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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We don't need to build more prisons - we need to send fewer people there

The government talks a good game on prisons - but at the moment, the old failed policies hold sway

Some years ago the Howard League set up an independent expert review of what should happen to the penal system. We called it Do better, do less.

Too many governments have come in with enthusiasm for doing more, in the mistaken belief that this means better. We have ended up with more prisons, more prisoners, a bulging system that costs a fortune and blights lives. It is disappointing that the new regime appears to have fallen into the same old trap.

It is a big mistake to imagine that the justice system can be asked to sort out people’s lives. Prisons rarely, very rarely, turn people into model citizens able to get a great job and settle with a family. It is naïve to think that building huge new prisons with fewer staff but lots of classrooms will help to ‘rehabilitate’ people.

Let’s turn this on its head. There are more than 80,000 men in prison at any one time, and 40,000 of them are serving long sentences. Simply giving them a few extra courses or getting them to do a bit more work at £10 a week means they are still reliant on supplementary funding from families. Imagine you are the wife or partner of a man who is serving five to ten years. Why should you welcome him back to your home and your bed after all that time if you have hardly been able to see him, you got one phone call a week, and he’s spent all those years in a highly macho environment?

The message of new prisons providing the answer to all our problems has been repeated ad nauseam. New Labour embarked on a massive prison-building programme with exactly the same message that was trotted out in the Spending Review today – that new buildings will solve all our problems. Labour even looked at selling off Victorian prisons but found it too complicated as land ownership is opaque. It is no surprise that, despite trumpeting the sell-off of Victorian prisons, the one that was announced was in fact a jail totally rebuilt in the 1980s, Holloway.

The heart of the problem is that too many people are sent to prison, both on remand and under sentence. Some 70 per cent of the people remanded to prison by magistrates do not get a prison sentence and tens of thousands get sentenced to a few weeks or months. An erroneous diagnosis of the problem has led to expensive and ineffective policy responses. I am disappointed that yet again the Ministry of Justice is apparently embarking on expansion instead of stemming the flow into the system.

A welcome announcement is the court closure programme and investment in technology. Perhaps, in the end, fewer courts will choke the flow of people into the system, but I am not optimistic.

It is so seductive for well-meaning ministers to want to sort out people’s lives. But this is not the way to do it. Homeless people stealing because they are hungry (yes, it is happening more and more) are taking up police and court time and ending up in prison. We all know that mentally ill people comprise a substantial proportion of the prison population. It is cheaper, kinder and more efficacious to invest in front line services that prevent much of the crime that triggers a criminal justice intervention.

That does leave a cohort of men who have committed serious and violent crime and will be held in custody for public safety reasons. This is where I agree with recent announcements that prison needs to be transformed. The Howard League has developed a plan for this, allowing long-term prisoners to work and earn a real wage.

The spending review was an opportunity to do something different and to move away from repeating the mistakes of the past. There is still time; we have a radical Justice Secretary whose rhetoric is redemptive and compassionate. I hope that he has the courage of these convictions.

Frances Crook is the Chief Executive of the Howard League for Penal Reform.