Healey seeks clarity on Lansley’s plans to turn NHS into a “genuine” market

Shadow health secretary John Healey MP to the Secretary of State Andrew Lansley MP seeking clarity on the coalition's plans to turn the NHS into a "genuine" market with price competition.

Below is the text of a letter sent by shadow health secretary John Healey MP to Secretary of State Andrew Lansley MP – released to Left Foot Forward


I am writing to seek clarity on your plans to turn the NHS into a “genuine” market with price competition.

The Health and Social Care Bill introduces a maximum rather than a fixed tariff, alongside the abolition of system management and the introduction of a full-blown market under EU competition law and commercial insolvency regime. These fundamental changes are of great concern to those who care about continuing the improvements of the NHS achieved under Labour. Experts and professionals from the BMA and NHS Confederation to the King’s Fund and London School of Economics have been particularly concerned about the plan to introduce price competition given the overwhelming evidence that it would lead to a race to the bottom, fragmentation of care and the destabilisation of high quality, highly-valued local services.

I was therefore interested and encouraged by recent communications from your Department denying the intention to introduce price competition under your reorganisation.

Sir David Nicholson, in a letter to the service on 18 February, wrote that

“There is no question of introducing price competition.”

His deputy, David Flory, emphasised on the same day that allowing managed flexibility on price did not mean a move to price competition:

“I want to stress that this flexibility is not intended to signal a move to price competition.”

Whilst I am aware you have tried to deny the intention, it is clear that introducing price competition was part of your purpose as long ago as 2005 when you told the NHS Confederation:

“It [price competition] will enable GPs, if they are budget-holders, to be able to purchase actively, including negotiating offers on quality or price that help them better to utilise their budget for their patients.”

Turning the NHS into a privatised utility market seems to have been your long-standing ambition.

[Minister of State] Simon Burns indicated your continued commitment to price competition in a full-blown market in a Newsnight interview on 19 January 2011, when he said:

“It is going to be a genuine market. It is going to be genuine competition.”

Price competition was also announced in your:

White Paper:

“Where price regulation is necessary, Monitor’s role will be to set efficient prices, or maximum prices, for NHS-funded services, in order to promote fair competition and drive productivity.” Equity and Excellence: Liberating the NHS, page 38

White Paper consultation:

“Monitor will be responsible for setting efficient prices, or maximum prices, for NHS-funded services, in order to promote fair competition and drive productivity.” Liberating the NHS: Regulating healthcare providers, page 16

Crucially, it is a central element of your legislation. Clause 103 sets out:

“(1) If a health care service is specified in the national tariff (as to which, see section 104), the price payable for the provision of that service for the purposes of the NHS is:

“(a) the price specified in the
national tariff for that service, or

“(b) where the national tariff specifies a maximum price for
that service, such price not exceeding that maximum as the commissioner and the provider
may agree.”

Of course, none of these plans were in your Manifesto or Coalition Agreement, but neither was the massive upheaval of the whole system.

Given the statements from your senior officials contradict your own views and legislation, you have a duty to make clear your intentions for the future market you are creating. As you know, I am committed to responsible opposition and will back Government moves that I believe will improve policy and the NHS for patients. If in the light of the chorus of criticism you have changed your mind on this matter, then clearly a change to the legislation is required and I look forward to Tory-led Coalition MPs on the front and backbenches supporting our amendments to the bill to prohibit competition on price.

I would also welcome your MPs’ support for Labour’s amendments to ensure that quality of care, integrated services and proper public accountability are put at the heart of the NHS, rather than the prime minister’s ideological “new presumption” that markets are better than democracy and clinically-led planning.

If, on the other hand, you intend to pursue this price competition as a key part of your plan to turn the NHS into a genuine market then I suggest you inform your officials, and expect the Opposition, along with independent experts and professionals, to continue to expose and oppose the deeply damaging results this will have for NHS services.

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30 Responses to “Healey seeks clarity on Lansley’s plans to turn NHS into a “genuine” market”

  1. j farrington-douglas

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  2. Ian Parker

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  3. Matt Horrocks

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  4. lewsosnhs

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  5. Shamik Das

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  6. lewsosnhs

    RT @shamikdas: RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  7. Rick Muir

    RT @leftfootfwd: Healey on nhs http://bit.ly/fiSW6v < spot on – no price competition, no presumption for markets, need accountability

  8. Ellie Gellard

    RT @leftfootfwd Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  9. Simon Blake

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  10. Political Animal

    http://is.gd/86Dpox Good stuff from Healey, but demonstrates clearly how complicating the issues is helping gvmnt get away with it on NHS.

  11. John Dilworth

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  12. Kelvin John Edge

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  13. Trevor Cheeseman

    This piece is spot on, namely : “the statements from [Department of Health] senior officials contradict [Lansley’s] own views and legislation” on price competition.

    This shambles reflects the confusion and nervousness about unleashing s msrket onto the NHS.

  14. Steve Kelly

    The Tories are liars. If John Healey believes them, then God help us.

  15. Mr. Sensible

    Steve, I don’t think Healey is indicating that he does believe them; he’s trying, I think, to get an understanding of who is actually in charge.

    Healey is entirely right. Marketizing health services in this way is definetly not what’s needed. The public don’t like it, doctors and nurses don’t like it, and even some of Lansley’s own MPs don’t really.

    And this sort of thing is the last thing the NHS needs given that Lansley has broken his promice to protect it.

  16. Ian Parker

    RT @shamikdas: RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  17. Freedom of Speech

    RT @BevaniteEllie: RT @leftfootfwd Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  18. Glenn Daltrey

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market http://bit.ly/eBqesF #savethenhs

  19. hlcheathrow

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market: http://bit.ly/fiSW6v

  20. Jackie Fleming

    Healey seeks clarity on Lansley’s plans to turn NHS into a “genuine” market http://bit.ly/eBA3F2

  21. 0iD

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market http://bit.ly/eBqesF

  22. Kelvin John Edge

    RT @0iD: RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market http://bit.ly/eBqesF

  23. Susan Ackroyd

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market http://bit.ly/eBqesF

  24. Broken OfBritain

    Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market | Left Foot Forward http://fb.me/IEdH1UXB

  25. Kelvin John Edge

    RT @BrokenOfBritain: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market | Left Foot Forward http://fb.me/IEdH1UXB

  26. annajnicholson

    RT @leftfootfwd: Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market http://bit.ly/eBqesF

  27. Powerbase

    Healey seeks clarity on Lansley's plans to turn NHS into a “genuine” market | Left Foot Forward http://ow.ly/44G5a

  28. Martin Rathfelder

    Lansley today is saying he’s going to amend the Bill to make it clear that there will not be competition on price. A very significant defeat.

  29. Lansley’s retreat on price completion for healthcare deceit | Left Foot Forward

    […] follows Labour health shadow John Healey’s letter last week, which sought clarity on this issue following conflicting statements between Lansley and […]

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