David Owen's NHS bill offers a final chance to save our health service

Labour and the Lib Dems must support a bill that restores the right of all citizens to comprehensive care.

David Owen has today published in full a bill in the House of Lords to reinstate the NHS and the secretary of state’s legal duty to provide a national health service throughout England. This duty has been in force since 1948 and is the legal foundation of the NHS and our rights and entitlements to health care, a duty the coalition’s Health and Social Care Act 2012 is abolishing.

Owen’s 'reinstatement' bill puts into reverse the monstrous 473 H&SC Act, which from April this year abolishes the NHS throughout England, reducing it to a stream of taxpayer funds and a brand or logo for the public bodies and private companies which will receive them. The bill does not entail yet more disruptive reorganisation, it simply restores the democratic basis of the NHS and the rights and entitlements of all citizens to comprehensive care; rights which were shredded by the 2012 Act.

As Owen has warned: "the NHS has remained by far and away the most popular public service because people sense rationing and restrictions are inevitable, and resources limited but that they value and recognise the fairness of those decisions being taken not by market forces or quangos but by some overall democratic, open, transparent decision-making."

This bill comes at an important moment. Next week, Health Secretary, Jeremy Hunt will determine the fate of Lewisham hospital and very soon the fate of many more hospitals as cuts and shareholders' profits bite deep into NHS budgets. By putting power into the hands of quangos, the government hopes to protect itself from the full force of public anger at the implementation of a four-year 'efficiency' plan expected to generate £20bn savings by 2014.

The plan, drawn up by US management consultants McKinsey on PowerPoint slides, the electronic equivalent of the back of a cigarette packet, has already led to the sacking of thousands of nurses and loss of services.

David Nicholson, the chief executive of the new NHS Commissioning Board, who appeared before the public accounts committee last week, warned of worse to come: "We are just going into a phase now where quite a lot of fairly contentious service change issues are surfacing." "Fairly contentious" makes a mockery of the scale of proposed losses and closures.

In north west London the government plans to cut 25 per cent of beds, and throughout London at least seven accident and emergency departments will close; 5,600 jobs in North West London will be lost by 2015, 4,000 in Merseyside, and thousands more in Rotherham, Devon and Cornwall, Bolton, and Portsmouth. Hospital closure and downgrading will take place in several major cities. Meanwhile, payments to private contactors continue to escalate, from those to management consultancies that have taken over from public officials, through expensive PFI deals involving payments that are contracted to rise each year, to outsourced services from which shareholders are seeking returns ranging from 15-25 per cent.

And yet the NHS returned over £2bn to the Treasury last year. Hospitals have deficits because the government chooses to load them with these costs, not because they are badly run. The government is manufacturing a financial crisis which is not of hospitals' own making.

The Health and Social Care Act legalises the break-up of the NHS under the efficiency plan. Some services will become the responsibility of local authorities and others will be the responsibility of private, for-profit firms; many services may no longer be provided free. For instance, mental health, immunisation and sexual health are being transferred to local authorities. Services for pregnant or breast-feeding women, for younger and older children, for the prevention of illness, even for the care of persons suffering from illness or needing after-care may no longer be mandatory parts of the free health service. In fact, pretty much everything is up for grabs.

MPs and the public have yet to realise that the Act will abolish the NHS by splitting up services in this way and removing the secretary of state’s control over provision. Unfairness has already been creeping in under existing rules. Two weeks ago the medical director of the NHS, Sir Bruce Keogh, admitted to the public accounts committee that for the last two years he has been "deluged by letters from people saying, 'This PCT isn’t paying for that', or that one PCT takes a different view on (entitlement of patients to) hip surgery or cataracts to another." We are outraged by the unnecessary pain this causes and authorities must be held to account for the denial of care. After April, when the Act is implemented, that will no longer be possible. Instead, a range of bodies not accountable to parliament, including for-profit companies, will decide which services will be freely available and who will receive them. That is no longer a national health service and people must understand that.

The coalition has deceived the public over the NHS. The Health and Social Care Act is not about making the service GP or patient-led, it is about abolishing the national service and transferring public funds and services to the private sector through a process of closure and the manufacture of a financial crisis. Loss of services coupled with new discretionary powers mean that people will be forced to pay out of their own pocket for more of their care. Owen’s bill exposes the truth behind the Act. For sixty years, the public , unlike their US cousins, had no fear of health care bills; this freedom from fear and commitment to the NHS model has stood the test of time. Will Labour and the Liberal Democrats support a Bill that restores the democratic and legal basis of the NHS and the principle of health care for all on the basis of need and not ability to pay?

Allyson Pollock is professor of public health policy and research at Queen Mary, University of London, and the author of NHS PLC

David Price is a senior research fellow at Queen Mary, University of London

Demonstrators protest against the proposed closure of the Accident and Emergency and maternity units at Lewisham hospital. Photograph: Getty Images.

 

Allyson Pollock is professor of public health policy and research at Queen Mary, University of London, and author of NHS PLC

David Price is a senior research fellow at Queen Mary, University of London

 

Getty Images.
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Tim Farron: We must not let racists hijack the EU referendum result

The Liberal Democrat leader says in an IPPR speech that "Britain is better" than "Farage, Le Pen and their ilk". 

Like so many people, I felt shocked and emotional about the result of the vote on 23 June.
 
I know many people who wept at the news.
 
I can understand that.​
 
Not because I love the specific institutions of the European Union, but because I feel European.
 
I also feel British. And English.
 
And northern.  And I don’t feel any conflict between those identities, in fact they reinforce each other.
 
But the result seemed to throw this balance into doubt.
 
And yes, I also felt angry.
 
I still feel angry now, but perhaps for a different reason.
 
Because never in recent history have we, in the political classes, let down the people of this country so disastrously.
 
And I make no distinction here between those who voted to Remain and those who voted to Leave.
 
They were battered with dodgy statistics. From both sides.
 
They were lied to.
 
On both sides too – though it is the NHS and the £350 million that particularly sticks in the throat.
 
And worse than that.
 
They were misled by lackadaisical politicians, playing games, who had campaigned for years to leave the EU – but hadn’t bothered to come up with a plan about what to do if it happened.
 
We, the political classes, have left a country bitterly divided as a result.
 
Between parents and children, families, neighbours.
 
Between the nations of our own union, who have worked and fought together for centuries.
 
Between us and our continental neighbours.
 
And now the biggest danger of them all.
 
That because of those divisions, we are in danger of letting malevolent forces hijack the result.
 
Plenty of my mates voted leave and I can tell you that the overwhelming majority of those who did vote leave are utterly appalled that Farage, Le Pen and their ilk now seek to claim the result as a victory for their hateful brand of intolerance, racism and insularity.  Britain is better than that.
 
But I’m not so blinded by those emotions that I don’t see the new divisions that are opening up between us.
 
New political boundaries which chop the old certainties of Tory and Labour into little pieces.
 
Because there’s a new battle emerging.
 
Between the forces of tolerant liberalism and intolerant, closed-minded nationalism.
 
And, of course, you know that, as leader of the Liberal Democrats, which side I’m on.
 
But I also know what side most people in this country are on too.
 
In the 48 per cent and also in the 52 per cent.
 
So let’s be clear about this.
 
I am absolutely committed to the cause of an open-minded, open-hearted United Kingdom.
 
United in every sense of the word.
 
Because, as Jo Cox said, we have more in common with each other in this country than what divides us. 
 
And, yes, I campaigned my heart out to stay a member of the European Union. And would do again given the chance.
 
But a nation divided against itself can’t stand.
 
Nor can it hammer out a way forward from the current impasse.
 
And our combined history cries out for some more inspiring political leadership.
 
Which can say that, in or out, we remain an open-minded, outward-looking nation.
 
Which can say, in or out, we will be European and British and from our own towns, villages and cities.
 
And be proud of all of them.
 
Which can say to those from other countries who have committed their lives alongside us in the UK: we will stand by you, no matter what.
 
Let me just say that again.
 
We will stand by you.
 
As we stood by each other across Europe in the Second World War.
 
We will stand by you, who have chosen British communities to live in.
 
Not only that but we need you.
 
If the tens of thousands of people who make it possible to run our schools and health service were to worry about our commitment to them...
 
So much so that it threatens their commitment to us...
 
It would seriously undermine services that are used by some of the most vulnerable people in this country.
 
The Conservative and Labour parties may have so forgotten themselves that they’ve missed this urgent consideration.
 
But we haven’t.
 
So I make this absolute promise.
 
To use what power we can muster, to make sure that those who have committed their lives and families to this country will be protected.
 
That no kneejerk populism will be allowed to threaten them or uproot them.
 
And I ask now all the many candidates for high positions in Westminster to join me in this undertaking.
 
I don’t just say this as the leader of a political party.
 
I don’t just commit my own party to this.
 
I speak as a Member of Parliament in one of the most open-hearted nations on earth.
 
I speak as a proud citizen of this country.
 
We will not stand by to let Nigel Farage or Marine Le Pen dictate our policy, our direction, or our morality.
 
So, yes, I campaigned to remain.  I’ll carry on campaigning to remain.
 
But we have gone beyond June’s referendum now.
 
There are more fundamental, more urgent issues that we must face today.
 
Existential issues about our nation.
 
About what they’re saying about us in the rest of the planet.
 
The newspapers.
 
The investors.
 
About protecting neighbours and friends born in other countries from hate.
 
So, yes, I recognise and understand the motivations of many of those who voted the other way to me.
 
I’m a white, working class, middle aged, northern male.  By voting remain, I pretty much confounded the predicted behaviour my demographic might suggest!  And for once it put me at odds with lots of the people I grew up with. 
 
Who are as proud as I am about the same things I’m proud of in our country.
 
I understand their fears for their own communities.
 
I completely get why being talked down to by Cameron and Osborne, threatened with a ‘punishment budget’ might push even the most internationalist person to vote leave! 
 
And nobody ever said the European Union was perfect. Least of all me.
 
Its aspiration of peace and co-operation in Europe is vitally important.
 
It still is.
 
But I’m aware that the reality of the EU can often be inflexible.
 
I understand that people’s liberal commitment to local communities, which I absolutely share, sometimes led them to vote differently to me.
 
I understand those who voted for Brexit and their frustration about the way that the big banks were allowed to torpedo the economy.
 
And torpedo so many people’s lives.
 
Without sanction. Without even a loss of bonuses.
 
While those who have tried to make a more tangible contribution their whole lives, have been sidelined, bullied and left behind.
 
I understand that, possibly better than any other leader.  Because whilst South Lakeland voted remain, it was the only place in Lancashire or Cumbria that did.  And I grew up in and I belong to the very part of British society that most heavily voted leave. 
 
And yes I understand their fears that their communities have been changed. Maybe even overwhelmed.
 
Not so much to satisfy Brussels, but specifically to reduce the wages of the big food manufacturers. 
 
Or the cleaning contractors.
 
Or the care homes.
 
Because what June’s vote did reveal, above everything else, is how angry people have become.
 
And though we might argue about the reasons for it, their anger is justified.
 
We have banking institutions that have let them down, suffocating their businesses.
 
We have an economic policy that favours the rich over everyone else, middle class, working class alike.
 
We have a housing crisis that’s consuming our children.
 
We have a Treasury so cut off from reality that they urged people not to vote for Brexit – because it might mean property prices would rise more slowly.
 
As if people weren’t struggling now to get a foot on the housing ladder.
 
To help their children scrape enough together to rent a place of their own.
 
We have people treated like cattle with zero-hour contracts.
 
We have those who worked as pillars of their community all their lives...
 
Running small businesses.
 
Managing farms...
 
Making a difference...
 
Only to see themselves gazumped by salaries ten or a hundred times as much by cash-hungry bankers in their twenties.  The devastation of our communities n the Lakes overwhelmed by excessive second home ownership is a case in point.
 
In short, we have an underlying, aching discomfort which goes to the heart of the reasons for the immediate crisis.
 
More than a discomfort.
 
It is a great and abiding fear, gnawing away at the heart of our society.
 
And we have a political class, which I don’t particularly like having to accept I’m a member of, which has abandoned people disastrously to their fate.
 
I believe that, in the national interest, we remainers and brexiters can most of us understand the motivations of voters on the other side to us.
 
We’re able to see beyond the stereotypes.
 
And to say together.
 
This open-minded nation will survive.
 
It will survive because these Liberal values are shared by so many of us. 
 
The right to say ‘this is who I am’. ‘This is who we are’.
 
And the enterprising commitment to challenge the big bureaucracies and the big businesses from below.
 
That’s why we will defend people wherever they came from originally.
 
Those who were born and bred here who are locked out of success by boneheaded cuts in adult education.
 
But also the Polish families who have work three jobs just to pay the rent, but who still help to run the school fete.
 
And the refugees who provide lynchpins to hospital after hospital from one side of the country to the other.
 
Right across the nation, and woven together, from Cornwall to Caithness.
 
Again, I say this not just as a party leader.
 
I don’t just say this to commit my party to it.
 
I say it as a proud citizen of this country.
 
With a shared history that’s always been outward-looking.
 
Connected through trade to other corners of the world in a way that no nation ever was before.
 
We provided the international language of the world.
 
We led the world in industrial development, moral development and scientific development.
 
And we stood up against tyranny even when it didn’t threaten us directly.
 
When all over Europe, those suffering under occupation, risked their lives to huddle around their wirelesses to listen to broadcasts from London.
 
There never was a moment in our history when we pulled up the drawbridge.
 
There never will be.
 
It just isn’t true that Britain voted to do that.
 
So that’s also my commitment as leader of the Liberal Democrats.
 
To listen to that fear and take it seriously. 
 
And then to hammer out and enact a more humane, more successful, more effective way of doing economics.
 
More challenging, more enterprising and more ambitious.
 
Which shares the rewards of success so that the state doesn’t have to step in so much.
 
To take on the real vested interests that hold us back as a nation.
 
The zero hour contractors.
 
The speculators.
 
The monopolists.
 
Those who would hijack people’s anger for their own racist agenda.
 
So that we can shape a fairer nation.
 
But also keep those outward-looking British values of tolerance and mutual respect that we all believe in.
 
Because there are going to be difficult, maybe dark, times ahead.
 
We’ve been made a laughing stock abroad.
 
We’ve had to watch the shaming pictures of Nigel Farage sneering on our behalf in the European Parliament.
 
We have to find a solution when both the biggest national parties have preferred to unravel than to take a lead.
 
But I’m a Liberal.
 
I believe in people.
 
And I especially believe in our people.
 
In their sense and their humanity, whether they voted to stay or to go.
 
People have been let down for decades by short-termist politicians who put the needs of one part of society above the rest.
 
Now, in the wake of the Brexit vote those divisions are more exposed than ever before.
 
With our country facing huge challenges…
 
– from inequality and injustice to an NHS in crisis and an economy in jeopardy –
 
…we are left with a reckless, divisive and uncaring Conservative Government and Labour fighting among themselves with no plan for the economy or the country.
 
That’s why the Liberal Democrats are needed more than ever.
 
We are the real voice of opposition to the Conservative Brexit Government and the only party fighting to keep Britain open, tolerant and united.
 
Britain is the most sophisticated and welcoming and innovative nation in the world and, in or out, we will stay that.
 
And we Liberal Democrats will do whatever we can, in Parliament and outside.
 
To reshape the way the nation works, to bring it back together.
 
To stay civilised. 
 
To stay united.
 
Because, wherever we were born, we love our country.​
 

Tim Farron is leader of the Liberal Democrats.