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.

Nicola Sturgeon. Photo: Getty
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For the first time in decades, there is genuine dissent in Scottish Nationalist ranks

The First Minister is facing pressure to talk less about independence - and bring on new talent in her party.

She so recently seemed all-powerful, licensed to reign for as long as she chose, with the authority to pursue the return of our national sovereignty. We would then have the ability to strike our own deals on our own terms, a smaller, smarter, leaner nation freed from the stifling constraints of partnership with a much larger neighbour. There was, she repeatedly told us, nothing to be afraid of.

Now, suddenly, she is the victim of her own miscalculation: having misread the public mood, having raced too far ahead of moderate opinion, she finds herself at bay. The voters have delivered a public humiliation, while an opposition party until recently lampooned as unelectable is on the march. There is, suddenly, talk of her departure sooner rather than later.

Yes, this is a tough time to be Nicola Sturgeon…

Let’s not overstate it. The position of Scotland’s First Minister is considerably more secure than that of the UK’s Prime Minister. Theresa May wants out as soon as is feasible; Sturgeon, one suspects, will have to be dragged from Bute House. Sturgeon retains enough respect among the public and support among her colleagues to plough on for now. Nevertheless, things are not what they were before the general election and are unlikely ever to return to that happy state.

It’s all because of Scexit, of course. Sturgeon’s unseemly sprint for the indy finishing line left enough Scottish voters feeling… what? Mistreated, taken for granted, rushed, patronised, bullied… so much so that they effectively used June 8 to deliver a second No vote. With the idea of another referendum hanging around like a bad headache, the electorate decided to stage an intervention. In just two years, Sturgeon lost 40 per cent of her Westminster seats and displaced half a million votes. One could almost argue that, by comparison, Theresa May did relatively well.

For the first time in decades, there is genuine dissent in Nationalist ranks. Tommy Sheppard, a former Labour Party official who is now an influential left-wing SNP MP, published an article immediately after the general election calling on the First Minister to ‘park’ a second referendum until the Brexit negotiations are complete. There are others who believe the party should rediscover its talent for the long game: accept the public mood is unlikely to change much before the 2021 devolved elections, at which point, even if the Nats remain the single largest party, Holyrood might find itself with a unionist majority; concentrate on improving the public services, show what might be done with all the powers of an independent nation, and wait patiently until the numbers change.

There are others – not many, but some – who would go further. They believe that Sturgeon should take responsibility for the election result, and should be looking to hand over to a new generation before 2021. The old guard has had its shot and its time: a party with veterans such as Sturgeon, John Swinney and Mike Russell in the key jobs looks too much like it did 20 years ago. Even the new Westminster leader, Ian Blackford, has been on the scene for donkey’s. There are more who believe that the iron grip the First Minister and her husband, SNP chief executive Peter Murrell, have on the party is unhealthy – that Murrell should carry the can for the loss of 21 MPs, and that he certainly would have done so if he weren’t married to the boss.

The most likely outcome, given what we know about the First Minister’s nature, is that she will choose something like the Sheppard route: talk less about independence for the next 18 months, see what the Brexit deal looks like, keep an eye on the polls and if they seem favourable go for a referendum in autumn 2019. The question is, can a wearied and increasingly cynical public be won round by then? Will people be willing to pile risk upon risk?

As the hot takes about Jeremy Corbyn’s surprise election performance continue to flood in, there has been a lot of attention given to the role played by young Britons. The issues of intergenerational unfairness, prolonged austerity and hard Brexit, coupled with Corbyn’s optimistic campaigning style, saw a sharp rise in turnout among that demographic. Here, Scotland has been ahead of the curve. In the 2014 referendum, the Yes campaign and its can-do spirit of positivity inspired huge enthusiasm among younger Scots. Indeed, only a large and slightly panicked defensive response from over-65s saved the union.

That brush with calamity seems to have been close enough for many people: many of the seats taken from the Nats by the Scottish Tories at the general election were rural, well-to-do and relatively elderly. The modern electorate is a fickle thing, but it remains rational. The Corbynites, amid their plans for total world domination and their ongoing festival of revenge, might bear that in mind.

Chris Deerin is the New Statesman's contributing editor (Scotland). 

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