Will the Lib Dems halt Hunt's backdoor NHS privatisation?

Health secretary promises to address "concerns" over Section 75 of the NHS bill after pressure from Lib Dems and Labour.

When the government's Health and Social Care Bill was finally passed by Parliament last year it was on the condition that GPs would not be forced to open up NHS services to private competition.

Andrew Lansley, the-then Health Secretary, told the Commons: "There is absolutely nothing in the Bill that promotes or permits the transfer of NHS activities to the private sector". In a letter to Clinical Commissioning Groups, he wrote:

I know many of you have read that you will be forced to fragment services, or put them out to tender. This is absolutely not the case. 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. 

Having accepted Lansley's assurances, the Lib Dems granted the bill their support. But new regulations published under Section 75 of the act flatly contradict the government's promises. The guidelines state that commissioners may only award a contract without competition if they are "satisfied that the services to which the contract relates are capable of being provided only by that provider". In practice, then, GPs will be forced to open up all NHS services to private companies, regardless of the wishes of local people, with the healthcare regulator Monitor granted the power to block any "unnecessary" restriction of competition. 

Secondary legislation like this is normally nodded through parliament without debate but Labour, smelling a rat, warned that the regulations amounted to an attempt at backdoor privatisation. Jeremy Hunt, Lansley's replacment as health secretary, initially sought to dismiss the opposition's concerns. In response to a question from Jamie Reed, the shadow health minister, he declared: "Who exactly are the section-75 bogeymen [he] hates: Whizz-Kidz, who are supplying services to disabled children in Tower Hamlets? Or Mind, which is supplying psychological therapy to people in Middlesbrough?"

But after the Lib Dems joined Labour in raising concerns, Hunt has been forced to think again. Norman Lamb, the Lib Dem health minister, told his party colleague Andrew George, one of those opposed to the regulations, "We are looking at this extremely seriously. Clear assurances were given in the other place during the passage of the legislation, and it is important that they are complied with in the regulations."

In reponse, as today's Guardian reports, Hunt has made it clear that he is prepared to rewrite the new guidelines. A source tells the paper: "We are aware that there are concerns over the wording and the way it may be interpreted. We are speaking to the Lib Dem peers to make sure they are happy. We want to make sure everyone is happy."

The shadow health secretary, Andy Burnham, said in response: "The government has been caught out trying to force through privatisation of the NHS by the back door.

"This is another humiliating U-turn to add to the government list, but we believe ministers will stop at nothing to drive through their plans to put the NHS up for sale to the highest bidder."

But will this be anything other than a comestic rewrite? Ahead of the Lib Dems' spring conference next month, this is a key test of the party's nerve. 

Health Secretary Jeremy Hunt speaks at the Conservative conference in Manchester last year. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

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How Tony Blair's disingenuous line on Iraq eroded our faith in politicians

Not the Chilcot Report by Peter Oborne reveals how Blair exagerrated evidence from the intelligence services to parliament – and the public.

In this incisive book, Peter Oborne calls the invasion of Iraq “the defining calamity of the post-Cold War era” and I am inclined to agree. Not long after the March 2003 attack, I interviewed Adnan Pachachi, a former foreign minister and UN ambassador for Iraq. He told me that he had visited President George W Bush in Washington a few weeks before the invasion and begged him not to go ahead with it. The overthrow of Saddam Hussein would, Pachachi warned, lead inevitably to civil war between Iraq’s two main religious groupings, the Sunnis and the Shias. Bush was shocked. According to Pachachi, he had no idea that any such division among Muslims existed.

Granted, Bush was an ignoramus – but you would have thought that someone might have explained this crucial fact to him. Pachachi turned out to be right. Iraq has fallen into a disastrous religious civil war as a direct result of the invasion and Isis, a more extreme force even than al-Qaeda, has come to the fore. Nearly 5,000 coalition soldiers died; many hundreds of thousands of Iraqi civilians, perhaps a million, have lost their lives; and the man who led the whole terrible business didn’t know that the danger even existed.

Pachachi, like many politicians across the Middle East, found this puzzling. The US had never understood the Middle East, he said, but the British did; so why hadn’t Tony Blair warned the Americans what was going to happen? We know the answer to that: although Blair was far cleverer than Bush and had better advisers, his approach was always a subservient one. Like the entire British establishment, he believed that Britain’s influence in the world depended on sticking close to the US and he was prepared to be led around on a leash because he knew that this was the only relationship Bush’s people understood or wanted from him.

To “stand shoulder to shoulder” with Bush – at least, to stand closer behind him, head bowed, than any other national leader – Blair had to persuade the British people that Saddam posed a threat to them. Oborne, in fine forensic form, demolishes (his word) the notion that Blair was simply repeating what the intelligence services had told him about Saddam’s weapons and capability; he shows that Blair exaggerated and misrepresented the intelligence he was given.

Lord Butler, the former cabinet secretary who had investigated the government’s pre-invasion use of intelligence, said the same thing in a speech in the House of Lords in 2007. He described Blair’s approach as “disingenuous”: mandarin-speak for dishonest. Oborne quotes Butler at length:

 

The United Kingdom intelligence community told him [Blair] on 23 August 2002 that, “We . . . know little about Iraq’s chemical and biological weapons work since late 1988.” The prime minister did not tell us that. Indeed, he told parliament only just over a month later that the picture painted by our intelligence services was “extensive, detailed and authoritative”.

 

Oborne’s central point is that this dishonesty has done serious damage to the fundamental trust that the British people used to have in their rulers. There are all sorts of reasons why people have lost faith in politicians but it was the charismatic Blair – along with his head of communications, Alastair Campbell – who let us down the most.

Campbell is a former journalist who, even when he was the political editor of the Daily Mirror, seemed far more concerned with pushing a party line than with trying to report things truthfully. In May 2003, the BBC journalist Andrew Gilligan accused him of “sexing up” the dossier on Saddam’s weapons of mass destruction. Campbell was irate. In July, Dr David Kelly, the Ministry of Defence weapons expert who had briefed Gilligan, committed suicide. If, indeed, it was suicide – once you start losing faith in the ­official version of things, there is no end to it. And that is Oborne’s point.

Kelly’s death was followed by the scandalous Hutton inquiry, which managed to deflect attention from the questionable nature of the dossier to the way in which Gilligan had reported on it. However, although Kelly wasn’t a sufficiently senior source for Gilligan to base his report on, there is no doubt that Gilligan was essentially right: the intelligence dossier had been grossly hyped up. Campbell’s frenzied efforts to protect himself and Blair did huge damage to the BBC, the judiciary, the intelligence and security agencies and public trust in government.

Oborne’s excellent book is clear-headed and furious in its condemnation of Blair. But what about the Chilcot report, when it appears on 6 July? The ludicrous delay in publishing it has given people the expectation that it, too, will be a whitewash. Yet we are starting to get leaks that it won’t be – that it will be just as savage as Oborne would like. That is the only way we can start to drain the poison that has built up in our national life since Blair took the calamitous decision to follow the US into invading a country that its president knew zip about.

John Simpson (@JohnSimpsonNews) is the world affairs editor of the BBC

Not the Chilcot Report by Peter Oborne is published by Head of Zeus (208pp, £10)

John Simpson is World Affairs Editor of BBC News, having worked for the corporation since the beginning of his career in 1970. He has reported from more than 120 countries, including 30 war zones, and interviewed many world leaders.

This article first appeared in the 26 May 2016 issue of the New Statesman, The Brexit odd squad