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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The 8 bits of good news about integration buried in the Casey Review

It's not all Trojan Horses.

The government-commissioned Casey Review on integration tackles serious subjects, from honour crimes to discrimination and hate crime.

It outlines how deprivation, discrimination, segregated schools and unenlightened traditions can drag certain British-Pakistani and Bangladeshi communities into isolation. 

It shines a light on nepotistic local politics, which only entrench religious and gender segregation. It also charts the hurdles faced by ethnic minorities from school, to university and the workplace. There is no doubt it makes uncomfortable reading. 

But at a time when the negative consequences of immigration are dominating headlines, it’s easy to miss some of the more optimistic trends the Casey Report uncovered:

1. You can always have more friends

For all the talk of segregation, 82 per cent of us socialise at least once a month with people from a different ethnic and religious background, according to the Citizenship Survey 2010-11.

More than half of first generation migrants had friends of a different ethnicity. As for their children, nearly three quarters were friends with people from other ethnic backgrounds. Younger people with higher levels of education and better wages are most likely to have close inter-ethnic friendships. 

Brits from Black African and Mixed ethnic backgrounds are the most sociable it seems, as they are most likely to have friends from outside their neighbourhood. White British and Irish ethnic groups, on the other hand, are least likely to have ethnically-mixed social networks. 

Moving away from home seemed to be a key factor in diversifying your friendship group –18 to 34s were the most ethnically integrated age group. 

2. Integrated schools help

The Casey Review tells the story of how schools can distort a community’s view of the world, such as the mostly Asian high school where pupils thought 90 per cent of Brits were Asian (the actual figure is 7 per cent), and the Trojan Horse affair, where hardline Muslims were accused of dominating the curriculum of a state school (the exact facts have never come to light). 

But on the other hand, schools that are integrated, can change a whole community’s perspective. A study in Oldham found that when two schools were merged to create a more balanced pupil population between White Brits and British Asians, the level of anxiety both groups felt diminished. 

3. And kids are doing better at school

The Casey Report notes: “In recent years there has been a general improvement in educational attainment in schools, with a narrowing in the gap between White pupils and pupils from Pakistani, Bangladeshi and African/Caribbean/Black ethnic backgrounds.”

A number of ethnic minority groups, including pupils of Chinese, Indian, Irish and Bangladeshi ethnicity, outperformed White British pupils (but not White Gypsy and Roma pupils, who had the lowest attainment levels of all). 

4. Most people feel part of a community

Despite the talk of a divided society, in 2015-16, 89 per cent of people thought their community was cohesive, according to the Community Life Survey, and agreed their local area is a place where people from different backgrounds get on well together. This feeling of cohesiveness is actually higher than in 2003, at the height of New Labour multiculturalism, when the figure stood at 80 per cent. 

5. Muslims are sticklers for the law

Much of the Casey Report dealt with the divisions between British Muslims and other communities, on matters of culture, religious extremism and equality. It also looked at the Islamophobia and discrimination Muslims face in the UK. 

However, while the cultural and ideological clashes may be real, a ComRes/BBC poll in 2015 found that 95 per cent of British Muslims felt loyal to Britain and 93 per cent believed Muslims in Britain should always obey British laws. 

6. Employment prospects are improving

The Casey Review rightly notes the discrimination faced by jobseekers, such as study which found CVs with white-sounding names had a better rate of reply. Brits from Black, Pakistani or Bangladeshi backgrounds are more likely to be unemployed than Whites. 

However, the employment gap between ethnic minorities and White Brits has narrowed over the last decade, from 15.6 per cent in 2004 to 12.8 per cent in 2015. 

In October 2015, public and private sector employers responsible for employing 1.8m people signed a pledge to operate recruitment on a “name blind” basis. 

7. Pretty much everyone understand this

According to the 2011 census, 91.6 per cent of adults in England and Wales had English as their main language. And 98.2 per cent of them could speak English. 

Since 2008-2009, most non-European migrants coming to the UK have to meet English requirements as part of the immigration process. 

8. Oh, and there’s a British Muslim Mayor ready to tackle integration head on

The Casey Review criticised British Asian community leaders in northern towns for preventing proper discussion of equality and in some cases preventing women from launching rival bids for a council seat.

But it also quoted Sadiq Khan, the Mayor of London, and a British Muslim. Khan criticised religious families that force children to adopt a certain lifestyle, and he concluded:

"There is no other city in the world where I would want to raise my daughters than London.

"They have rights, they have protection, the right to wear what they like, think what they like, to meet who they like, to study what they like, more than they would in any other country.”

 

Julia Rampen is the editor of The Staggers, The New Statesman's online rolling politics blog. She was previously deputy editor at Mirror Money Online and has worked as a financial journalist for several trade magazines.