Baroness Thornton, along with three other Labour peers, has introduced an amendment to the health and social care bill going through the House of Lords, that aims to embed in legislation a full description of the principles of the NHS.
It asks for the following to be inserted into the bill at the start:
Principles of the Health Service in England:
(1) Any person or body performing functions or exercising powers under this Act in relation to the Health Service in England must have regard to the principles and values outlined in the NHS Constitution.
(2) Any person or body performing functions or exercising powers under this Act in relation to the Health Service in England, or providing services as part of the Health Service in England, must provide quality, equity, integration and accountability, not the market.
(3) The primacy of patient care shall not be compromised by any structural or financial re-organisation of the Health Service in England.
(4) There must be transparency and openness wherever taxpayers’ money is being spent, and all accountable individuals and bodies should abide by the Nolan principles.
(5) “The Nolan principles” means the seven general principles of public life set out in the First Report of the Committee on Standards in Public Life.
(6) Schedule (Principles of the Health Service in England) has effect.
Each of these principles puts into law claims independently made by the coalition. It is a document built from their own words, and if they vote against it they will be recanting their rhetoric to keep their bad bill law.
Principle one brings the NHS constitution into the bill, in the same way as it was in the 2009 health act.
In 2009, Andrew Lansley said:
“We will put the NHS at arms length from politicians, with a strong Constitution to make sure the core values of the NHS are protected.”
Principle two is a reworking of the motion carried at the Liberal Democrat’s spring conference, when they moved to commit the Government to an NHS that:
i) Is genuinely centred on patients and carers.
ii) Achieves quality and outcomes that are among the best in the world.
iii) Refuses to tolerate unsafe and substandard care.
iv) Puts clinicians in the driving seat and sets hospitals and providers free to innovate, with stronger incentives to adopt best practice.
v) Is more transparent, with clearer accountabilities for quality and results.
vi) Is more efficient and dynamic, with a radically smaller national, regional and local bureaucracy.
vii) Gives citizens a greater say in how the NHS is run.
Principle three brings in the famous claim in the coalition agreement to be against any top down reorganisation.
The original says (pdf):
We will stop the top-down reorganisations of the NHS that have got in the way of patient care. We are committed to reducing duplication and the resources spent on administration, and diverting these resources back to front-line care.
Finally, principles four and five incorporate the government’s response to the ‘future forum’ – Lansley’s ‘listening exercise’. The Nolan principles are rules regarding exercise of public power, and are needed to prevent the conflicts of interest we highlighted earlier this month.
The future forum response says (pdf):
Commissioning groups will be required to have governance arrangements consistent with Nolan principles, and will be held to account for this on an ongoing basis.
All that remains to be seen is if the coalition will betray their own words while they betray the NHS.
• Second reading of NHS bill offers a second chance to kill it – Alex Hern, October 6th 2011
• Northern Ireland health workers strike over budget cuts – Ed Jacobs, October 6th 2011
• UK Uncut: Stop the traffic to stop the NHS being run over – Tim Holmes, October 7th 2011
• Wales to see increase in health spending as Lansley accused of dismantling NHS – Ed Jacobs, October 5th 2011
• Can Lansley be trusted with the NHS? 400 more experts say NO – Shamik Das, October 4th 2011
• Lib Dem MP tells Lords: How the NHS bill needs to be changed – Andrew George MP, September 21st 2011
• Lib Dem activists face reality about their MPs’ NHS vision – Trevor Cheeseman, September 20th 2011