Jos Bell reports on the latest criticism of health secretary Lansley's "fatally flawed" healthcare bill, from Lord Owen of.
“No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means” – Aneurin Bevan, In Place of Fear, 1952
The Health and Social Care Bill presents the coalition government with its biggest policy headache to date. Attacked by the British Medical Association and rattled by Liberal Democrat concerns, the coalition have been forced into delaying the bill and launching a “listening” process. They are left in a position described by Ed Miliband today as “utter confusion” on a bill he called a betrayal.
Lord Owen also joined the attacks today, confirming that he has written to the cabinet secretary to complain about the reforms. This follows on from his paper; ‘Yes to the NHS internal market – No to the External Market’, in which Owen criticised almost every aspect of Lansley’s bill. He has even called for the health secretary to be replaced.
Lord Owen is appalled at the destruction of PCTs, challenges Cameron and the coalition on betraying their election promises to preserve the NHS andstates that the bill will mean that the task of achieving integrated care will be even more difficult.
Speaking on Boulton and Co. today, Lord Owen said he was “a great advocate of the internal market” but:
“I believe that to go to an external market will do great damage…. It is basically treating health as another commodity… They (the coalition government) don’t even know if their new form of wording, “any qualified provider”, will invoke EU competition law.”
For a Tory party long concerned with any supposed EU interference this must create difficulties. Lord Owen also went on to question the legitimacy of aspects of the bill.
“They haven’t any legislative authority for this… They have no authority.
“You shouldn’t legislate in this chaotic fashion… I think there are far deeper issues in this legislation than we have realised… a lot of the democratic controls are going out the window.”
In his paper Dr Owen is unequivocal on the failings of the bill. He states that “for all its length the bill offers few insights into the purpose of the future NHS”.
Owen’s paper clearly differentiates between the manageable internal market and the predatory external market.
“The formation of an NHS European Office to deal, in part, with European Competition Law issues affecting NHS organisation should have been a warning sign.”
Lord Owen, a former health minister himself, goes to the nub of the conflict of interest, demonstrating that patient need will no longer be at the core of consultation, stating:
“The NHS in England as we know it will, under this bill, no longer maintain or even expect to provide a uniform national service.”
So much for the continuity of integrated pathways of care. Previous governments having always kept NHS tariffs at the core of purchasing policy. As Lord Owen points out:
“Providers would be able to undercut applicable NHS tariff prices – thus bringing competition into the core of our health system.”
As for the role of Monitor, Dr Owen decries the “abdication of the secretary of state’s responsibility for monies”.
Nor is Lord Owen alone in the line up of grandees who oppose the bill – we already know that Baroness Williams has delivered a barnstorming critique, also cross-bencher Baroness Mary Warnock and the surprise addition of Tory old boy Lord Norman Tebbit.
Tebbit has sharply criticised his own party’s front bench for arrogance and contempt, speaking up forcibly in support of the NHS, he alerts his party to the risks of patient cherry-picking, along with the sheer incapacity of the private sector to deal with complex cases. He summarises by saying that the only member of his family to receive private care is the dog.
In the final part of Lord Owen’s paper, he affirms that the bill will at the least have to be clearly amended across a range of areas – most particularly in matters of competition, conflict and medical ethics. He states “there must be no equivocation in this matter”. He also demands a slowing of the pace of the reforms, a second opinion from a Lords Bill Committee – and ends with:
‘The prime minister will hopefully act long before this happens in the summer and replace the existing health minister in the House of Commons and allow for fresh thinking and much less dogmatism.”
We can only hope that the emergency has been averted, enabling the Lords to take a six month review of the bill – the cross-benchers having clearly said that this is the only condition upon which they will admit it for a second reading. Meanwhile, for all of us involved in lobbying for the NHS, there must be no let up. Much of the bill has already been set in motion at arrogant variance with parliamentary protocol, and ongoing specialist advice.
The NHS needs our help if it is to survive in a form which will continue to support the health of all of our generations – present and future.
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