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
Show Hide image

After Richmond Park, Labour MPs are haunted by a familiar ghost

Labour MPs in big cities fear the Liberal Democrats, while in the north, they fear Ukip. 

The Liberal Democrats’ victory in Richmond Park has Conservatives nervous, and rightly so. Not only did Sarah Olney take the votes of soft Conservatives who backed a Remain vote on 23 June, she also benefited from tactical voting from Labour voters.

Although Richmond Park is the fifth most pro-Remain constituency won by a Conservative at the 2015 election, the more significant number – for the Liberal Democrats at least – is 15: that’s the number of Tory-held seats they could win if they reduced the Labour vote by the same amount they managed in Richmond Park.

The Tories have two Brexit headaches, electorally speaking. The first is the direct loss of voters who backed David Cameron in 2015 and a Remain vote in 2016 to the Liberal Democrats. The second is that Brexit appears to have made Liberal Democrat candidates palatable to Labour voters who backed the party as the anti-Conservative option in seats where Labour is generally weak from 1992 to 2010, but stayed at home or voted Labour in 2015.

Although local council by-elections are not as dramatic as parliamentary ones, they offer clues as to how national elections may play out, and it’s worth noting that Richmond Park wasn’t the only place where the Liberal Democrats saw a dramatic surge in the party’s fortunes. They also made a dramatic gain in Chichester, which voted to leave.

(That’s the other factor to remember in the “Leave/Remain” divide. In Liberal-Conservative battlegrounds where the majority of voters opted to leave, the third-placed Labour and Green vote tends to be heavily pro-Remain.)

But it’s not just Conservatives with the Liberal Democrats in second who have cause to be nervous.  Labour MPs outside of England's big cities have long been nervous that Ukip will do to them what the SNP did to their Scottish colleagues in 2015. That Ukip is now in second place in many seats that Labour once considered safe only adds to the sense of unease.

In a lot of seats, the closeness of Ukip is overstated. As one MP, who has the Conservatives in second place observed, “All that’s happened is you used to have five or six no-hopers, and all of that vote has gone to Ukip, so colleagues are nervous”. That’s true, to an extent. But it’s worth noting that the same thing could be said for the Liberal Democrats in Conservative seats in 1992. All they had done was to coagulate most of the “anyone but the Conservative” vote under their banner. In 1997, they took Conservative votes – and with it, picked up 28 formerly Tory seats.

Also nervous are the party’s London MPs, albeit for different reasons. They fear that Remain voters will desert them for the Liberal Democrats. (It’s worth noting that Catherine West, who sits for the most pro-Remain seat in the country, has already told constituents that she will vote against Article 50, as has David Lammy, another North London MP.)

A particular cause for alarm is that most of the party’s high command – Jeremy Corbyn, Emily Thornberry, Diane Abbott, and Keir Starmer – all sit for seats that were heavily pro-Remain. Thornberry, in particular, has the particularly dangerous combination of a seat that voted Remain in June but has flirted with the Liberal Democrats in the past, with the shadow foreign secretary finishing just 484 votes ahead of Bridget Fox, the Liberal Democrat candidate, in 2005.

Are they right to be worried? That the referendum allowed the Liberal Democrats to reconfigure the politics of Richmond Park adds credence to a YouGov poll that showed a pro-Brexit Labour party finishing third behind a pro-second referendum Liberal Democrat party, should Labour go into the next election backing Brexit and the Liberal Democrats opt to oppose it.

The difficulty for Labour is the calculation for the Liberal Democrats is easy. They are an unabashedly pro-European party, from their activists to their MPs, and the 22 per cent of voters who back a referendum re-run are a significantly larger group than the eight per cent of the vote that Nick Clegg’s Liberal Democrats got in 2015.

The calculus is more fraught for Labour. In terms of the straight Conservative battle, their best hope is to put the referendum question to bed and focus on issues which don’t divide their coalition in two, as immigration does. But for separate reasons, neither Ukip nor the Liberal Democrats will be keen to let them.

At every point, the referendum question poses difficulties for Labour. Even when neither Ukip nor the Liberal Democrats take seats from them directly, they can hurt them badly, allowing the Conservatives to come through the middle.

The big problem is that the stance that makes sense in terms of maintaining party unity is to try to run on a ticket of moving past the referendum and focussing on the party’s core issues of social justice, better public services and redistribution.

But the trouble with that approach is that it’s alarmingly similar to the one favoured by Kezia Dugdale and Scottish Labour in 2016, who tried to make the election about public services, not the constitution. They came third, behind a Conservative party that ran on an explicitly pro-Union platform. The possibility of an English sequel should not be ruled out.  

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.