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.

Getty
Show Hide image

Theresa May wants a Global Britain? Then stay in the single market

The entrepreneur Lord Bilimoria argues the Prime Minister risks both the prosperity and reputation of the UK. 

Since coming to the UK as a student in the early 1980s, I have witnessed the shattering of its glass ceiling and the birth of one of the world’s most enterprising nations. Much of this progress is now under threat due to the great uncertainty Brexit is causing.

It has been six months since the referendum, and we are still presented with no clear strategy except a blind leap of faith out of the single market. By continuing to pursue a closed and inward-looking Brexit, Theresa May risks both the prosperity and reputation of this country. 

Last week I joined with thirty other entrepreneurs and business leaders in urging the Prime Minister to keep Britain within the EU single market. In the coming months Mrs May will face having to make a trade-off between immigration control and loss of single market access. The decision she makes will determine whether we retain much of our economic strength. 

That is why I was disappointed to see May’s most recent comments simply reinforcing the message that the government is pursuing a "hard" Brexit. Over the weekend her big interview sent the pound plunging – yet again. 

It is clear the government is solely focused on delivering stricter immigration regulation, regardless of whether it leaves Britain stranded outside the single market. To fall into the trap of calling the PM "Theresa Maybe" masks the decisive nature of her emerging strategy – which is to head for the hardest of exits.

We know that neither Council President Donald Tusk nor chief negotiator Michel Barnier will accept access to the single market without freedom of movement being part of the deal. This is incompatible with the vision set out by the government.

Yet, movement and access to the single market are vital to the future interests of British business. The PM must do more to reassure those set to be affected. We are currently part of a 500m-strong single market; this is good for British business. Although I believe the whole of Europe needs to reform the current free movement of people, not least for security reasons, we nevertheless must continue to have the ability to move freely within the EU for tourism, business and work.

It is becoming unequivocally clear that the PM is willing to pay any economic price to achieve stricter immigration controls for political gain. Driven by the fear that the far-right will use immigration in future election battlegrounds, the issue of immigration is undermining our ability to negotiate an exit from the EU that is in the best interest of businesses and the nation as a whole. 

The government’s infuriating failure to prioritise continued movement of people means we are set to lose a hugely competitive edge, reducing access to talented employees, and undermining the UK’s rich history of an open, diverse, and welcoming nation.  

To achieve the government’s absurd immigration control, we will have to leave the European single market. In doing so 44 per cent of our exports, the current percentage that go to Europe, will be jeopardised, as they will no longer have free access to their original markets. 

In tandem with an exit from the world’s largest single market, British business will also lose access to one of the strongest international talent pools. This has the potential to be even more devastating than the forfeiture of markets and trade.

Access to skilled workers is critical to future success. As a nation we have the lowest level of unemployment in living memory with less than 5 per cent currently out of work, and that’s in spite of 3.6m people from the EU working in Britain.

Britain will continue to need the expertise that free movement currently provides, regardless of whether Brexit happens or not. You cannot simply replace the skilled doctors, nurses or teachers living and working here overnight. 

The focus on immigration has also strayed into more dangerous territory with the government persisting in including international students as immigrants when calculating net migration figures, whilst having a target to reduce net migration to the tens of thousands. The PM’s insistence on this policy not only stifles encouragement of talent flows, but also sends an incredibly negative message to the international community. It is a policy that I have continually called on the PM to change and I will continue to do so.

Our competitor countries, the United States, Canada, and Australia, do not categorise international students as immigrants and, in fact, they also provide generous incentives to stay in their countries to work after graduating. In comparison, we removed our popular two year post-study work visa in 2012.

Brexit poses an increasingly dangerous reality that we are destined to be viewed as an inward-looking, insular and intolerant nation. That is not the Britain I know and love. That is not the Britain that has attracted enterprising individuals. The UK needs to establish itself once more as an outward-facing nation that welcomes international talent and entrepreneurship. This starts with retaining membership of the single market.  

Lord Karan Bilimoria is a leading British businessman and the founder of Cobra Beer.