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
Show Hide image

The future of policing is still at risk even after George Osborne's U-Turn

The police have avoided the worst, but crime is changing and they cannot stand still. 

We will have to wait for the unofficial briefings and the ministerial memoirs to understand what role the tragic events in Paris had on the Chancellor’s decision to sustain the police budget in cash terms and increase it overall by the end of the parliament.  Higher projected tax revenues gave the Chancellor a surprising degree of fiscal flexibility, but the atrocities in Paris certainly pushed questions of policing and security to the top of the political agenda. For a police service expecting anything from a 20 to a 30 per cent cut in funding, fears reinforced by the apparent hard line the Chancellor took over the weekend, this reprieve is an almighty relief.  

So, what was announced?  The overall police budget will be protected in real terms (£900 million more in cash terms) up to 2019/20 with the following important caveats.  First, central government grant to forces will be reduced in cash terms by 2019/20, but forces will be able to bid into a new transformation fund designed to finance moves such as greater collaboration between forces.  In other words there is a cash frozen budget (given important assumptions about council tax) eaten away by inflation and therefore requiring further efficiencies and service redesign.

Second, the flat cash budget for forces assumes increases in the police element of the council tax. Here, there is an interesting new flexibility for Police and Crime Commissioners.  One interpretation is that instead of precept increases being capped at 2%, they will be capped at £12 million, although we need further detail to be certain.  This may mean that forces which currently raise relatively small cash amounts from their precept will be able to raise considerably more if Police and Crime Commissioners have the courage to put up taxes.  

With those caveats, however, this is clearly a much better deal for policing than most commentators (myself included) predicted.  There will be less pressure to reduce officer numbers. Neighbourhood policing, previously under real threat, is likely to remain an important component of the policing model in England and Wales.  This is good news.

However, the police service should not use this financial reprieve as an excuse to duck important reforms.  The reforms that the police have already planned should continue, with any savings reinvested in an improved and more effective service.

It would be a retrograde step for candidates in the 2016 PCC elections to start pledging (as I am certain many will) to ‘protect officer numbers’.  We still need to rebalance the police workforce.   We need more staff with the kind of digital skills required to tackle cybercrime.  We need more crime analysts to help deploy police resources more effectively.  Blanket commitments to maintain officer numbers will get in the way of important reforms.

The argument for inter-force collaboration and, indeed, force mergers does not go away. The new top sliced transformation fund is designed in part to facilitate collaboration, but the fact remains that a 43 force structure no longer makes sense in operational or financial terms.

The police still have to adapt to a changing world. Falling levels of traditional crime and the explosion in online crime, particularly fraud and hacking, means we need an entirely different kind of police service.  Many of the pressures the police experience from non-crime demand will not go away. Big cuts to local government funding and the wider criminal justice system mean we need to reorganise the public service frontline to deal with problems such as high reoffending rates, child safeguarding and rising levels of mental illness.

Before yesterday I thought policing faced an existential moment and I stand by that. While the service has now secured significant financial breathing space, it still needs to adapt to an increasingly complex world. 

Rick Muir is director of the Police Foundation