The Government has broken a critical promise on the NHS

A new regulation means that every service commissioned will have to be open either to competitive tendering or the Any Qualified Provider system.

“The NHS is safe in our hands”, the government has been proclaiming - and it promised last year that it wouldn't be forcing competition into the new system for commissioning services.

Yet, surreptitiously, Jeremy Hunt has introduced in the National Health Service (Procurement, Patient Choice and Competition) Regulations 2013 (S.I., 2013, No. 257) - a regulation that does just that. Every service commissioned, with a very small number of exceptions, will have to be open either to competitive tendering or the Any Qualified Provider system. These are bureaucratic, dull-sounding, words, which could have a huge impact.

Unless there's a big public and parliamentary outcry, this fundamental change to the NHS will open almost every aspect of the NHS to the foreign multinational healthcare companies and money-draining, staff-exploiting ways. And it is a massive broken promise. A widely publicised letter from then Health Secretary Andrew Lansley on 16 February 2012, issued as the Health and Social Care Bill struggled to get through parliament, said: "It is a fundamental principle of the Bill that you as commissioners, not the Secretary of State and not regulators, should decide when and how competition should be used to serve your patients’ interests."

Jeremy Hunt has just spectacularly broken that promise - and he must not be allowed to get away with it.

Under his plan the regulator Monitor will be able to decide when commissioners have breached competition regulations, will be able to set aside contracts and impose competitive tendering and the offer of Any Qualified Provider. Green MP Caroline Lucas is with Ed Miliband jointly proposing a “prayer” (that’s the official form – and a further argument for modernisation of parliamentary procedure), that if it wins sufficient parliamentary support could at least force parliament to debate the regulations. (Please email your MP to ask them to back it – EDM No 1104.)

Public opposition is also going to be important – please sign the 38 Degrees petition.

If allowed the come into effect, the damage caused by these regulation will be almost irreversible, since once our much-valued local hospitals and services are broken up, it would take an immense amount of money to re-establish them.

Moving towards an American-style system, immensely expensive, profit-driven, which doesn't put the needs of patients first, is an ongoing disaster (we’ve already gone far too far down this road, and been seeing the consequences) and this is a big step on the accelerator towards that.

I’m delighted that Green Party spring conference last weekend strongly backed an emergency motion opposing Jeremy Hunt’s regulation, and restating our commitment to a publicly owned and publicly run NHS.

The Hunt regulations are part of a broader government direction that’s clearly driven by ideology. This government has a simple mantra – private good, public bad. Despite the fact that we know that outsourcing is a disastrous, expensive model that delivers poor services and slashes wages, this government is wedded to this ideology – just as is far too much of the top bureaucracy of the NHS, who either come from the private health sector, or are the glossy recipients of mediocre MBAs, who’ve learnt a few neo-liberal management mantras and know nothing else.

The NHS is a world-admired system, which despite the damage done by the marketising trend that started under Margaret Thatcher and was enhanced by Tony Blair’s Labour, still provides for the vast majority of Britons superb quality healthcare, which they receive independent of their financial status. The system is under strain, with our ageing population, increasingly expensive medical technology and massive drug company profits. And it is under attack from a rightwing media that’s backing the privatising agenda.

We do need to make improvements, particularly to focus more on prevention than treating people when they’re ill, and ensure that perverse incentives and bad management don’t produce more Mid Staffs, but bleeding off billions in profit to multinational health companies is not only financial madness, it will also result in huge damage to the service we all receive – and all need.

Natalie Bennett is the leader of the Green Party of England and Wales and a former editor of Guardian Weekly.

Jeremy Hunt. Photograph: Getty Images

Natalie Bennett is the leader of the Green Party of England and Wales and a former editor of Guardian Weekly.

Photo: Getty Images
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I'm far from convinced by Cameron's plans for Syria

The Prime Minister has a plan for when the bombs drop. But what about after?

In the House of Commons today, the Prime Minister set out a powerful case for Britain to join air strikes against Isil in Syria.  Isil, he argued, poses a direct threat to Britain and its people, and Britain should not be in the business of “outsourcing our security to our allies”. And while he conceded that further airstrikes alone would not be sufficient to beat Isil, he made the case for an “Isil first” strategy – attacking Isil now, while continuing to do what we can diplomatically to help secure a lasting settlement for Syria in which Assad (eventually) plays no part.

I agreed with much of David Cameron’s analysis. And no-one should doubt either the murderous barbarism of Isil in the region, or the barbarism they foment and inspire in others across the world.  But at the end of his lengthy Q&A session with MPs, I remained unconvinced that UK involvement in airstrikes in Syria was the right option. Because the case for action has to be a case for action that has a chance of succeeding.  And David Cameron’s case contained neither a plan for winning the war, nor a plan for winning the peace.

The Prime Minister, along with military experts and analysts across the world, concedes that air strikes alone will not defeat Isil, and that (as in Iraq) ground forces are essential if we want to rid Syria of Isil. But what is the plan to assemble these ground forces so necessary for a successful mission?  David Cameron’s answer today was more a hope than a plan. He referred to “70,000 Syrian opposition fighters - principally the Free Syrian Army (FSA) – with whom we can co-ordinate attacks on Isil”.

But it is an illusion to think that these fighters can provide the ground forces needed to complement aerial bombardment of Isil.  Many commentators have begun to doubt whether the FSA continues to exist as a coherent operational entity over the past few months. Coralling the myriad rebel groups into a disciplined force capable of fighting and occupying Isil territory is a heroic ambition, not a plan. And previous efforts to mobilize the rebels against Isil have been utter failures. Last month the Americans abandoned a $500m programme to train and turn 5,400 rebel fighters into a disciplined force to fight Isil. They succeeded in training just 60 fighters. And there have been incidents of American-trained fighters giving some of their US-provided equipment to the Nusra Front, an affiliate of Al Qaeda.

Why has it proven so hard to co-opt rebel forces in the fight against Isil? Because most of the various rebel groups are fighting a war against Assad, not against Isil.  Syria’s civil war is gruesome and complex, but it is fundamentally a Civil War between Assad’s forces and a variety of opponents of Assad’s regime. It would be a mistake for Britain to base a case for military action against Isil on the hope that thousands of disparate rebel forces can be persuaded to change their enemy – especially when the evidence so far is that they won’t.

This is a plan for military action that, at present, looks highly unlikely to succeed.  But what of the plan for peace? David Cameron today argued for the separation of the immediate task at hand - to strike against Isil in Syria – from the longer-term ambition of achieving a settlement in Syria and removing Assad.  But for Isil to be beaten, the two cannot be separated. Because it is only by making progress in developing a credible and internationally-backed plan for a post-Assad Syria that we will persuade Syrian Sunnis that fighting Isil will not end up helping Assad win the Civil War.  If we want not only to rely on rebel Sunnis to provide ground troops against Isil, but also provide stable governance in Isil-occupied areas when the bombing stops, progress on a settlement to Syria’s Civil War is more not less urgent.  Without it, the reluctance of Syrian Sunnis to think that our fight is their fight will undermine the chances of military efforts to beat Isil and bring basic order to the regions they control. 

This points us towards doubling down on the progress that has already been made in Vienna: working with the USA, France, Syria’s neighbours and the Gulf states, as well as Russia and Iran. We need not just a combined approach to ending the conflict, but the prospect of a post-war Syria that offers a place for those whose cooperation we seek to defeat Isil. No doubt this will strike some as insufficient in the face of the horrors perpetrated by Isil. But I fear that if we want not just to take action against Isil but to defeat them and prevent their return, it offers a better chance of succeeding than David Cameron’s proposal today. 

Stewart Wood is a former Shadow Cabinet minister and adviser to Ed Miliband. He tweets as @StewartWood.