The Staggers

The New Statesman’s rolling politics blog

Lansley opens the door to full-scale NHS privatisation (Updated: no, he doesn't)

The 49% cap on private work done by NHS trusts will be abolished.

By George Eaton Published 13 July 2012 9:01

Health Secretary Andrew Lansley. Photograph: Getty Images.

Health Secretary Andrew Lansley plans to allow NHS trusts to raise 100% of their income from private treatments. Photograph: Getty Images.

Update 2: Just to clarify, this piece was based on a Financial Times story, which the Department of Health has told us is incorrect. The FT has silently changed the headline, standfirst and content of its story. However, we have decided to leave this piece online, with the relevant correction.

Update: The Department of Health has been in touch to say that the cap is not being removed, rather that the planned 49% limit will be introduced from 1 October 2012.

The spokesman added: "Services for NHS patients will still be protected as the Health and Social Care Act 2012 sets out that foundation trusts still have a core legal duty to provide services to them. The majority of their income must also come from NHS sources. Income from non-NHS sources will also be reinvested back into wider hospital services, to benefit NHS patients."

When the government unveils a policy change on a Friday it's a sure sign that it doesn't want you to notice. Today, Andrew Lansley will announce that the 49% cap on private work done by NHS hospitals, which his bill introduced, will be abolished. In other words, the Health Secretary has just opened the door to the full-scale privatisation of the NHS, with hospitals able to raise 100% of their income from private healthcare.

Sue Slipman, the chief executive of the NHS Foundation Trust Network, describes the removal of the cap as "a really creative way of bringing more money into the health service". What she doesn't say is that foundation trusts, in pursuit of profit, will likely prioritise the treatment and care of private patients over NHS ones. Since the most profitable procedures are usually the simplest, those requiring more complex treatment will be pushed to the back of the queue. As Howard Catton, head policy at the Royal College of Nursing, has previously warned: "NHS patients may feel a subtle pressure to reach for the credit card." Since all of the remaining 113 NHS trusts are required to become self-governing foundation trusts by April 2014, the removal of the cap will apply to all NHS services - hospitals, ambulances, mental health, community services and clinics.

What makes this change so unexpected is that Lansley's original plan to place no ceiling on private treatment was rejected under trade union and Liberal Democrat pressure. There are two possible explanations: either the Lib Dems signed off on the policy or they weren't told. Either is disastrous for their credibility.

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Tags: NHS Andrew Lansley

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26 comments

Fri, 2012-07-13 11:31 — ffhfhffh (not verified)

This is really sloppy journalism. Making such silly errors like this completely undermines many valid criticisms of the bill.

Fri, 2012-07-13 11:26 — Alex Baldwin

Oh, profanity filter, why must thou hinder the true expression of my feelings?

Fri, 2012-07-13 10:53 — Richard Blogger (not verified)

The Health and Social Care Act 2012 says that every Foundation Trust has to produce a strategy document to indicate its plans for the following year. The board of directors prepares this strategy document and they must "have regard to the views" of governors (27(3) of Schedule 7 of the 2006 Act amended by HSCA 2012). Since it is only to "have regard" this means that directors can ignore the wishes of governors, however, the strategy document must mention any non-NHS (ie private) activities that are planned and the expected income from those activities (section 164(3) of HSCA 2012 adds a new section 43(3B) to the 2006 Act).

Governors must decide whether these activities "interfere" with the trust's NHS work, and must inform the board of their decision (the Act does not say that directors have to act on governors' concerns, but governors can report a failure of governance at the Trust to Monitor if governors' concerns are ignored).

We really need move collective action from FT governors, they must reject *any* FT plans to increase private patients citing that the policy will "interfere" with the NHS work of the Trust and threaten them that if they do not act on the governors concerns they will report the Trust to Monitor for governance failure. Trusts are scared of Monitor because the new regulator can remove board members.

Fri, 2012-07-13 10:39 — Delwyn (not verified)

Errr... Is it me or does the update to this article directly contradict the original story? George?

Fri, 2012-07-13 11:03 — Dave Page (not verified)

That'll be why they slipped the update right to the bottom where it won't be read, and haven't changed the headline.

Fri, 2012-07-13 10:36 — Sally smith (not verified)

How can the Lib Dems continue to prop up these monsters? The tories just laugh in their face. Yesterday the tories refused to back Lords reform, today they ignore the deal on the NHS.

Remember all those silly naive Lib Dems telling us they were "putting in safe guards" waste of time. The lib Dems are either the most stupid, spinless bunch of morons or they are closest tories. The rank and file need to pull these bastards down.

No wonder all the tories banged the cabinet table when Clegg refused to kill the NHS bill. They have wanted to destroy the NHS for years, and they did not even have to put it into their manifesto or the coalition agreement. They just had to look for a sucker to give them cover, and along bumbled Clegg.

Fri, 2012-07-13 10:58 — Dave Page (not verified)

And now it turns out to be untrue... looks like those "safeguards" were real.

Fri, 2012-07-13 10:08 — Ian on the Hill (not verified)

Plotting Sue Slipman's move to the right my curve predicts that next year she will have to grow a tiny moustache and comb her hair forwards.

It's amazing that these mandateless scumbags can start to smash the NHS, all the while denying it with fake sincerity, and the press just lets it slip by. Where is the outcry? Easy. there isn't one because they lie about it and slip it though as bureaucracy. not un-mandated policy change.

might be worth remembering that a major reason that so many trusts are financially screwed is because of Tories putting rings through their noses and placing them in massive debts via PFI frauds.

Fri, 2012-07-13 10:47 — Dave Page (not verified)

Hmm, pretty sure most of the PFI debt to hospitals happened under Labour, not under the Tories... Gordon liked to keep this massive chunk of high-interest debt off the Government balance sheet using this dirty accounting trick.

Fri, 2012-07-13 10:02 — Raymond Kelly (not verified)

The other side of this is the unwillingness of this government to fund any increased spending from National Insurance, forcing NHS trusts/CCG's to turn to providing funds by doing private work.

Fri, 2012-07-13 09:46 — Peter McGlade (not verified)

I have a 14 month-old son. He is in perfect health and I am grateful for it.

Lansley may just have condemned him to death for some future illness.

I can't express how this makes me feel.

Fri, 2012-07-13 09:55 — Will Slater (not verified)

I'm pretty shocked an horrified that only the FT and NS have realised this!!

Fri, 2012-07-13 09:45 — Will Slater (not verified)

This has just lost the Tories the North, even more so than before. Lib Dems, goodbye you backstabbing and lying c**ts

Fri, 2012-07-13 09:45 — Rolo Tamasi

I'm interested to understand why this claims simple operations are more profitable than complex ones. In all other areas the reverse is generally true as complexity is a barrier to competition and thus increases margins.

Can anyone explain please?

Fri, 2012-07-13 09:57 — Wintermute (not verified)

The answer is two fold:

1. It's quicker to do, therefore more patients can be seen in a day.

2. There's less support, equipment and staff needed. Some operations require the patient to be sent to ITU straight after which costs thousands of pounds a night.

Dr. Keir Shiels has done a VERY good YouTube video on the matter:

http://www.youtube.com/watch?v=zssLG-pRnEM&feature=youtube_gdata_player

Fri, 2012-07-13 09:39 — Grumpy Bob (not verified)

I think that the Sue Slipman of 1977 vintage, when she was a communist NUS president, would be appalled at the statement you report her as making. Her career trajectory described on her Wikipedia page is interesting in this context.

Fri, 2012-07-13 09:38 — hugh markey (not verified)

Let's not prevaricate. Andy we know has a senior Civil Service pension funded by the taxpayer.
Does the Secretary( can't type a word) hold a private pension part-funded by that old-reliable funder of last resort - Mr Taxpayer?
There's a lot of medicos in the public sector sharpening their knives and hoping for a response.
Surely, Andy will not go private! Or his ever-loving family? Needs looking into.

Dr Giggles

Fri, 2012-07-13 09:45 — Livers (not verified)

This post is a good example of why we need a rating system for comments here.

Fri, 2012-07-13 09:28 — Guillermo (not verified)

Two very old men meet at a coffee shop, one was a priest and the other a retired construction worker. As it had been a long time since they met last they spoke about their lives for the last 10 years. When they were leaving they shook hands and the priest kindly said, "god keeps you healthy" to what the other men replied, thank you old friend, but just in case let's keep the NHS working.

Fri, 2012-07-13 09:27 — Lil (not verified)

Is this shambles of a 'government' really trying to push us towards revolution? Certainly feels like it!

Fri, 2012-07-13 09:26 — TheGilb. (not verified)

What an absolute piece Lansley is

Fri, 2012-07-13 09:21 — Livers (not verified)

It is a scandal. Where are the BBC in all this?

Fri, 2012-07-13 11:05 — MarkP (not verified)

As the update to the New Statesman's story (see the foot of the story above) basically says, "The story is all wrong", perhaps the BBC were checking the facts and realised that... :)

(Kudos though to the New Statesman for the clear update.)