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

 

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Richmond is a victory for hope - now let's bring change across the country

The regressives are building their armies. 

Last night a regressive alliance was toppled. Despite being backed by both Ukip and the Conservative Party, Zac Goldsmith was rejected by the voters of Richmond Park.

Make no mistake, this result will rock the Conservative party – and in particularly dent their plans for a hard and painful Brexit. They may shrug off this vote in public, but their majority is thin and their management of the post-referendum process is becoming more chaotic by the day. This is a real moment, and those of us opposing their post-truth plans must seize it.

I’m really proud of the role that the Green party played in this election. Our local parties decided to show leadership by not standing this time and urging supporters to vote instead for the candidate that stood the best chance of winning for those of us that oppose Brexit. Greens’ votes could very well be "what made the difference" in this election (we received just over 3,500 votes in 2015 and Sarah Olney’s majority is 1,872) - though we’ll never know exactly where they went. Just as importantly though, I believe that the brave decision by the local Green party fundamentally changed the tone of the election.

When I went to Richmond last weekend, I met scores of people motivated to campaign for a "progressive alliance" because they recognised that something bigger than just one by election is at stake. We made a decision to demonstrate you can do politics differently, and I think we can fairly say that was vindicated. 

There are some already attacking me for helping get one more Liberal Democrat into Parliament. Let me be very clear: the Lib Dems' role in the Coalition was appalling – propping up a Conservative government hell bent on attacking our public services and overseeing a hike in child poverty. But Labour’s record of their last time in office isn't immune from criticism either – not just because of the illegal war in Iraq but also their introduction of tuition fees, privatisation of our health service and slavish worship of the City of London. They, like the Liberal Democrats, stood at the last election on an austerity manifesto. There is a reason that we remain different parties, but that doesn’t mean we shouldn't also seize opportunities like this to unite behind what we have in common. Olney is no perfect candidate but she has pledged to fight a hard Brexit, campaign against airport expansion and push for a fair voting system – surely progressives can agree that her win takes us forward rather than backwards?

Ultimately, last night was not just defeat of a regressive alliance but a victory for hope - a victory that's sorely needed on the back of of the division, loss and insecurity that seems to have marked much of the rest of this year. The truth is that getting to this point hasn’t been an easy process – and some people, including local Green party members have had criticisms which, as a democrat, I certainly take seriously. The old politics dies hard, and a new politics is not easy to forge in the short time we have. But standing still is not an option, nor is repeating the same mistakes of the past. The regressives are building their armies and we either make our alternative work or risk the left being out of power for a generation. 

With our NHS under sustained attack, our climate change laws threatened and the increasing risk of us becoming a tax haven floating on the edge of the Atlantic, the urgent need to think differently about how we win has never been greater. 

An anti-establishment wave is washing over Britain. History teaches us that can go one of two ways. For the many people who are utterly sick of politics as usual, perhaps the idea of politicians occasionally putting aside their differences for the good of the country is likely to appeal, and might help us rebuild trust among those who feel abandoned. So it's vital that we use this moment not just to talk among ourselves about how to work together but also as another spark to start doing things differently, in every community in Britain. That means listening to people, especially those who voted for Britain to leave the EU, hearing what they’re saying and working with them to affect change. Giving people real power, not just the illusion of it.

It means looking at ways to redistribute power and money in this country like never before, and knowing that a by-election in a leafy London suburb changes nothing for the vast majority of our country.

Today let us celebrate that the government's majority is smaller, and that people have voted for a candidate who used her victory speech to say that she would "stand up for an open, tolerant, united Britain".  But tomorrow let’s get started on something far bigger - because the new politics is not just about moments it's about movements, and it will only work if nobody is left behind.

 

Caroline Lucas is the MP for Brighton Pavilion.