NHS has failed. The attempt by Lord Owen and others to prevent the Health and Social Care Act being used to force GPs, through the newly formed Clinical Commissioning Groups, into wholesale outsourcing of services was defeated. So what next for campaigners who want to retain an NHS, publicly funded and publicly provided?
The 1990 Health and Social Care Act, the brainchild of Margaret Thatcher, introduced an internal market into the NHS. It split the service into purchasers and providers.
As long as this purchaser-provider split is left in place, the NHS will be prone to privatisation. Private companies will always be ready to provide services to an NHS purchaser, particularly those services that are easy to perform with an attractive tariff attached.
The new legislation that came into force in April merely extends what was already there. Even if a future Labour government repeals the Health and Social Care Act, it will not be enough. The danger of wholesale privatisation remains. It may not be as quick, or as intense, and it may slow to a crawl, but the danger will still be there. Privatisation of health services has been an ongoing affair under both Labour and Tory governments since the 1990 Act began to bite.
Despite Labour’s 1997 General Election commitment to ‘abolish the market in healthcare’, it didn’t happen. Some may argue, how could it? and point to prominent Labour MP and former Health minister Alan Milburn sitting on the European Advisory Board of Bridgeport along with disgraced banker Lord Patten.
Bridgepoint is a equity Fund with extensive interests in private healthcare provision.
Not only were a few senior Labour politicians were in bed with the private health sector but many, particularly at senior levels in the party, felt that private companies could deliver better and more cheaply than the NHS itself. Hence there was no attempt or enthusiasm to honour the General Election pledge amongst the Labour leadership.
This lack of confidence in public provision of healthcare flies in the face of the British Medical Association’s advice and overlooks worldwide healthcare statistics which consistently show the NHS is one of the cheapest and most effective health services in the world.
We need to convince the Labour party to repeal the Health and Social Care Act should they win the next election. There must be a further commitment to abolish the purchaser-provider split. Until that time the NHS remains vulnerable to privatisation.
We need an NHS where all parts are working together and not in competition with each other. Integration between Health and Social Care would further enhance cooperation.
What do we do in the meantime?
As suggested by others we need to take full advantage of the limited opportunities available to us within the structures of the NHS.
We should put pressure on Clinical Commissioning Groups not to outsource services to the private sector.
The possibility of influencing policy on Foundation Trust (FT) hospitals is very limited. Despite all the talk about local accountability, FT hospitals are effectively run by unelected Boards of Directors.
We should also support our local ‘Keep Our NHS Public’ branches which have been at the forefront of campaigning against the dismantling and privatisation of our NHS.
We must undoubtedly campaign against the effects of the Health and Social Care Act but me the key to a permanent victory would be the abolition of the internal market. Without that the NHS will always be threatened with privatisation. If we want to safeguard an integrated health service for future generations Labour needs to bite the bullet and end the Thatcherite purchaser-provider split.